生产前后准备细则

VWang · 发表于 2012-2-9 10:05

各位姐妹，一直得到大家无私的帮助，今天在网上看生产前后的准备的文章，感觉这篇文章很有用，就拿来跟大家分享，也算是对大家一直以来热心热情帮助的一点点回报。希望能帮到那些有需要的JM。不好意思，我直接把英文贴出来了，如果需要翻译成中文，请告诉我，我会抽时间去翻译，或者英语好的姐妹们每人一段的翻译，可能更快更好。

While you can't predict everything that will arise during labor and delivery, a birthing plan, or birth preferences list, can help you think through your many options. Having pre-selected birth preferences to discuss with your health care provider allows you to make thoughtful decisions about many birth-related topics, including the hospital environment, your involvement during labor and birth, medical options, and the immediate care of your newborn.

Before deciding on your preferences, do some homework to learn about the different options available and about what the health care providers and hospitals in your area offer. For example, if the majority of doctors in the practice you've chosen perform episiotomies as a routine procedure, you may want to choose a different doctor if you wish to avoid an episiotomy. Don't be afraid to ask questions of your doctor or hospital—they want you to have the best experience possible!

Review and select the choices below to create your personal Birth Preference Letter (click here for a printable version). When finished, use this letter to talk about your preferences with your health care provider at your next visit. It's also a good idea to make a list of questions and bring them with you to your doctor visits.

A BIRTH PREFERENCE LETTER

Name:
Current Date:
Doctor and/or Midwife:
Pediatrician:
Other Attendees (examples: Doula, Coach):
Birth Center or Hospital:
Due Date:

Last Days Before Birth
If I go past my estimated due date, but the baby and I both are considered fine by my    doctor, I would like to wait until labor begins naturally rather than be induced.
If my baby is overdue, I would like to discuss alternatives to induction.

Personal Requests for Labor
I would prefer to avoid an enema and/or shaving of pubic hair (Note: these are no longer    standard procedures at many hospitals).
I prefer that my partner remain with me at all times during labor and birth, unless a    medical emergency dictates otherwise.
I would like to be able to walk around during labor.
I would like to be able to change positions and move around to get more comfortable    during labor.
I wish to try a birthing ball to help my labor progress and decrease discomfort.
I would like the following in my room during labor:
dimmed lights
music that I provide
voices lowered and as quiet as possible
other: _______________
I wish to wear my own freshly laundered nightgown during labor and birth.
I would like to wear my contact lenses (or glasses) at all times, while medically    appropriate.
I would like my partner/coach/other to be able to film or photograph the labor and/or birth.
If hospital rules prohibit food, I would like access to clear fluids, such as water, ice chips, a    Popsicle, Gatorade, other.
Other: _______________

Monitoring
I wish to discuss options of continuous fetal monitoring, including internal vs. external    monitors, intermittent monitoring, and telemetry.
I would like to keep internal vaginal exams to a minimum.
If the hospital is a teaching hospital, I am not comfortable having students observe or    participate in my labor/birth.

Labor Induction
I do not wish to have the amniotic membrane ruptured artificially unless the baby requires    internal monitoring or other assessments.
If my labor is not progressing as it should, before Pitocin is given, I would like to have the    amniotic membranes ruptured and try other methods to stimulate labor (such as walking,    birthing ball, nipple stimulation).
Other: _______________

Pain Management
I'd like to have a drug-free birth if possible. Please offer pain medications only upon my    request.
I'd like to try alternatives to pain medications to relieve pain, such as:
massage
relaxation and/or breathing techniques
shower or bath
position changes (rocking chair, slow dancing, hands and knees, squatting, etc.)
birthing ball
hot/cold therapy
aromatherapy
other: _______________
I would like an epidural for my labor. Please let me know when I can request one.
I would like to be given a low dose or walking epidural if available, so I can move and use    different positions for comfort during labor.
Other: _______________

Cesarean
Given ideal conditions, I would like to try to avoid having a Cesarean.
If a Cesarean delivery is recommended, I would like to be included in the decision-making    process.
It is important that my partner remain with me at all times during the birth.
I wish to have an epidural for my Cesarean anesthesia so I can be awake at the time of    my baby's birth.
I would like to discuss my anesthesia options before the Cesarean is done.
Please discuss the surgical procedure with me before beginning my Cesarean birth.
If possible, please give the baby to my partner to hold as soon as possible after birth.

