Birth Plans

angelfire9

Only 5 weeks to go.. Yippee

I have decided to create a birth plan for this one as my labour for No. 1 was an absolute disaster and not an experience I want to repeat!

Couple of questions though:

Is it reasonable for me to request that my hubby stays with me for any routine examinations the doctors might want to perform?
Its not like he'd be seeing anything he hasn't seen before :rolleyes: and the last time I felt like he was being kicked out every 5 minutes so they could poke & prod at me but it being my first time I never asked and did what we were told!

Do Irish hospitals provide a "walking epidural" ??
I don't want to be in agony but neither do i want to be stuck on a bed

This is what I have so far: (please feel free to comment)

Due Date: 19/12/2010
Patient of / St. Munchin's Limerick

We are looking forward to sharing our birth experience with you. We have created this birth plan in order to outline some of our preferences for birth. We would appreciate you reviewing this plan, and would be happy to do so with you. We understand that there may be situations in which our choices may not be possible, but we hope that you will help us to move toward our goals as much as possible and to make this labor and birth a great experience. We do not want to replace the medical personnel, but instead want to be informed of any procedures in advance, and to be allowed the chance to give informed consent. Please feel free to ask if you have any questions or comments. Thank you!

Please Note
My bloodtype is Rh- (Rhesus Negative)

Labor
Please perform no routine prepatory tasks (shaving, enema, etc.), unless requested.
I expect that doctors and hospital staff will discuss all procedures with me before they are performed.
I would like to be free to walk, change positions and use the bathroom as needed or desired.
I prefer to wear my own clothes, rather than a hospital gown.
I prefer to eat and drink throughout labor, as desired.
I will remain hydrated by drinking moderate amounts of fluids (water, juice, ice chips).
Please do not administer an IV or heparin lock unless there is a clear medical indication that such is necessary.
Please limit the number of vaginal exams.
As long as Our baby is doing well, I prefer that fetal heart tones be monitored intermittently with an external monitor or doppler, even if the membranes have ruptured.
I would prefer if my husband could remain with me at all times (including routine exams)

Labor Augmentation/Induction
I would like to avoid induction unless it is medically necessary.
Please do not rupture my membranes artificially unless medically indicated.

Anesthesia/Pain Medication
I would like to have a light dose (walking) epidural.
I would like to have pethadine injection during early stages of labour

Cesarean Section Delivery
I feel very strongly that I would like to avoid a cesarean delivery
If a cesarean is necessary, I expect to be fully informed of all procedures and actively participate in decision-making.
I would prefer epidural anesthesia, if possible, in order to remain conscious through the delivery.

Perineal Care
I prefer not to have an episiotomy unless it is medically indicated.
I would rather have an episiotomy than risk a tear.
Please administer local anesthesia when repairing any episiotomy or tear(s).

Delivery
Even if I am fully dilated, and assuming Our baby is not in distress, I would like to wait until I feel the urge to push before beginning the pushing phase.

Immediately after the birth
I would prefer to have the baby cleaned before being given to me
I do not want to see the placenta
I have no problem with medication to speed up the placenta delivery

Newborn Care
If Our baby must go to the nursery for evaluation or medical treatment, My husband, or someone I designate, will accompany Our baby at all times.

Postpartum Care
I would prefer not to be catheterized until I've had some private time to attempt urination on my own.
Assuming I feel up to it and Our baby is healthy, I would like to be released from the hospital as soon as possible following the birth.

Breastfeeding
I plan to breastfeed and want to nurse immediately following the birth.

Source: http://pregnancyandbaby.sheknows.com/pregnancy/baby/Birth-plan-creator-241.htm

cynder

HI angelfire9

hope it goes according to plan,

All my 3 were different so i took whatever came my way. I didn't do any birth plans as I'm more of a spontaneous person, i don't like following routines either.

Just to point out sometimes they dont have a clue and something has happened before they know its going to, with my second guy he was 5 weeks early and was out in 5 pushes, they were not expecting him and a gave a might big push and he flew out also tearing me really, really bad, they did not know i was able to push that hard (neither did i but i was in fecking agony) and pushed, he was also badly bruised from the whole thing, it took them an hour to stitch me up.

also with your hubby staying in , does he want too? I know my fella willing left a few times (he was feeling faint).


