Thursday, 12 December 2013

Umbilical Cord Wrapped Around Baby's Neck

The Facts
You may have heard that umbilical cords wrapped around a baby's neck is bad since it can strangle the baby. Wikipedia says that 6-37% of babies have a nuchal cord (cord wrapped 360 degrees around the neck). VBAC facts states that around 25-35% of babies have nuchal cords. Texas Tech University of Health Sciences states that it's around 50%. Some (1-3%) babies have the cord wrapped around their neck more than once.

How Babies Breath
Most of the time there is no cause for concern and the cord will not strangle your baby. If you think of the cord as a hose, water can still get through a hose even if it's wrapped around something. First of all, your baby isn't breathing the way we are; they're breathing through their umbilical cord, so something around their neck won't strangle them. In order for there to be a problem, there has to be a kink or cord compression which prevents oxygen from traveling through the cord and to the baby.

Cord Entanglement
The cord can also wrap itself around the baby's torso or extremities. I have heard that up to 80% of baby's have the cord wrapped around some part of their body, but can't find the link. (If you know of it, please let me know.) Twins have even a higher rate of cord entanglement, with up to 70%.

Cord Wrapped Around Baby's Neck Five Times
There's a Youtube video (not safe for work!) that shows an unassisted birth (no one catches the baby, he just kind of plops out onto the bed) with the cord wrapped around the baby's neck five times! I think it's also great that the woman is giving her space and allowed to birth in the position that she wants, can push when she wants, and wear what she wants. (She chooses not to wear anything)

Knots
Even knots and true knots are often not a problem since these are formed at the beginning of the pregnancy when the baby can flip and turn and Wharton's Jelly helps prevent compression of the vein and arteries. 

My Story
My daughter was born with the cord wrapped around her neck, waist, and right leg. Rosa simply unwrapped the cord and put her on my chest. She was fine.


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Tender Embrace Birthing offers childbirth, breastfeeding, and newborn care classes and support.



Wednesday, 11 December 2013

The Business of Being Born

While it talks about medical practices in the US, The Business of Being Born still resonates with me since many of the interventions they do in the US are done here in Korea. You can watch the video on Youtube. There's also a sequel, called More Business of Being Born, which has four parts.
  1. Down on the Farm
  2. Special Deliveries
  3. Explore Your Options
  4. The VBAC Dilemma
Released in January 2008 with Ricki Lake and Abby Epstein it raises many questions about birthing in the US. This isn't the first time that the US is under the microscope. The State of the World Mother's Reports also points its finger at the US. Despite being a first world country, the US rivals third world countries with some of its statistics about infant mortality rates and breastfeeding.

While the US seems to have changed some of its practices over the year, Korea hasn't and many things that happen here in Korea are what were happening in the US a couple of decades ago. Shaving, enemas, and episiotomies are all part of the assembly line birthing practices here. Natural birth isn't for everyone and C-sections are necessary, but there shouldn't be a one size fits all birth plan for everyone.

In both the US and Korea, the C-section rate is about 30%, however, they can vary widely from doctor to doctor and hospital/birthing center to hospital/birthing center. Many women are given interventions, such as shaving, enemas, episiotomies, pitocin, IVs, epidurals, spinal blocks, cord traction, etc.

There are other videos about natural birthing. You might want to watch Orgasmic Birth and Organic Birth. Also, Ina May's TED talk about reducing fear during birthing is also an eye-opening video that makes you re-think about all the interventions done to women in labor. Ina May Gaskin is a pioneer in the natural birthing field and has many women get the birth they want. 
 
Reviews about The Business of Being Born
Resources


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Tender Embrace Birthing offers childbirth, breastfeeding, and newborn care classes and support.


Tuesday, 3 December 2013

Cord Blood Banking in Korea

On Mama Seoul's blog she talks a bit about cord blood banking in Korea. Keep in mind that the info is from 2008 and prices have gone up a bit. Now you're probably looking at about 1.5 mil to 2 mil to do cord blood banking.

Pros and Cons of Cord Blood Banking
There's lots and lots of info out there and I'm not going to re-hash it all. Do your research. It's a very hot topic and people are very opinionated about it. It's a relatively new process. Here's some info about the Top 3 places in the USA.

Some people say that it's worth it, others say it's not. Some say it can help with a variety of diseases. Some say that the cord cells are only viable for 10 years. Some say that it's more likely that you can use them for your other children rather than the child whose blood you banked.


Basic Info
Contacts are usually 10-20 years. **Make sure you pick a company who can do all the paperwork necessary to transport the cells back to your home country if necessary!** Also ask about fees. The company here as well as the company back home may charge you. Transporting cord blood back home is not an easy process to do alone since there are legal issues with transporting live cells. Make sure the company can help you out.

For those of you interested in delayed clamping, it is possible to do both cord blood banking and delayed cord clamping. Birth Anarchy has more info about it.

Cord Blood Banking Companies (if you know of any more, please let me know)


  • Medipos Cell Tree: 080-264-9380

Hospitals that do Cord Blood Banking (they only do it if you give birth at their hospital)
  • Cha General Hospital, I Cord, Cord Bank. 650-9 Yeoksam-dong, Gangnam-gu, Seoul. Telephone: : 02-3468-3000. International Clinic: 02-3468-2632 or 02-3468-3127

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Tender Embrace Birthing offers childbirth, breastfeeding, and newborn care classes and support.




Monday, 25 November 2013

Birthing in Korea's Birth Plan

Introduction
Birth plans are very helpful and even more so if you're birthing in Korea where you may not speak the language and the culture may be very different. Here in Korea, the doctor is all-knowing and patients don't ask questions. The doctor is the expert and does whatever he or she sees fit. Sitting down with your doctor and having them read, sign, and stamp your birth plan will help you both.

Get at least two copies (one for you and one for your doctor) and have them in both English and Korean (get a friend to help or if all else fails use Google Translate). Bring it to the hospital with you. If necessary, when you're in labor you can point out (in Korean) what the doctor has agreed to when the nurse comes over and tries to do something that you don't want.

You might decide to change hospitals if your doctor doesn't agree most of your requests. Enemas, shaving, episiotomies, laboring on your back with IVs and epidurals are common here. As are C-sections, with the national average around 30%, which is similar to the USA.