Vaginal Delivery
I would appreciate encouragement and guidance on how to push most effectively, so the    perineum can stretch gradually.
I would like to be able to respond to my own natural urge to push, rather than to have to    push forcefully if there is no urge.
I wish to try multiple positions (such as squatting, side-lying, standing, sitting) for pushing    in second stage labor, and be upright for giving birth.
I would like a mirror available so I can see the baby's head as it crowns and is born.
I would prefer not to have an episiotomy unless the baby's safety is at risk.
I would prefer an episiotomy rather than having the perineum tear.
Other: _______________

After Birth
I would like to have my partner cut the umbilical cord.
I would like to have _____ cut the cord.
I would prefer that the cord stop pulsating before it is cut.
I would like to hold the baby, if all is well, immediately after birth.
I would love for the medical evaluation of the baby to be done either while I am holding    him/her or in the isolette right next to me.
If the baby requires other medical treatment, I would like my partner to accompany    him/her at all times.
I prefer to hold the baby as much as possible, instead of using heat lamps.
I would like to delay the eye medication and other injections for the baby until a couple of    hours after birth.
I would like to discuss any medical procedures before they administered to my baby.
I would like to see the placenta, if possible.
I have made arrangements to bank the umbilical cord blood.
I would like to donate the umbilical cord blood, if possible.

Newborn Care
I would like my baby to be gently bathed and washed according to hospital procedures at    my bedside.
I have other wishes about washing my baby: _______________
Unless medically necessary, I do not wish to be separated from my baby at any time.
I would like the baby to room in and be with me at all times.
I would like the baby to room in with me, after I have had some recovery time.
I would like the baby to be with me during the day and stay in the nursery at night.
I would like the baby to be with me during the day and stay in the nursery at night, but    brought to me for nursing.
I would like my pediatrician's exam of my baby to be done at my bedside.
Other: _______________

Feeding
My feeding preference is:
exclusive breastfeeding—please do not offer my baby any bottles and/or pacifiers.
exclusive formula feeding—please discuss formula options with me.
I am undecided. I would like to discuss all of my options.
I would like a consultation with a lactation assistant to aid me in breastfeeding.
Other: _______________

Circumcision
I do not want to have the baby circumcised.
I am having my baby circumcised, but not at the place of birth.
I would like to have my baby circumcised before we leave the hospital.
Other: _______________

Postpartum Care
I would like the nurses to explain all care procedures to me.
I would like my partner and other designated family members to be with me as much as I    desire.
I would like my other child/children to be able to visit while I'm in the hospital.
Other: _______________

Other
Other comments or wishes: ________________________

Definitions of terms included in the Birth Preference Letter

Midwife—Certified nurse-midwives (CNMs) are licensed health care practitioners. They provide primary health care to women, including gynecological exams, preconception care, prenatal care, labor and delivery care, care after birth, newborn care, assistance with family planning decisions, menopausal management, and counseling in health maintenance and disease prevention.

Doula—a certified birth assistant, either a nurse or lay woman, who assists a mother with her physical and emotional needs during labor, birth, and sometimes home care after the birth of the baby.

Induction—the process of initiating or enhancing labor through the use of a drug called Pitocin; may also include artificial rupture of the membranes.

Birthing Ball—a large, plastic, air-filled ball used to promote comfort, decrease pain, and facilitate maternal movement during labor. Rocking while sitting on the ball helps the baby move through the birth canal; leaning over the ball while on hands and knees in the bed helps keep the baby in good position and relieves backache.

Continuous Fetal Monitoring—an electronic recording of the baby's heart rate and the mother's uterine contractions throughout labor and birth. The fetal monitor is attached to the mother either externally with the use of two belts around her belly or internally with two electrodes inserted through the vagina to attach to the baby's head to measure his heart rate and to the uterus to measure the contractions.

Internal Vaginal Exams—an examination done by the nurse, nurse midwife, or physician to assess progress during labor. The examiner inserts two fingers into the vagina to feel the cervix to determine its degree of opening (dilatation, measured from 0 to 10 centimeters) and thinning (effacement, measured from 0 percent to 100 percent). The internal vaginal exam also assesses how far the baby has moved down through the mother's pelvis.

Amniotic Membrane—the balloon-like sac that develops around the baby early in pregnancy. It's composed of two layers, the amnion and corion. The sac contains the amniotic fluid, which keeps the baby warm and buoyant throughout the pregnancy.

Pitocin—a synthetic drug used to stimulate uterine contractions during labor. Administered by an IV drip into the mother's vein, it is used to start (induce) a labor or stimulate (augment) existing contractions that are not strong enough for the labor to progress.

Epidural—a regional anesthetic given in active first-stage labor by injection of an anesthetic drug through an indwelling plastic catheter into the area outside the spinal column called the epidural space. An epidural provides pain relief for the contractions of labor and for birth; it also blocks motor function of the mother's legs, so she must remain in bed after it is administered.

Walking Epidural—a term used to describe a very low dose epidural with anesthetic drugs that do not block motor function, so the mother has movement of her legs. Walking is actually not encouraged, but the mother can use more positions during labor and may be able to sit in a rocking chair or use a birthing ball.

Cesarean—the surgical delivery of the baby, when needed for maternal or fetal complications or emergencies, through an abdominal and uterine incision.

Perineum—the muscles and tissues of the woman's external genitalia located between the clitoris and rectum. This area includes the labia minora (the inner lips), the urethra (the opening from the bladder), and the vagina.

Episiotomy—a surgical incision made at the time of birth to enlarge the vaginal opening to allow for easier delivery of the baby.