Food, food was the last thing on my mind, also 2nd labours normally are quicker than your first, my first was 30 hours (at 26 hours i had the epidural) my 2nd was 7 hours had epidural but it didn't kick in in time, my 3rd was 5 hours epidural kicked in 5 mins before i started pushing. My 2nd and 3rd were night time labours and morning babies. Also a point if you have the epidural is that sometimes you dont feel the need to push and have to be told when to push (at each contraction)
.

My advice expect the unexpected. Im sure it wont be like your first time.

At least with the birth plan they know where you are coming from and should not put up too much resistance. My premature baby was born on the 16th of july at 10am we were both released on the 18th of july at 9am. I had a aunt who left the hospital just 6 hours after her son was born, with my 3rd guy i had him on the 29th of dec and left the hospital on the 1st of january as i wanted time to rest.

Best of luck, let us know when little one has arrived and the hospitals reaction and implementation of your birth plan.




Also you might like to add your feelings on a student midwife being present and examining you, will you or wont you allow it?

with 2 of mine i allowed a student midwife to examine me, and they were really nice. They did the breathing techniques with me as hubby didn't have a clue. I also knew a few that would not the the students anywhere near them.

What about the vitamin k injection for baby after birth, yes or no.

Cat Melodeon

It's completely reasonable for your husband to remain with you at all times. Very few delivery rooms are so small now that space is that restricted. Let them know at the start that you don't want him to leave at any point and they should be fine with that. I don't think my husband even left to go to the bathroom - it was a relatively short labour though!

As far as I'm aware, no Irish hospitals offer walking epidurals. Possibly the private clinics do, but I'm fairly certain none of the state-run hospitals have it. Have you considered gas and air, using a tens machine, alternative labouring positions, showers and massage before going directly to pethidine?

My birth plan was broadly similar to yours (except I wanted to avoid drugs beyond gas/air) - in the end I asked about an epidural but the midwife calmed me down and encouraged me to wait 15 mins, by which time I was ready to push. Once I got to that phase I didn't need pain relief - the build up to labour was much more painful than the delivery itself, which was sort of exhilarating in a weird way.

I also asked them not to examine me internally at all - the midwife had a quick look when I came to the ward and checked again when I asked for the epi, but nothing invasive. She was very supportive of letting me do it myself, I felt much more in control than I had anticipated.

The one thing they did insist on was keeping the monitor attached, which I didn't want as it meant I couldn't use the tens machine. I was induced though, so I think that was a factor in their insistence.

Like grindelwald, I had no interest in eating during the birth. I had one sip of water throughout. I was very ill when I took the first whiff of gas and air though, so my stomach took a while to settle after than.

Good luck with it all.

cynder

Cat Melodeon wrote: »

I was very ill when I took the first whiff of gas and air though, so my stomach took a while to settle after than.

Good luck with it all.

I was like that with my first, i felt as if i was drunk, but with my 2nd and 3rd i would not give it back, it was great for biting on, and really controlled my breathing.

Nevyn

Eating during 2/3 stage labour isn't really a good idea, strong contractions can make you throw up and if heavens for bid anything doesn't got to plan and you need an emergency general anaesthetic it can't be administered. You usually can have smoothies and fruit juices.

angelfire9

grindelwald wrote: »

Just to point out sometimes they dont have a clue and something has happened before they know its going to, with my second guy he was 5 weeks early and was out in 5 pushes, they were not expecting him and a gave a might big push and he flew out also tearing me really, really bad, they did not know i was able to push that hard (neither did i but i was in fecking agony) and pushed, he was also badly bruised from the whole thing, it took them an hour to stitch me up.

I had 9 stitches the last time (following an episitomy) and would rather avoid that this time round if possible

grindelwald wrote: »

also with your hubby staying in , does he want too? I know my fella willing left a few times (he was feeling faint).

He'll stay if he wants to stay married
I have tried to talk to him about it but I keep getting "whatever you want dear" in response

grindelwald wrote: »

Food, food was the last thing on my mind, also 2nd labours normally are quicker than your first, my first was 30 hours (at 26 hours i had the epidural) my 2nd was 7 hours had epidural but it didn't kick in in time, my 3rd was 5 hours epidural kicked in 5 mins before i started pushing. My 2nd and 3rd were night time labours and morning babies. Also a point if you have the epidural is that sometimes you dont feel the need to push and have to be told when to push (at each contraction)
.