Every hospital is different and even within hospitals, doctors have different ideas. If you're trying to avoid a C-section, knowing your doctor's C-section rate is important. Also ask about your hospital C-section rate since you might not always get your doctor for the birth.

Useful Links and Sample Birth Plans
Here's a list of hospitals and clinics that foreigners have gone to. Here's a list of doulas, breastfeeding counselors, and childbirth educators. Below you can find Birthing in Korea's Birth Plan. I also have more sample birth plans on my birthing plans for Korea post. I don't deserve credit for any of them as I haven't written any of them. I've linked to them as well as copied and pasted them in the posts.

Birthing in Korea's Birth Plan
This was taken from Birthing in Korea.

We have chosen to give birth to our child at _________________ Hospital under the care of Dr. __________________. We believe that their outstanding care and concerns for the child and mother’s birthing opinion is most important for this beautiful process. In our desire to have the most memorable and happiest birth possible, we have listed our preferences below. These decisions have been made after much research, consultation and thought. Therefore, your help in achieving these goals is very appreciated by us. You can be assured that in the unlikely event of complications, our full co-operation will b rendered after an informed discussion with our doctor has taken place along with adequate time for private consideration between my partner and I. The birthing plan is listed below.

저희는 닥터 (dr. name)___________ 선생님의 (hospital’s name)_____________ 병원에서 저희 아이를 낳기로 결정했습니다. 선생님의 저의 분만에 대한 의견에의 존중과 저희 아이에 대한 탁월한 보살핌과 염려가 이 아름다운 분만의 여정에서 가장 중요하다고 믿었기에 여기 성 바오로 병원에 오게 되었습니다. 저희는 가장 기억에 남고 행복한 분만을 맞이하기 위한 소망으로 심사숙고하며여러 전문가들과 이야기를 나누고 연구한 끝에 아래 저희의 바램과 부탁을 기술한 분만 플랜을 만들었습니다. 이러한 저희의 소망을 이루는 데 있어 여러분께서 도움을 주신다면 저희는 진심으로 감사를 드리겠습니다. 비록 저희 분만 계획서에서 요청되었다 할 지라도 만의 하나 어렵거나 위급한 상황이 닥칠 시에 저희는 저희 담당 선생님과 함께 의논한 후에 그 결정에 따르도록 할 테니 너무 걱정은 안 하셔도 됩니다. 저희 분만 플랜은 다음과 같습니다.

Admission 
입원 
Husband (xxx) and Doula(s) ___________ to be present throughout labour and delivery
저의 남편 xxx와 Doula인 ___________ 제 분만 전 과정 동안 함께 할 수 있도록 해 주시기 바랍니다.

I would like to book a private room
저는 1인실을 원합니다.

Admission day can be modified
제 상황에 따라 퇴원날짜는 조정될 수 있도록 해 주세요.

I would like admission and discharge procedure assistance from the International Clinic.
제가 입, 퇴원시 외국인 진료소에서 직접 오셔서 도와 주세요.

Several copies of Korean and English birth certificate to be given.
국문 , 영문 출생 증명서를 원하는 대로 발급해 주세요.

I intend to do Cord Blood banking.
탯줄 혈액 보관 과정.

I wish to receive a western diet, but reserve the right to change this if not satisfactory.
식사는 기본적으로 서양식을 원하지만 만약 필요한 경우에는 다른 옵션으로 바꿀 수 있게 해 주세요.

Environment 
To preserve my privacy and dignity, I would prefer that everyone knock before entering.
제 방에 들어 오시기전에 항상 노크를 부탁드립니다.

Soft light (maybe some candles) and calming music to be played, unless it is a medical emergency and full lighting is needed.
응급한 경우가 아니라면 너무 밝은 조명을 피하고 촛불을 사용하거나 은은한 음악을 들을 수 있도록 해 주세요.

Please prepare a CD player in room.
CD 플레이어 준비해 주세요.

I would prefer the lights to be dimmed.
분만실 조명은 조도 조절 가능하게 해 주세요-너무 밝지 않게.

No males, students or non-essential personnel to be in the room.
분만실에 꼭 필요한 분이 아닌 인턴이나 실습생, 특히 남자분들을 들여 보내지 말아 주세요.

Routine Procedures 
My husband must be allowed at all times for any procedure, please.
저희 남편 아마르가 분만 전 과정에 항상 참여할 수 있도록 허락해 주세요.

Not to have an IV fluid line, although a Heparin lock is acceptable.
저희는 IV 보다는 Heparin lock을 원합니다.

No enema unless requested until 4 cm dilated.
꼭 필요한 경우가 아니라면 4cm 전에는 관장을 하지 말아 주세요.

No catheter unless requested.
꼭 필요한 경우가 아니라면 catheter를 하지 말아 주세요.

No shaving of pubic area.
면도는 하지 말아 주세요.

We would like to be able to eat/drink (not only ice) during labour.
진통시 음식이나 물 섭취 원함

We would like to be able to drink fluids and have light snacks.
간의 음료와 스낵을 섭취할 수 있게 해 주세요.

I wish to avoid having my membranes ruptured unless medically indicated or discussed with us.
꼭 필요한 상황이 아니면 양수를 인위적으로 터트리지 말아 주세요.

Intermittent monitoring of the baby’s heartbeat.
모니터링은 필요 시에만 하게 해 주세요.

EFM only for first 20 minutes of every hour to enable mother to have mobility during each phase of labor.
모니터링은 매 시간 첫 20분간만 해서 제가 분만 각 시기 동안 몸을 움직일수 있게 해 주세요.

Induction and Augmentation 
After water breaks, induction of labour to start if it doesn’t start on its more than 24 hours 양수가 터진 이후 24시간내에 자연 진통이 없는 경우 유도분만을 시작해 주세요.

Please do not induce my labour at 40 weeks. I would prefer to wait until 42 weeks to start induction.
40주가 지나도 진통이 없는 경우 아이가 괜찮을 경우 42주까지는 기다려 주세요.

Please, no augmentation of labour, no pitocin, amniotomy, or stripping of the membrane unless deemed necessary for the babies health.
분만 과정 중 아기의 건강이 염려되는 필요한 경우가 아니라면 어떠한Augmentation, Pitocin주입이나 양수 터트리기 혹은 회음부 stripping자극등을 하지 말아 주세요.

