A Birth Plan...

I have never imagined I would be sitting in a room at the NICU (Neonatal Intensive Care Unit), in the presence of a doctor, a palliative care doctor, an RN and a social worker designing a birth plan for my dying unborn baby. At around ten minutes into the conversation I zoned out. I started
having my own thoughts... "Is this real?? Is this really happening??" It all seemed like a dream and I was hoping in a second or two I was going to snap out of it.. It would all be ok.
It never happened that way. I was once again brought back into the conversation with a room full of very caring people who were kindly making every effort to ease my pain. We discussed many things and the most important of all of them was coming up with a "Birth Plan". In a situation like ours, where there is no hope of survival for the baby, a team of doctors and social worker help us to create a birthing plan in which mother and baby's best interests come into play... We have designed a Birth Plan for baby Harlow, in hopes to provide her a dignified, loving and caring birth and death...

Harlow’s Birth Plan

Essential Information:

Infant’s Name: Harlow Maia Cofran

Parent’s Names: Isabela G Maia and Heath M Cofran

OB Provider: HROB Clinic

"As many know, baby Harlow has been diagnosed with bilateral renal agenesis (also known as Potter’s Syndrome), and is not expected to live very long beyond birth. We may have only seconds or minutes with her alive, but we may also be blessed with hours. Whatever we are given, we mean to make the most of it, and we ask for your help and support in accomplishing that.

Some of the things that we think will help us through this difficult time are listed below. We know that circumstances beyond everyone’s control may prevent or change some of these things, but we thought it would help all of us to have this down on paper, to refer to, in time of indecision or great stress.

This is our wish list:

1. We hope to have a vaginal birth, aided by pain relief. Mom Isabela wishes to be alert during and after delivery, to the extent medically possible but would much like an epidural when the time is right.

2. Isabela wishes to hold Harlow until the time of her death.

3. We would like for Harlow to be monitored throughout the labor and delivery and to be immediately informed if she is experiencing distress.

4. If Harlow is born alive and conscious, and is interested, Isabela would like to breastfeed her.

5. We would like for mechanical assistance to be used only temporarily to initiate Harlow’s breathing, if necessary, immediately after birth. We do not want any extraordinary measures taken to maintain breathing or to initiate a heartbeat. We are prepared to let baby Harlow go when her time comes, even if it is at the moment of her birth. Please do not admit Harlow to NICU. Also, Please Do Not Resuscitate Harlow; Allow for Natural Death.

6. Since we have been diagnosed with a genetic disorder, it is important that cord blood be drawn to be sent out for genetic testing. Any other tests can be done as long as it is focused on studies of Potter’s Syndrome in the future for us or others. Chromosomal Labs are to be completed for genetic testing.

7. Isabela would like a hospital Chaplain present for prayer and spiritual support.

8. We have brought clothing for Harlow that we would like to dress her in, when the time is right. We have a green owl SwaddleMe Blanket (her mom loves owls and used to call her “little owl” all through the pregnancy), a green/brown blanket and a yellow hair bow.

9. To help us celebrate and remember this special time with our daughter, we have thought about mementos and other things that we would like to do. Here is a list of those things; if there are others that you think we might want, we would be grateful for those suggestions.

a. Photographs taken via Now I Lay Me Down to Sleep.
b. Hand and foot prints
c. Lock of hair
d. Hospital bracelets

10. Once Harlow has passed on may we need your help with notifying the funeral home about making decisions about next step-we have chosen Cremation. If there is a recommendation that there is a specific need for an autopsy, we will consider it at that time.

This is a very difficult time for all of us – including you, as you work to support us and care for us throughout this part of our journey. We truly appreciate your help and support, and ask that you understand if we seem indecisive or even angry at times. We also appreciate and find great comfort in your expressions of grief, be it through tears or even through humor, so please do not hesitate to cry or be sad in front of us, if that is how you feel.

We have tried our best to prepare for this short time with our beloved baby Harlow, and we want to be able to spend as much time with her as possible. Thank you so much for helping us and supporting us through this celebration of our daughter’s short but precious and meaningful life. Harlow is our angel and we want her time here on earth to be significant and dignified as she leaves us to head home- Heaven."