Funnily I alternated between feeling sick (with the gas) and feeling STARVED the last time
I just want to have the option of having something with me to eat if I do feel like it

grindelwald wrote: »

My advice expect the unexpected. Im sure it wont be like your first time.

It certainly can't be any worse :rolleyes:

grindelwald wrote: »

Also you might like to add your feelings on a student midwife being present and examining you, will you or wont you allow it?
What about the vitamin k injection for baby after birth, yes or no.

I've no problem with student midwives (I actually found them far nicer than the qualified ones last time) as Munchin's is a teaching hospital I feel that they have to learn and one more person poking & prodding at me isn't going to make much of a difference!

As for Vit K i'm not sure, I THINK it is standard procedure in Lmk for bottlefed babies have to ask them at the clinic the next day

Thanks for the detailed response girls
All other comments welcome!

Nevyn

Mine were breastfed and they were given the Vit K shot for clotting when they were born.

cynder

Thaedydal wrote: »

Mine were breastfed and they were given the Vit K shot for clotting when they were born.

My eldest was never given it (that was 11 years ago and i don't think they implemented it then( in limerick)), but my other 2 were given it in the labour ward straight after birth.


My sister in law was breast feeding her boy and she would not let them give him the vitamin k injection, that was 9 years ago. That was the first i ever heard of the vitamin k injection.

cynder

angelfire9 wrote: »

It certainly can't be any worse :rolleyes:


!

Well at least your looking on the bright side:)

angelfire9

grindelwald wrote: »

Well at least your looking on the bright side:)

My first time was an unmitigated DISASTER
I was induced then I had my waters broken then there followed 12 hours of agony with zero pain relief because it was so busy I ended up in the home birthing "suite" where I could only be given gas which made me sick

Ended up with an episiotomy for which I had 9 stitches for which I had to go to theatre and have an epidural :rolleyes:

This time really can't be any worse than that!

Lola92

Hi all, don't mean to hi-jack here but I didn't think this warranted making a whole new thread!

I'm due my first in a week and a half and had thought about making a birth plan, the main problem being I didn't really know where to start!

Angelfire's post really shocked me, in so far as that I thought a lot of that had to be done - regarding informed consent for any procedures/examinations, pushing when I feel ready to, not being cut unless absolutely necessary etc.

Is this not the case? I was also quite upset at the fact that my partner could be asked to leave, when I thought that the whole point of having a birth partner was for support through out the entire labour process?

Also in posters experience, do the medical team really consider your birth plan and try to accommodate your wishes? (Obviously within reason, if my baby is in stress/danger then I can understand deviating from the ideal situation plan!)

Many thanks

Crea

I had my 3 in St. Munchins. There is no harm in giving them the birth plan but don't be surprised if they don't remember all of it. The most important person to remember you birthplan is your partner. I found that in the throws of labour I couldn't think straight and needed him to speak for me.

Going through your list - I had pretty much all you wanted as routine. Mind you I didn't go into the hospital until the pain was unbearable at home. Before I left I had tea and toast so didn't need to eat in there.
I don't know if they do the walking epidural. If you do get an epidural you'll have to wear a hospital gown as they need it to be open at the back.

It sounds like your 1st birth was fairly horrendous so best of luck with this one.
BTW - 9 stitches isn't too bad!!!!:P

angelfire9

Crea wrote: »

BTW - 9 stitches isn't too bad!!!!:P

:eek:

I couldn't sit down for a week!
I hope and pray that this one is easier especially with an EDD of 19th Dec I don't want to be walking wounded on Christmas day

angelfire9

Lola92 wrote: »

Hi all, don't mean to hi-jack here but I didn't think this warranted making a whole new thread!

I'm due my first in a week and a half and had thought about making a birth plan, the main problem being I didn't really know where to start!

Angelfire's post really shocked me, in so far as that I thought a lot of that had to be done - regarding informed consent for any procedures/examinations, pushing when I feel ready to, not being cut unless absolutely necessary etc.

Is this not the case? I was also quite upset at the fact that my partner could be asked to leave, when I thought that the whole point of having a birth partner was for support through out the entire labour process?

Also in posters experience, do the medical team really consider your birth plan and try to accommodate your wishes? (Obviously within reason, if my baby is in stress/danger then I can understand deviating from the ideal situation plan!)