 No artificial induction, including rupture of membrane, if the baby and I show no signs of infection or stress.
저나 아기나 어떤 감염이나 스트레스의 징후가 있는 경우를 제외하고는 유도분만이나 인위적인 양수 터트리기를 하지 말아 주세요.

Pain Relief Options 
I intend to have pain relief with epidural anesthesia.
경막외 마취 무통 분만(에피듀럴)을 제게 시술 부탁 드립니다.

Not to have an epidural unless I ask for it. But please have an anesthesiologist available the whole time in case it is needed.
저는 가능한 한 무통분만을 하지 않기를 원하지만 만약의 경우를 대비해 마취과 선생님을 준비시켜 주세요.

I would prefer to manage pain on my own. Please do not offer drugs for pain relief. I will ask for it if I need it.
진통 경감을 위한 약을 쓰지 말아 주세요. 필요 시엔 제가 말씀 드리겠습니다.

No analgesia/anesthesia unless we requests the use of it.
저희가 요청하는 경우가 아니라면 어떠한 무통제제/ 마취제제를 주지 말아 주세요

Pain medication/anesthesia only if requested by us (Demerol).
진통제는 저희가 원할 경우에만 Demerol로 해 주세요.

Please no epidural.
epidural 원하지 않습니다

We would like to use of a shower, if desired for pain relief.
제가 원할 경우 샤워를 하게 해 주세요.

We would like to use a birth ball, cold/hot therapy, massage for pain relief.
분만 공, 핫팩, 마사지등을 사용하겠습니다.

Labour 
분만 제1기

If baby and I are fine, we wish to be free of time limits.
아기와 제가 건강한 경우에는 너무 분만 시간에 얽매이지 말아 주세요.

During labour I wish to adopt whatever position feels right for me at that time (for example, squatting, side lying, on all fours, sitting on the ball.)
진통 중 가능한 한 제가 마음대로 자세를 바꿀 수 있게 해 주세요.

Before doing any procedure, please let us know and explain to us why it is necessary.
의학적인 처치나 작업을 하시기 전에 미리 저희에게 왜 이것이 필요한 지를 말씀하고 설명해 주시면 감사하겠습니다.

Vaginal exams only upon consent: as few and gentle as possible, please.
내진은 최대한 제게 말씀해 주신 후 부드럽게 그리고 최소한으로 해 주세요.

To avoid internal vaginal examinations unless they are medically necessary or I request them.
꼭 필요하거니 제가 원할 때에만 내진을 해 주세요.

Minimum number of vaginal exams and only with permission.
내진은 가능한 한 적게 미리 말씀을 해 주신 뒤 해 주세요.

I would like to have mobility during each phase of labor.
분만 진통시 가능한 한 제가 많이 움직일 수 있도록 해 주세요.

To be allowed to move around as much as possible and assume labour positions of choice (squatting, on all fours, lying on my side).
분만 과정 동안 가능한 한 움직일 수 있고 자세를 바꿀 수 있도록 도와주세요.

We would like the freedom to move/walk around during stages of labour.
분만 과정 동안 자유롭게 움직일 수 있게 해 주세요.

We would like to use the shower, if desired, before membrane rupture.
양수가 터지기 전엔 제가 원할 경우 샤워를 하게 해 주세요.

Please allow me to vocalize as desired during labour and birth without comment or criticism.
제가 요구가 많더라도 노여워 마시고 들어주시고 이해해 주시길 부탁드립니다.

Birth 
분만 제2기

If baby and I are fine, we wish to be free of time limits.
아기와 제가 건강한 경우에는 너무 분만 시간에 얽매이지 말아 주세요.

I do not want to lie on my back to give birth.
똑바로 눕지 않게 해 주세요.

During birth I wish to adopt whatever position feels right for me at that time (for example, squatting, side lying, on all fours.
진통 중 가능한 한 제가 마음대로 자세를 바꿀 수 있게 해 주세요.

We would like to assume any of the following positions for birth: squat, side lying, on all fours.
진통시 자유로운 자세를 취하길 원함

We wish to assume an up-right position or an alternate gravity inducing position during the pushing stage to help with the birthing, please.
힘 주기때 아기가 잘 내려올 수 있도록 선 자세나 중력을 이용할 수 있는자세를 취할 수 있도록 해 주세요.

I will bring a mirror placed at the foot of the bed to see the birth of my baby. 작은 손거울을 침대 발치에 놓겠습니다.

To be allowed to rest and wait if I do not have the urge to push straight away, if the baby and I are fine.
아기와 제가 괜찮다면 힘주기때 너무 급하게 재촉하지 말아 주세요

To push instinctively rather than be coached or told when to push.
힘주기때 제가 스스로 알아서 할 수 있도록 너무 코치를 하지 말아 주세요.

Not to be coached or told when to push by medical staff. My husband and/or doula will offer prompts to birth the baby, please let us.
가능한 한 의료진에 의한 인위적인 힘주기보다는 제가 저의 남편, 듈라와 같이 호흡을 이용한 자연스러운 힘주기를 할 수 있도록 허락 해 주세요.

No one put their hands on my abdomen to “push the baby down” unless it is a medical emergency.
의학적인 응급 상황이 아니라면 인위적으로 배를 누르며 힘주기를 도와주는 작업을 하지 말아 주세요.

Measures taken to try and ensure an intact perineum (warm compress, massage with lubricant, gentle pressure on baby’s head to stop it coming too quickly).
perineum이 제 역할을 잘 할 수 있도록 따뜻한 마사지나 지압을 좀 해 주시고 아기 머리가 너무 빨리 나오는 것을 방지하도록 아기 머리를 부드럽게 눌러 주세요.)

To risk a tear rather than have an episiotomy (unless a medical emergency).
위급한 상황이 아니라면 회음부 절개보다는 자연적인 tearing을 원합니다.)

Perineal massage instead of an episiotomy would be preferred.
아기가 아주 지쳐 있지 않는 한 회음부 절개 보다는 회음부 마사지를 해 주세요.

Immediately after Birth 분만 후
Voices to be soft within room.
분만시 조용한 분위기를 유지해 주세요.

Please place the baby immediately upon the mother’s abdomen.
아기가 태어나자마자 제 가슴에 올려 주세요.