Placenta—the organ that develops in the uterus early in pregnancy to exchange oxygen and nutrients from mother to baby. The placenta implants into the wall of the uterus and is attached to the baby by the umbilical cord.

Umbilical Cord Blood—the blood in the baby's umbilical cord at the time of birth. It can be "banked" or saved for use in the future by the baby's family or donated to others. The cord blood is rich in stem cells that can be valuable in the treatment of diseases that respond to regeneration of cells (such as leukemia, Alzheimer's, diabetes, etc.). Parents must arrange in advance with a cord blood banking company; the initial cost is about $1,750 with an annual fee to store the cord blood.

Lactation Assistant—a consultant used by the hospital to coach nursing moms on the art of breastfeeding. This consultant will show mothers the best positions, ways to get the baby latched on properly, and help solve other nursing issues.

悠然我心 · 发表于 2012-2-9 11:45

谢谢，文章内容很详细，但是有点小罗嗦。这里的医生和护士都很忙，如果真有人拿这么一个list去一个一个问他们的话，恐怕他们的脾气不会太好了。况且产检时候的医生经常不是生产时候的医生，有些问题提前提醒了也没用。

悠然我心 · 发表于 2012-2-9 11:48

帮你找了其中重要的部分，给翻译了
1．过预产期后的生产选择
（选项a）预产期过了，但是医生说孩子情况还挺好，我愿意等几天直到自然生产If I go past my estimated due date, but the baby and I both are considered fine by my doctor, I would like to wait until labor begins naturally rather than be induced.
（选项b）如果预产期过了，我愿意马上开始跟医生讨论催产的手段If my baby is overdue, I would like to discuss alternatives to induction.

2．问一下医生，生产时能带隐性眼镜吗？（我个人很怀疑这句话，国内不是都不允许带吗？）I would like to wear my contact lenses (or glasses) at all times, while medically appropriate.)

3．生产时麻醉剂的使用
（选项a）从来不用
（选项b）我不排斥用epidural，请给我用epidural 当我要求时（千万要早一点申请如果想用的话，我就等麻醉师等到花儿也谢了）I would like an epidural for my labor. Please let me know when I can request one

4．我想有人教我怎么push, (很重要，但是现学恐怕来不及，最好由劳工提前学好，到时候指导你)
I want encouragement and guidance on how to push most effectively

5．婴儿头有点小大时，是选择侧切还是自然撕裂？
（选项a）不要侧切，除非婴儿出现状况I would prefer not to have an episiotomy unless the baby's safety is at risk
（选项b）宁愿侧切，也不愿意自然撕裂I would prefer an episiotomy rather than having the perineum tear.

6．脐带血的保存
（选项a）我已经事先联系好脐带血银行了
I have made arrangements to bank the umbilical cord blood.
（选项b）如果可能，我愿意捐献脐带血
I would like to donate the umbilical cord blood, if possible.

7．孩子生出来后，是完全由自己和家人照顾，还是有部分时间最好送到护士那里代为托管
（选项a）除非必须分开，我愿意24小时照顾孩子
Unless medically necessary, I do not wish to be separated from my baby at any time.
（选项b）赶快抱走，老娘要睡一会

8．喂养手段Feeding
（选项a）我希望完全母乳喂养，不要给孩子任何奶粉和安慰奶嘴
exclusive breastfeeding—please do not offer my baby any bottles and/or pacifiers.
（选项b）我希望完全配方奶，请及时和我讨论奶粉的选择
exclusive formula feeding—please discuss formula options with me.
（选项c）我还没有决定，请告诉我所有选择的利弊
I am undecided. I would like to discuss all of my options.
（选项d）我很菜，快帮我找一个母乳喂养培训师来教我
I would like a consultation with a lactation assistant to aid me in breastfeeding.

9．男孩割包皮
（选项a）不割I do not want to have the baby circumcised.
（选项b）要割，但不是现在割
I am having my baby circumcised, but not at the place of birth.
（选项c）在孩子离开医院之前，最好帮我把他的包皮割了
I would like to have my baby circumcised before we leave the hospital.

qualityshop · 发表于 2012-2-10 13:13

，学习了

永安里 · 发表于 2012-2-10 18:49

隐性眼镜：NO
Glasses: OK

私人脐带血：Talk to your own doctor see if s/he is willing to collect for you.
捐献：不是每个婴儿的脐带血都要的。很严格的要求。。。

7: 选项b......除非你有产后并发症，否则都要你自己照顾，或者LG照顾。。。。。

永安里 · 发表于 2012-2-11 06:50

pitocin: 这里叫oxytocin,or synto
walking epidural: 这边的产科好像不用这玩艺。一旦上了Epi,就只能床上呆着，插Foley
另外：
internal lead: 内置的胎心检测，在baby脑袋上放根天线。更加准确。妈妈可以少量活动。

nina2008nina · 发表于 2012-2-12 00:12

谢谢分享～

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