Many thanks

There was no "informed consent" for No. 1
It was more a case of "Right we are here to do X,Y,Z if you don't like it you can lump it!"
My husband was TOLD to leave at least 10 times it wrecked my head because it seemed that everytime he was gone I had a contraction and the staff were too obsessed at completing their tests that they didn't even notice

I remember reading my chart after we got back to the ward and the midwife had stated that mini me had required a forceps delivery because of "NO MATERNAL CO-OPERATION"
10 years later and I still remember that!

Lola92

angelfire9 wrote: »

There was no "informed consent" for No. 1
It was more a case of "Right we are here to do X,Y,Z if you don't like it you can lump it!"
My husband was TOLD to leave at least 10 times it wrecked my head because it seemed that everytime he was gone I had a contraction and the staff were too obsessed at completing their tests that they didn't even notice

I remember reading my chart after we got back to the ward and the midwife had stated that mini me had required a forceps delivery because of "NO MATERNAL CO-OPERATION"
10 years later and I still remember that!

Wow... that is quite shocking. As far as I knew it was illegal do any form of medical test/procedure without explaining it (including risks!!) to the patient first! Obviously emergency situations mightn't always allow for this but surely within reason?

A birth plan is definitely on the cards for me then, even if it only means having my wishes down on paper, for the record so to speak.

Cat Melodeon

Crea wrote: »

BTW - 9 stitches isn't too bad!!!!:P

+1 !

The trainee doctor who was observing the obstetrician after my son's birth was horrified by the state of my bits afterwards and very foolishly told me the next morning that she 'had never seen anything like it.' :eek: I really did not want to hear that! I received well over 50 stitches - they wouldn't tell me exactly how many but it took over an hour and three shots of local anaesthetic to complete the quiltwork afterwards! That's what happens when you get carried away with a 9lb 6 first baby and don't listen when the midwife says 'stop pushing!' Luckily they were all internal tears, the perineum was left intact and they all healed without any problem. Everything still functions exactly as it did before so a few stitches (although literally a pain in the arse) really aren't the end of the world. Tea tree oil baths and plenty of ponstan (safest for breastfeeders) got me through.

@ Angelfire, I really think things have progressed a lot since you had your first.

@ Lola, certainly I included a lot of basics on mine, such as not wanting to be shaved, no episiotomy unless absolutely necessary etc, but the midwives told me that was all standard hospital policy anyway. Usually your antenatal clinic will give you a sample birth plan showing what they consider normal, you can usually judge from this how woman-centred their practises are or if they still follow outdated doctor-led care.

Moonbeam

My partner knows mine off by heart and last time things couldn't have gone better which makes me more nervous this time!!

cynder

angelfire9 wrote: »

:eek:

I couldn't sit down for a week!
I hope and pray that this one is easier especially with an EDD of 19th Dec I don't want to be walking wounded on Christmas day

Try too many to count!

They lost count of the stitches on 2 and 3, but with my first i got an infection 12 hours after her birth and that was more painful than "too many to count stitches", they didn't even have cream for me, i had to wait 4 days to be let out then go to my own doctor, all my skin had pealed away and i was red raw. painkillers didn't work and the nappy rash cream the hospital gave me made it worse, cant remember what cream the GP gave me but it took at least 3 weeks to heal. Also with number 1 i had stitches inside (where she had grazed me), none on the outside.


Im sure you will have a better experience this time round, I think if you have a baby under the age of 20 the nurses/midwifes do push you round a little bit, but when you are older they seem to respect that you know what you are talking about.

limerick_lady

Hi Angelfire9 (and the rest of ye too!)

I had my first in Limerick last year and did a birth plan, although it was alot more vague than yours. I filled in the form that was printed on the center pages in the hospital handbook. I did fill my dp in on what I wanted, in case it became an issue.

Mine was along the lines of
- epidural : no
- pethadine, gas & air : yes
- induction : no
- episiotomy : only if absolutely necessary
- breastfeeding : yes, immediately after birth

obviously there were a few more line involved but they all commented on how great it was to have such a concise plan - towards the end, the head matron on duty came in, quickly scanned through it and knew exactly what I wanted! There was no need for her to sit down and read through an essay.

Her purpose in coming in was that I had been in active labour for 45 minutes and my contractions weren't coming quickly enough together. She wanted to put me on a drip but once she read that I had asked for no induction, she said she'd leave me another 20minutes seeing as baby was doing fine. Within 10minutes, I had given birth and there was no need for any drugs.