If warming is required, please place the child on the mother’s chest with blankets.
만약 아기에게 보온이 요구되는 경우에는 아기를 제 가슴에 놓고 따뜻한 담요로 보온할 수 있도록 해 주세요.

Umbilical cord is to be cut by the husband.
남편이 탯줄을 자를 수 있게 해 주세요.

To wait until the umbilical cord stops pulsating before it is clamped and cut.
탯줄이 스스로 pulsating이 멈출 때까지 자르지 말아 주세요.

Skin to skin contact with my baby.
아기와 제가 스킨십을 바로 할 수 있도록 해 주세요.

I want to know the Apgar score after five minutes.
5분 뒤 체크하시는 Apgar score를 알려 주세요.

Not to have my baby’s nose and mouth suctioned unless it is medically necessary.
응급상황이 아니라면 아기의 코와 입에 suction을 하지 말아 주세요.

If stitching of the perineum is necessary, please use local aesthetic.
만약 회음부에 상처가 생겨 봉합이 필요한 경우에는 국소 마취를 사용해 주세요.

Please allow the baby to breastfeed immediately to assist with the natural delivery of the placenta. Please no pulling, pitocin, or uterine massage unless deemed necessary.
태반이 자연적으로 잘 배출될 수 있도록 아기가 바로 젖을 빨 수 있도록 해 주세요. 가능한 한 태반을 억지로 당겨 내거나, 피토신을 사용하거나 자궁 마사지를 하지 않도록 해 주세요.

To wait until after I have fed my baby before having stitches, if possible.
스티치(봉합)를 하기 전에 제가 아기에게 먼저 수유할 수 있도록 해 주세요.)

Time to allow the placenta to deliver spontaneously.
태반이 자연적으로 배출되도록 기다려 주세요.

No pushing of belly after birth.
분만후 배를 누르지 말아 주세요.

I want to see the placenta after it is delivered.
태반 분만후 제게 보여 주세요.

I wish to have my placenta and cord placed in a clean container for us to take home.
태반과 탯줄은 깨끗한 용기에 담아주셔서 집에 가져갈 수 있게 해 주십시요

To avoid injection to help control bleeding and deliver the placenta, unless medically necessary.
의학적으로 꼭 필요한 경우가 아니라면 지혈이나 태반출산을 돕는 주사나 약물을 사용하지 말아 주세요.

To delay newborn procedures (weighing and measuring, etc) until I have had time to breastfeed my baby.
제가 충분히 아기에게 수유를 한 후에 아기 체중 측정이나 키 측정 같은 신생아 관리를 스케줄대로 해 주세요.

Husband will carry the baby to nursery.
남편이 아기를 신생아실로 데리고 가기를 원합니다.

Baby Care
신생아를돌보실때 
The newborn is to stay with parents at all times, please.
아기가 항상 저희와 같이 있을 수 있도록 해 주세요.

Rooming in at all times.
항상 rooming in 원합니다.

Please perform all physical exams and procedures with one parent present at all times.
아기를 위한 모든 검사나 과정은 항상 저희 중 한 사람이 있을 때 꼭 해주세요.

Breast feeding only, please no bottles, artificial nipples, formula, glucose, or water.
아기에게 젖병이나 고무 젖꼭지, 분유, 글루코스나 물을 주지 마시고 꼭 모유수유만 하게 해 주세요.

No bottles of formula, water or glucose, if necessary tube-feeding or spoon-feeding (even if Caesarean or premature).
(분유, 글루코스,물을 아기에게 주지 마세요.필요시엔 튜브나 스푼으로 먹여 주세요.)

If the baby is dehydrated, please ask our permission before giving any glucose or water, and please use a spoon rather than bottle.
만약 아기가 탈수 증세가 있을 경우 저희에게 먼저 말씀을 해 주신다음 글루코스나 물을 젖병이 아닌 스푼을 통해 먹여 주세요.

We will exclusively breastfeed (no glucose or formula) our baby until there is a 7% weight loss.
체중이 7%이하로 줄기 전에는 모유수유만 하겠습니다.

No pacifiers, artificial nipples to be given.
공갈 젖꼭지나 젖병 주지 마세요

Please do not use a pacifier.
공갈 젖꼭지는 사용하지 말아 주세요.

Regular baby check up at regular hours.
정해진 시간마다 오셔서 아기의 건강상태를 봐 주세요.

No circumcision.
circumcision하지 않겠습니다.

Please circumcise our baby boy.
circumcision를 원합니다

We would like to use the hospital’s breast pump and feeding pillow if requested.
모유수유를 위한 유축기나 수유 패드를 준비해 주세요

Please don’t wake mother or baby for routine vitals and check-ups unless immediately medically necessary.
꼭 필요한 경우가 아니라면 회진시 산모와 아기가 잘 경우 깨우지 말아 주세요

Please don’t bath the baby immediately post-birth – excess blood, material and fluids can be gently removed from the face and head area mainly. Do not remove excess vernix.
분만 직후 아기를 바로 목욕시키지 말아 주세요. 아기 머리나 얼굴 부분에 있는 묻어있는 피나 양수, 분비물 등만 부드럽게 닦아 주세요. 태지는 제발 제거하지 마시고 놔둬 주세요.

We request that the first bath to be given – father to be present and video tape/photograph this. This can occur 1 day after birth.
분만 그 다음날 아기의 아빠가 아기의 첫 목욕을 사진 혹은 비디오로 찍을 수 있도록 해 주세요.

If my baby is ill 
아기가아플경우

Please update us on the condition of the baby throughout delivery and post birth – especially if baby is not well- we want to know what is going on and planned at all times. 분만 시, 그리고 분만 이후에도 지속적으로 아이의 상태를 저희 부부에게 알려 주세요, 저희는 개인적으로 모든 사실 하나하나를 알면 더 편안히 느끼는 편입니다.

If baby is premature, allow baby to breastfeed only.
미숙아라도 모유 수유만하게 해 주세요.

Have unrestricted visitation for my partner and myself.
저희 부부는 언제든지 아기를 방문할 수 있도록 해 주세요.

I wish to be involved with and care for my baby if possible.
같이 care에 동참하게 허락해 주세요.

We request that an English-speaking pediatrician be on duty.
영어 가능한 소아과 선생님 상주 원함.

