The Birth Plan

This has not been an easy thing to do and after working on it for a month it is finished and I will take it to both Doctor's offices tomorrow.
Birth Plan for Mackinley Ann Koyle

“Every child no matter how fragile their life or brief their days changes the world.”

We have known since the end of October that our daughter Mackinley has Trisomy 18, a chromosome abnormality. With this knowledge we are fully aware of the severity of this condition. And with this knowledge we know that she will more then likely not survive very long after birth. We have chosen to write this birth plan to help all of those that are involved with Mackinley’s delivery to understand our wishes for her birth and our hospital stay. With the severity of her complications we desire that she only receive comfort care with minimal intervention after her birth. Because we know that our time with Mackinley will be very brief it is our desire for her to be surrounded by her family in a loving and caring environment. With this knowledge our main goals are:
1) That this birth plan be followed as closely possible allowing Mackinley to have the best chance to be born alive.
2) Mackinley’s life and passing be as peaceful as possible.
We truly appreciate all of your help and support. Please do not hesitate to cry, or be sad in front of us if that is how you feel. This is a part of life we will walk together and we appreciate all that you will do for our family.

Desires for Kassey’s Care during Labor and Delivery
1) We would like all staff to be fully informed and aware of our situation.
2) Any and all procedures not outlined in this birth plan should be approved in advance by Jared or Kassey
3) We desire to have continual fetal monitoring at all times
4) We have discussed having a cesarean section and determine it to be unnecessary in this situation.
5) Kassey requests for pain to only have an epidural upon request. It is her desire to not be given any other form of pain medication before or after deliver that would impede her memories of the time that we will have with Mackinley.
6) It is very important that NOBODY enter the room without knowing the situation.
7) If possible it is Kassey’s desire to breastfeed Mackinley

Our Desires for Mackinley’s Birth and Any Time We Might Have With Her
In the Instance of a Live Birth
1) If Mackinley is born breathing on her own we desire for her to be handed immediately to Jared or Kassey. If necessary please perform standard suctioning rubbing and vigorous drying. The use of a 0-2 bag is acceptable we do not want any extraordinary measures. And do not want her transferred to a hospital with a NICU.
2) It is Jared’s desire to cut the cord
3) Certain procedures (weighing, eye ointment, etc...) are to be delayed until both parents have held her, and if possible these procedures should be done while being held by her parents.
4) We desire no warming tables, incubators, etc. be used instead we would prefer the use of skin contact and warm blankets providing us the most time possible with Mackinley
5) We ask that no procedures be done without one of the parents present.
6) We would like to room in with Mackinley and request that any and all procedures be done in our presents. And ask that Jared accompany her if any procedures must be done elsewhere.
7) We desire for Jared or Kassey to be holding her at all times possible
8) We would like to give Mackinley her first bath, and dress her in clothes we will provide, and have as much hands on contact as possible.
9) An NG tube may be used if necessary (placed and maintained while in our room if at all possible.
10) If Mackinley stabilizes we would like to take her home as soon as possible on comfort care and with the help of hospice.
11) If Mackinley’s condition begins to deteriorate we wish to be the ones holding her at her time of death.
12) If she experiences apneic episodes we do not desire to for her to be stimulated we will just hold her and love her during those moments.

Visitors
1) If possible we desire a place for our children and close family to be waiting so that they will be there for whatever time we may have with Mackinley
2) It is our desire that our children: Avery, Tucker, and Jordyn be brought in first to meet and hold Mackinley. Please have a member of the nursing staff bring in our children, and no one else. We will ask for the others when we are ready.
3) Please check with us before allowing in any visitors.
4) Please do not make visiting hours an issue. We desire our family to be able to spend as much time as they would like with Mackinley. We ask they be allowed in at any time we have family that might be traveling to see her and don’t want anyone to have any Avoidable regrets or missed opportunities.

If Mackinley is Stillborn
1) If Mackinley’s heart is not beating at birth we do not want any attempts at CPR. Or any other form of life sustaining measures. We are fully aware of her complications and are prepared to let her go whenever that time may be.
2) If Mackinley is stillborn we desire for her to stay with us for as long as we feel necessary. We ask that you give us privacy to grieve, without abandoning us.
3) It will still be our desire to bathe and dress her when we feel ready
4) We do not desire to have a chaplain (if you have one) as a member of our clergy will be coming.

Lasting Memories
1) To help us celebrate and remember these special times with Mackinley we would greatly appreciate it if you would help us by saving any keepsakes or other mementos: crib cards, hats, blankets, locks of hair, hand and foot prints (we have scrapbook pages done up for these), bracelets, cord clamp, molds of hands a feet (a friend will do those), bassinet card, and anything else you can think of.

Mackinley is a miracle and a blessing. She is very special to our family, and we are grateful to be able to have her in our life no matter how long or short her time may be. We feel she is a blessing to us and all she will come in contact with. We have tried our best to prepare ourselves as well as our children for this time in our lives. We desire to spend as much time as possible with her before she returns to her Heavenly Father. We understand this will be difficult for you as well, and we appreciate all of your help, support and care for our sweet baby girl. And hope that she will touch you life as she has touched ours.