Just a thought - short & sweet!!

Best of luck with everything though!

cynder

Cat Melodeon wrote: »

+1 !

The trainee doctor who was observing the obstetrician after my son's birth was horrified by the state of my bits afterwards and very foolishly told me the next morning that she 'had never seen anything like it.' :eek: I really did not want to hear that! I received well over 50 stitches - they wouldn't tell me exactly how many but it took over an hour and three shots of local anaesthetic to complete the quiltwork afterwards! That's what happens when you get carried away with a 9lb 6 first baby and don't listen when the midwife says 'stop pushing!' Luckily they were all internal tears, the perineum was left intact and they all healed without any problem. Everything still functions exactly as it did before so a few stitches (although literally a pain in the arse) really aren't the end of the world. Tea tree oil baths and plenty of ponstan (safest for breastfeeders) got me through.

.

Very like me, i had continuous stitches inside with my first, as far as i know the 2nd and 3rd didn't graze me inside, but the 2nd guy tore the perineum with his shoulder (as he came out very fast), the 3rd guy i was told to stop pushing , i couldn't and they shouted at me, i thought there was something wrong with the baby (cord around his neck, it was but that wasnt the problem) so i stopped and all of a sudden 6 people were in the room having a good look at my bits (with baby's head crowing) and was all taking and then i was told to push very slow, turns out the perineum burst and i was a right mess. Dont know why they had to call everyone in to take a look, half the hospital staff must have seen my bits by now.

I went for my smear test 6 weeks later and the nurse says i need reconstructive surgery, but only if I'm not having another one as the damage would be worse for number 4 (no hopes of having another one anytime soon, but i wont say never again)

Also if i ever have another one i to inform them i had a 3rd degree tear, and that its really bad.

cynder

angelfire9 wrote: »

:eek:

I couldn't sit down for a week!
I hope and pray that this one is easier especially with an EDD of 19th Dec I don't want to be walking wounded on Christmas day

I hope your hubby is cooking xmas dinner!


Was a new baby on your daughters x mas list? At least she is old enough to lend a helping hand....

How Strange

Its my first pregnancy but this is what I was told about birth plans; start by thanking the midwives and hospital staff. Put everything in bullet points so it's quick and easy to read. Keep it to one page. Re eating and drinking it's hospital policy to prohibit this so don't include it on the plan. Bring your snacks and drinks and the
midwives will turn a blind eye.

Your partner is your voice so make sure he's on the same page with regards to medical interventions etc. If medical staff are acting against your wishes without giving explanations he needs to be informed and speak up. Have a preagreed code word for give me the epidural etc if you've wanted to do it naturally but find the pain too
much.

Afaik there is only one type of epidural in Ireland and if you get it you're in bed for the whole time as they won't let you do anything for insurance reasons.

Nevyn

grindelwald wrote: »

My eldest was never given it (that was 11 years ago and i don't think they implemented it then( in limerick)), but my other 2 were given it in the labour ward straight after birth.


My sister in law was breast feeding her boy and she would not let them give him the vitamin k injection, that was 9 years ago. That was the first i ever heard of the vitamin k injection.

Both mine got the Vit K injection and that was nearly 13 years ago for my son and 10 for my daughter who were born in Dublin.

cynder

Thaedydal wrote: »

Both mine got the Vit K injection and that was nearly 13 years ago for my son and 10 for my daughter who were born in Dublin.

Its mad how differnt counties differ, i was born in cork and no baby in cork got the BCG at birth yet many other counties did, I never got he bcg until i moved to clare (at 15).

angelfire9

grindelwald wrote: »

Try too many to count!

:eek:
I was DYING after 9
I shiver to think how you felt

grindelwald wrote: »

Im sure you will have a better experience this time round, I think if you have a baby under the age of 20 the nurses/midwifes do push you round a little bit, but when you are older they seem to respect that you know what you are talking about.

I was 25 last time round
But thanks for the compliment

grindelwald wrote: »

I hope your hubby is cooking xmas dinner!

Hubby is working 6-2
Having dinner at my mothers and will stay there til he collects us

grindelwald wrote: »

Was a new baby on your daughters x mas list? At least she is old enough to lend a helping hand....