Vaccinations and screening 
예방접종 & 신생아대사이상검사에관하여
Vitamin K shot to be given as per routine protocol immediately post-birth.
분만 직후 비타민 K를 병원 규칙대로 저희 아이에게 접종해 주세요.

Don’t give any vaccinations directly after birth – postpone until one day before discharge: only Hep B.
간염 B 접종은 제가 퇴원하기 하루 전 쯤에 접종해 주세요. 비타민 K외에 다른 예방접종은 분만 직후에 바로 주고 싶지 않습니다.

Please carry out the full enzyme screening.
기본이 아닌 종합 신생아 대사이상 검사를 해 주세요.

Please give the baby vitamin K and Hep B shots. But please separate these shots by at least one day.
비타민 K 접종과 간염 B 접종을 해 주시되 같은 날이 아닌 하루 정도 사이를 띄우고 해 주세요.

C-Section 
If a C-section is necessary, my husband to be present the whole time.
만약의 경우 제왕절개를 해야 한다면 저의 남편이 죽 제 옆에 같이 있을 수 있도록 해 주세요.

I would prefer epidural anesthesia, if possible, in order to remain conscious through the C-section
가능한 한 epidural c-section 원함

No chest x-Ray and if an x-ray is absolutely necessary an apron should be worn.
x-ray를 하지 않기를 원합니다. 꼭 필요 시에는 앞치마로 가리고 해 주세요.

If possible, please do not strap my arms to the table during the procedure.*ask the anesthesiologist*
마취과 선생님께 말씀 드려서 수술준비시 제 팔을 수술대에 묶지 않도록 해 주세요.

If conditions permit, I would like to be the first to hold the baby after the delivery.
가능한한 아이가 태어나자마자 제게 안겨 주세요.

If possible, I would like to breastfeed the baby immediately after the birth.
분만 직후 아기에게 바로 수유하게 해 주세요.)

Will try to lower the screen just before delivery so I may see the birth of the baby.
아기가 태어나기 바로 직전에 제가 볼 수 있도록 스크린을 좀 밑으로 내려 주세요.

During surgery, we’d like to understand more about why the surgery might have been necessary i.e. malposition, short cord etc. Please let us know what you find, when you find it.
수술시 저희에게 왜 수술이 필수적이었는지의 이유를 발견하신다면 바로 알려 주세요.-예를 들어 아기 자세이상, 탯줄 비정상등

Thanks 
Thank you!
감사 드립니다!

Thank you very much for your help and understanding!
널리 이해해 주시고 도와주신 점, 진심으로 감사 드립니다!

We thank you warmly in advance for your support and kind attention to our choices. We look forward to a wonderful birth.
저희를 늘 도와 주시고 저희의 선택을 존중해 주심을 미리 감사 드리고 싶습니다. 멋진 분만을 기대해 보며 제 글을 마칩니다. 감사합니다.


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Tender Embrace Birthing offers childbirth, breastfeeding, and newborn care classes and support.



Sunday, 24 November 2013

Earthy Mama Angel Baby's Birth Plan

Introduction
Birth plans are very helpful and even more so if you're birthing in Korea where you may not speak the language and the culture may be very different. Here in Korea, the doctor is all-knowing and patients don't ask questions. The doctor is the expert and does whatever he or she sees fit. Sitting down with your doctor and having them read, sign, and stamp your birth plan will help you both.

Get at least two copies (one for you and one for your doctor) and have them in both English and Korean (get a friend to help or if all else fails use Google Translate). Bring it to the hospital with you. If necessary, when you're in labor you can point out (in Korean) what the doctor has agreed to when the nurse comes over and tries to do something that you don't want.

You might decide to change hospitals if your doctor doesn't agree most of your requests. Enemas, shaving, episiotomies, laboring on your back with IVs and epidurals are common here. As are C-sections, with the national average around 30%, which is similar to the USA.

Every hospital is different and even within hospitals, doctors have different ideas. If you're trying to avoid a C-section, knowing your doctor's C-section rate is important. Also ask about your hospital C-section rate since you might not always get your doctor for the birth.

Useful Links and Sample Birth Plans
Here's a list of hospitals and clinics that foreigners have gone to. Here's a list of doulas, breastfeeding counselors, and childbirth educators. Below you can find Earthy Mama Angel Baby's Birth Plan. I also have more sample birth plans on my birthing plans for Korea post. I don't deserve credit for any of them as I haven't written any of them. I've linked to them as well as copied and pasted them in the posts.

Earthy Mama Angel Baby's Birth Plan
This was taken from Earthy Mama Angel Baby

Personal Information 
Your Name
Partner's Name
Due Date Address
Email
My Doctor
Hospital

Before Labor Begins 
□ As long as the baby and I are healthy, I would like to go at least 10 to 14 days over my due date before inducing labor.
□ As long as the baby and I are healthy, I would like to have no time restrictions on the length of my pregnancy.
□ I would like to discuss laboring at home as long as possible.
□ I trust that my practitioner will seek out my opinion concerning all of the issues directly affecting my birth before deviating from my plan.
□ If NST observation becomes necessary after my due date, I am flexible and support this procedure.
□ I would like to discuss the option of induction before I reach my due date.
□ If I go past my due date and the baby and I are fine, I prefer to go into labor naturally rather than be induced.

Vaginal Exams 
□ Please obtain my permission before stripping my membranes during a vaginal exam. I prefer to have no vaginal exams until I go into labor.
□ I prefer to have only one vaginal exam on or around my due date.
□ During a vaginal exam, I prefer at no time to have my membranes broken unless there is an emergency situation.
□ I prefer minimal internal vaginal exams or at my request only.
□ I would like no internal vaginal exams, within reason, during my labor until I have an urge to push.

Hospital Admittance 
□ I would like the option of staying in the hospital regardless of my dilation and the discussion of induction.
□ If I am less than four centimeters dilated, I would like to discuss with my healthcare provider the option of going home.