She wants a sister (i'm convinced its a boy)
She's not happy though cos she is so used to being an only child and having 100% of the attention
Will see how things pan out I guess

grindelwald wrote: »

Its mad how differnt counties differ, i was born in cork and no baby in cork got the BCG at birth yet many other counties did, I never got he bcg until i moved to clare (at 15).

Limerick do the BCG on day 2
Me being the big softie I am had to leave the room when mini me was getting it cos I couldnt bear to watch
Had to do the same for the vaccinations (my mother stayed with her)

metrovelvet

Walking epidurals are a bit of a myth. You dont get to walk as much as you might think.

I dont know about Ireland but if you want to refuse the VIT K injection for the child you need a court order.

I had a very nice birth plan done until my baby was considered two weeks over due and I had an induction and everything on the plan went out the window.

lynski

Had a very clear idea of what we wanted on No 1 but once induction starts here the hospital really say they are in charge and there was nothing that they wanted to hear from us. I did refuse an epi for the first 10 hrs, then had one and an ECS in the end. terrible infection and a 10 day stay in hospital.
With No 2 I used hypnobirthing and gas and air and she was born after 3.hrs 25mins, had a tear, but no stitches, 36 hrs in total in hospital.
This time i intend to avoid gas even, i will hopefully be hypno the whole way and hope for a quick easy-ish labor.
It is worth reading the Irish pregnancy book by Peter Boylan and The Better Birth Book by Tracy Donegan to get a clear picture of the norms in irish hospital (no walking epi, monitoring req is previous cs, induction or other reasons, immediate cord cutting, drug induced placenta delivery would all be norms here and it is hard to get the hospitals to move from that position)
I will be pulling the 'informed consent' card this time for anything i dont want.

Hannibal Smith

angelfire9 wrote: »

He'll stay if he wants to stay married

Love it

Hannibal Smith

lynski wrote: »

Had a very clear idea of what we wanted on No 1 but once induction starts here the hospital really say they are in charge and there was nothing that they wanted to hear from us. I did refuse an epi for the first 10 hrs, then had one and an ECS in the end. terrible infection and a 10 day stay in hospital.
With No 2 I used hypnobirthing and gas and air and she was born after 3.hrs 25mins, had a tear, but no stitches, 36 hrs in total in hospital.
This time i intend to avoid gas even, i will hopefully be hypno the whole way and hope for a quick easy-ish labor.
It is worth reading the Irish pregnancy book by Peter Boylan and The Better Birth Book by Tracy Donegan to get a clear picture of the norms in irish hospital (no walking epi, monitoring req is previous cs, induction or other reasons, immediate cord cutting, drug induced placenta delivery would all be norms here and it is hard to get the hospitals to move from that position)
I will be pulling the 'informed consent' card this time for anything i dont want.

What's a hypno birth? What was it like having a birth after a Section? I'm pregnant now on my second and the first was an emergency Caesarian Section, so I don't know what to expect

Nevyn

Another thing which the mammy's to be who are not married should be aware of it that
their partner is not their legal next of kid or medical guardian if anything goes awry.
This means that if during the labour you are considered no in a fit state to make decisions the drs/midwife/consultant can and will take over and make decisions with out having to ask your partner.

Also once the baby is born the mother becomes legal and medical guardian of the baby from birth and the father won't unless he is married to the mother, and again if the mother is unable to make decisions the medical team makes them about the baby and the father does not have to be consulted and has no power to make medical decisions.

I remember running into this while having stitches after my first and being asked about the Vit K shot and my son's father saying to the dr to give it to our son but the dr saying that he needed my consent.

If you are not married your legal next of kin and medical guardian is your father, if your father is not alive it is your mother. If you are not married and your baby is born you are the legal nest of kin and medical guardian and then it is your father and then your mother.

IF you are not married you can make your partner your legal next of kin and medical guardian, it is a matter of going to a solicitor and getting the forums filled out.

Hannibal Smith

Thaedydal wrote: »

Also once the baby is born the mother becomes legal and medical guardian of the baby from birth and the father won't unless he is married to the mother, and again if the mother is unable to make decisions the medical team makes them about the baby and the father does not have to be consulted and has no power to make medical decisions.

Sometimes that's not only confined to non married couples. When I was in recovery after the section I got a phone call from the nurses on the ward where my son was telling me his blood sugars were low and asking me if they could give him formula milk. Even though my husband was there with him, and was perfectly capable of making the decision.