Induction 
□ If induction becomes necessary, I would like to try natural induction techniques first (with the guidance of my practitioner)

Natural induction techniques I would like to try (check all that apply) 
□ Breast stimulation
□ Walking
□ Herbs
□ Enema
□ Castor oil
□ Chiropractic
□ Acupuncture
□ Sexual intercourse

If Medical induction becomes necessary, I prefer to try (check all that apply)
□ Stripping membranes
□ Prostaglandin gels
□ Pitocin
□ Rupturing membranes

If my water breaks before I go into labor, I would like to 
□ wait 6 hours before being induced
□ wait 12 hours before being induced
□ talk to my practitioner about alternatives to treatments such as antibiotics

Environment 
□ Upon arrival at the hospital, I prefer to have my partner with me at all times.
□ Please, no residents or students attending my birth.
□ I request the following people to be present during my labor and/or 2nd stage labor ____________________________________
□ Please do not allow the following people: _____________________

I prefer to give birth in a 
□ Birthing room
□ Room with a shower and/or bath
□ Delivery room 
□ At home

If birth equipment is available, I would like to use (check all that apply)
□ Birthing bed
□ Birthing ball
□ Bean bag chair
□ Birthing tub/pool/shower
□ Birthing stool
□ Squatting bar

Miscellaneous environment items (check all that apply) 
□ I would like to have dimmed lights.
□ I would like for people entering the room to speak softly.
□ I would like to play music.
□ I would like no one to speak during the actual delivery.
□ I would like to wear hospital clothing.
□ I would like to wear my own clothes during labor and delivery. I would like to be reminded to remove my clothing during the actual delivery.
□ I would like to have a TV available.
□ I would like to have a VCR available.
□ I would like to wear headsets during my labor and delivery.
□ I would like to have my birth photographed.
□ I would like to have my birth filmed/videotaped.
□ I would like to wear my glasses or contact lenses unless removal becomes medically necessary.

Pain Relief 
□ Please only offer pain medications if I ask for them.
□ Please suggest pain management options for me if you see that I am too uncomfortable to handle the pain.
□ Please discuss pain management options for me as soon as possible.
□ After medical guidance for pain relief, I would appreciate some private time with my partner to discuss which pain management technique or medication I would like to use.

I am prepared to try to handle pain with these natural and alternative methods (check all that apply) 
□ Breathing techniques
□ Distraction techniques
□ Hypnotherapy
□ Acupressure
□ Acupuncture
□ Massage
□ Visual imaging work
□ Color therapy
□ Deep (or guided) relaxation
□ Water/bath/shower

If I choose to use drugs, my preference is 
□ Walking epidural
□ Classic epidural
□ Sedative
□ Tranquilizer
□  arcotics

Other Considerations 
□ Ideally, I want to be able to walk around and move as I wish while in labor.
□ I would like to feel unrestricted in accessing any sounds of chanting, grunting, or moaning during labor.
□ Please always keep my door closed while I am in labor.

Monitoring 
□ I prefer the baby to be monitored.
□ Continuous fetal monitoring Intermittently monitored to allow for as much mobility as possible

I have prepared for this birth with 
□ Lamaze techniques
□ Bradley techniques
□ Childbirth Hypnosis
□ Other
□ I am seeking my practitioner's assistance with this technique.

Second Stage Labor 
□ As long as the baby and I are healthy, I prefer to have no time limits on pushing.
□ If pushing for more than several hours, I am open to medical intervention in 2nd stage labor.

I would like to be encouraged to try the following different positions for labor (check all that apply) 
□ Squatting
□ Classic semi-recline
□ Hands and knees
□ On the toilet
□ Standing upright
□ Side Lying
□ Whatever feels right at the time

Enemas 
□ I will ask for an enema if I feel that I need one.
□ I would like to have an enema upon being admitted.

Episiotomy 
□ I prefer to have an episiotomy
□ I prefer to have no episiotomy and risk tearing (unless I'm having a medical emergency)
□ If I need an episiotomy, I prefer a pressure episiotomy.

To help prevent tearing, please 
□ Apply hot compresses
□ Apply oil
□ Use perineal massage
□ Encourage me to breathe properly for slower crowning.

Other labor considerations 
□ If possible, please allow the shoulders and body of my baby to be born spontaneously, on their own.
□ Please use a local anesthetic for repairs.
□ No stirrups please unless I'm having a medical emergency

The Delivery Misc. (check all that apply)
□ I would like to view the birth using a mirror.
□ I would like to touch my baby's head as it crowns.
□ I would like to catch my baby and pull it onto my abdomen as it is born.
□ I would like my partner to catch my baby. I would like the doctor to catch my baby.
□ For spiritual or religious reasons, I would like the room to be totally silent as the baby is born.
□ I would like for our baby to hear our voices first.
□ I prefer to have the lights dimmed for delivery or, if it is daylight, to access only natural light.

Pushing 
□ It's important to me to push instinctively. I do not want to be told how or when to push. □ Please tell me when to push

After Baby is Born 
□ As long as my baby is healthy, I would like my baby placed immediately skin-to-skin on my abdomen with a warm blanket over it.
□ Please do not separate me and my baby until after my baby has successfully breastfed on both breasts.
□ Please delay all essential routine procedures on my baby until after the bonding and breastfeeding period (i.e., bathing).
□ Please place my baby on pulse oximetry after 24 hours of life to rule out any obvious heart conditions present at that time, as recommended by the federal government, American Academy of Pediatrics and American Heart Association.

Cesarean 
□ If a C-Section is not an emergency, please give my partner and me time alone to think about it before asking for our written consent.
□ My partner is to be present at all times during the c-section. Ideally, I would like to remain conscious during the procedure.
□ I would like the baby to be shown to me immediately after it's born.
□ I would like to have contact with the baby as soon as it is possible in the delivery room. I prefer to have a hand free to touch the baby.
□ We would like to photograph or film the operation as the baby comes out. We would like to film or photograph only the baby after delivery.
□ If possible, please discuss anesthesia options with me (including morphine options). I prefer a low transverse incision on my abdomen and uterus.
□ Please respect my wishes to be quiet during the operation (e.g., avoiding "small talk" with other practitioners in the room).

Recovery (check all that apply) 
□ If my baby is healthy, I would like to hold my baby and nurse it immediately in recovery.
I would like to sign any waivers necessary to permit me to be with my baby in recovery.
□ As long as my baby is healthy, I would like my partner to be the baby's constant source of attention until I am free to bond with it (i.e., holding, skin-to-skin contact, etc.).
□ I would like my baby to be sent to the nursery while I am in recovery.
Please pay special attention to our nursing needs in recovery.
□ I may need some extra help nursing after the operation.
□ I would like to have my catheter and IV removed ASAP after my recovery period.
□ Please discuss with me what I can expect to feel immediately following the procedure. □ Please discuss my post-operative pain medication options with me before or immediately following the procedure.

Third Stage Labor 
□ Please wait for the umbilical cord to stop pulsating before it is clamped.
□ Please allow my partner to cut the umbilical cord.
□ I would like to bank my baby's cord blood and have made arrangements for this procedure prior to the birth.

Placenta (check all that apply) 
□ I would prefer for the placenta to be born spontaneously without the use of pitocin, and/or controlled traction on the umbilical cord.
□ I would like to have routine pitocin given to me after the placenta is born.
□ I would like to delay routine pitocin after the placenta is born unless there are any signs of hemorrhaging. I would like the option of taking home the placenta.

Newborn Procedures 
□ If the baby has any problems, I would like my partner to be present with the baby at all times, if possible.
□ I would like to have routine newborn procedures delayed until bonding and breastfeeding have occurred.
□ I would like all newborn routine procedures to be performed in my presence.
□ I would like all newborn routine procedures to be performed right away.

Administration of Eye Drops 
□ I would like my baby to have eye drops administered immediately after birth.
□ I would like to delay the administration of eye drops until after breastfeeding and bonding has occurred.
□ Please do not administer eye drops to my baby, I am willing to sign a formal waiver if need be.

Vitamin K 
□ I would like my baby to receive a routine injection of vitamin K immediately after birth.
□ I would like to delay the administration of vitamin K up to 1 hour after birth, after breastfeeding and bonding, unless medically necessary.
□ I would like only the orally administered vitamin K to be given to my baby.
□ Please do not administer vitamin K to my baby, I am willing to sign a formal waiver if need be.

Immunizations 
□ I prefer any immunizations be postponed to a later time.
□ Immunize the baby according to normal procedures.

Bathing Baby 
□ Please bathe my baby after we have had time to bond.
□ Please do not bathe my baby at all.
□ We would like to give our baby his/her first bath using our own non-toxic baby products.

Circumcision 
□ Please do not circumcise my baby.
□ I would like my baby circumcised.

Other circumcision options 
□ Please use a local anesthetic.
□ Please delay procedure as long as possible

PKU 
□ Please do routine PKU Testing after 24 hours
□ We decline routine PKU testing at the hospital and have made other arrangements for this procedure at a later date this week.
□ We would like to wait, and delay the PKU testing until we are ready to leave the hospital

Feedings 
□ My baby is to be exclusively breastfed.
□ My baby is to be formula-fed exclusively.
□ I would like to combine breastfeeding and formula feeding.
□ Please offer guidance on the issue of formula versus breastfeeding.
□ I would like to see a lactation consultant as soon as possible for further recommendations and guidance.

Do not offer my baby the following without my consent (check all that apply) 
□ Formula Pacifiers
□ Any artificial nipples
□ Sugar water

If my baby's health is in jeopardy, I would like (check all that apply)
□ To be transported with my baby if possible.
□ My partner to go with the baby.
□ To breastfeed or express my milk for my baby.
□ To have as much bodily contact with my baby as possible.
□ To be offered a room at the hospital for the duration of my baby's stay (within reason).

I would like my in-hospital routine to be 
□ Full rooming in, no separation, no exceptions, unless my baby is sick.
□ Delayed rooming in until I have had time to rest.
□ Partial rooming in. I prefer to have the baby sent to the nursery at night so that I can rest.
□ Nursery care: I would like the nursery to fully care for my baby and bring it to me for feedings.

My Hospital Stay 
□ I prefer that my hospital stay be
□ As short as it can be.
□ As long as it can be.

Other hospital preferences 
□ I prefer a private room.
□ I prefer to have my partner stay with me for the duration of my hospital stay.
□   would like my other children (regardless of age) to be allowed to visit with me for as long as they wish or as long as hospital policy permits.
□ I would like my guests to be permitted to stay as long as they wish.
□  I want privacy during my stay and for my guests to limit the time they are visiting me.

Additional Notes


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Tender Embrace Birthing offers childbirth, breastfeeding, and newborn care classes and support.



Saturday, 23 November 2013

Birthing Miracles Birth Plan

Introduction
Birth plans are very helpful and even more so if you're birthing in Korea where you may not speak the language and the culture may be very different. Here in Korea, the doctor is all-knowing and patients don't ask questions. The doctor is the expert and does whatever he or she sees fit. Sitting down with your doctor and having them read, sign, and stamp your birth plan will help you both.

Get at least two copies (one for you and one for your doctor) and have them in both English and Korean (get a friend to help or if all else fails use Google Translate). Bring it to the hospital with you. If necessary, when you're in labor you can point out (in Korean) what the doctor has agreed to when the nurse comes over and tries to do something that you don't want.

You might decide to change hospitals if your doctor doesn't agree most of your requests. Enemas, shaving, episiotomies, laboring on your back with IVs and epidurals are common here. As are C-sections, with the national average around 30%, which is similar to the USA.

Every hospital is different and even within hospitals, doctors have different ideas. If you're trying to avoid a C-section, knowing your doctor's C-section rate is important. Also ask about your hospital C-section rate since you might not always get your doctor for the birth.

Useful Links and Sample Birth Plans
Here's a list of hospitals and clinics that foreigners have gone to. Here's a list of doulas, breastfeeding counselors, and childbirth educators. Below you can find the Birthing Miracles Birth Plan. I also have more sample birth plans on my birthing plans for Korea post. I don't deserve credit for any of them as I haven't written any of them. I've linked to them as well as copied and pasted them in the posts.

Birthing Miracles' Birth Plan
This was taken from EPK! and I think it downloaded from Birthing Miracles. If you'd like me to email it to you I can. My email is sharonkcouzens@gmail.com .

Personal Birth Plan
Your name: __________________________
E-mail Address: __________________________________________
Partner's name: ___________________________________
Due date: ___________________________________________
Name of obstetrician / midwife: ______________________
Other birth-support (doula, other family): ________________
Where do you want to give birth? Hospital (name of hospital) _______________________ Hospital Or Birth Center ____________________
□ Home birth
□ Not sure yet

Questions all parents should ask
What you can ask the doctor when you feel rushed…
Is this an emergency or do we have time to talk about this?
What are the benefits of doing this?
If we do this, what other procedures might we end up needing as a result?
What else could we try first, or instead?
What if we wait an hour or two before doing this?
What would happen if we don't do it at all?
May we have a few minutes alone to talk about it?

Labor & Birth Environment 
□ Dim Lights
□ Quiet Music
□ Aromatherapy Oils
□ Wear my own clothes
□ OK to have training medical staff observe labor & birth
□ Other ____________________________________________

Mobility during Labor 
□ I would like to keep active during labor if possible (walking, yoga b ll, etc.)
□ Mobility is not important to me

Relaxation and Comfort during Labor
□ Massage
□ Bath
□ Shower
□ Fit Ball
□ Bean Bag
□ Hot towels
□ Acupressure
□ Hypnotherapy
□ Other ____________________________________________

Do you want to use any special facilities? 
□ Birthing pool
□ Other ____________________________________________

Position(s) for Labor & Birth 
Underline preferred birth position
Walking
Standing
Squatting
Sitting
Kneeling
Lying down
Birth Stool
Other ____________________________________________

Fetal Monitoring 
□ Continuous monitoring (will mean limited mobility)
□ Intermittent monitoring
□ No monitoring - except in emergency situations

Vaginal / Cervix Examinations 
□ I would like minimal examinations
□ I am happy for examinations as deemed necessary by medical staff
□ No monitoring - except in emergency situations Pain Relief
□ Do not offer; I will ask if I want pain relief
□ Offer if I appear uncomfortable
□ Offer as soon as possible

Medical Pain Relief Options 
□ I would like to try to manage without medical pain relief options
□ Gas / Air
□ Epidural
□ Other ____________________________________________

Rupturing of the amniotic sac 
I prefer my amniotic sac be allowed to rupture on its own

Episiotomy 
I do not want an episiotomy unless there is an emergency situation

Delivery 
□ I would like to touch baby's head when it crowns
□ I would like a mirror available to view pushing/crowning/birth

Immediately following delivery 
□ I want baby placed on my chest immediately after birth
□ Please delay cord clamping and cutting until pulsating ceases
□ I would like my birth-partner to cut the cord
□ I would like to cut the cord
□ Birth-partner does not want to cut cord
□ I would like to hold the baby while the placenta is delivered
□ I do not want an injection to assist with placenta delivery
□ I would like the baby to be examined in my presence
□ If the baby cannot be examined in my presence, I would like my birth-partner to remain with the baby at all times
□ I want to donate cord blood to the public cord blood bank (if service is available)
□ I want to bank cord blood privately

Assisted Delivery
If additional medical assistance is required for the birth, I would prefer options to be discussed.

Caesarean 
In the event that a cesarean section is deemed necessary, I would like the following: Birth-partner present
Other support present ______________________________________
Photos / video
Screen lowered at delivery I would like the procedure described as it is happening Anything else _________________________________________________

Baby Care 
□ Feeding Baby
□ I wish to breastfeed exclusively
□ I wish to breastfeed, but formula supplementation is acceptable
□ I wish to formula feed
□ I do not want baby to be given a pacifier
□ I would like to meet with a lactation consultant

Vitamin K 
□ I would like my baby to have the single injection of Vitamin K
□ I would like my baby to have oral Vitamin K
□ I do not want my baby to have Vitamin K

Hepatitis B 
I would like my baby to be vaccinated with Hepatitis B vaccine before discharge
I would not like my baby to be vaccinated with Hepatitis B vaccine before discharge

Any Special Dietary Requirements for the new mum ___________________________________________________________ ___________________________________________________________

Any other special needs for new Mum and/or birth-partner (language, religion, disability, etc) ___________________________________________________________ ___________________________________________________________

Length of stay in hospital 
□ I would like to have as short a stay as possible in hospital
□ I would like to stay in hospital for 1-2 days after the birth
□ I would like to stay in hospital for more than 2 days after the birth In the event that baby requires special care due to trauma or illness
□ I would like to breastfeed/pump breast milk
□ Birth-partner will accompany baby if transferred to another hospital
□ I would like to be transferred to baby's hospital

Your Signature _________________________________ Date _________
Healthcare Provider's Name _____________________________________
Healthcare Provider's Signature ____________________ Date _________


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Tender Embrace Birthing offers childbirth, breastfeeding, and newborn care classes and support.


Friday, 22 November 2013

A Shorter Birth Plan for Korea

Introduction
Birth plans are very helpful and even more so if you're birthing in Korea where you may not speak the language and the culture may be very different. Here in Korea, the doctor is all-knowing and patients don't ask questions. The doctor is the expert and does whatever he or she sees fit. Sitting down with your doctor and having them read, sign, and stamp your birth plan will help you both.

Get at least two copies (one for you and one for your doctor) and have them in both English and Korean (get a friend to help or if all else fails use Google Translate). Bring it to the hospital with you. If necessary, when you're in labor you can point out (in Korean) what the doctor has agreed to when the nurse comes over and tries to do something that you don't want.

You might decide to change hospitals if your doctor doesn't agree most of your requests. Enemas, shaving, episiotomies, laboring on your back with IVs and epidurals are common here. As are C-sections, with the national average around 30%, which is similar to the USA.

Every hospital is different and even within hospitals, doctors have different ideas. If you're trying to avoid a C-section, knowing your doctor's C-section rate is important. Also ask about your hospital C-section rate since you might not always get your doctor for the birth.

Useful Links and Sample Birth Plans
Here's a list of hospitals and clinics that foreigners have gone to. Here's a list of doulas, breastfeeding counselors, and childbirth educators. Below you can find A Shorter Birth Plan. I also have more sample birth plans on my birthing plans for Korea post. I don't deserve credit for any of them as I haven't written any of them. I've linked to them as well as copied and pasted them in the posts.

A Shorter Birth Plan
This was taken from AFIK. This was in a chart format. If you'd like me to email it to you I can. My email is sharonkcouzens@gmail.com .

Birthing
저의 남편 제 분만 전 과정 동안 함께 할 수 있도록 해 주시기 바랍니다.
Husband to be present throughout labour and delivery.

국문 , 영문 출생 증명서를 원하는 대로 발급해 주세요.
Several copies of Korean and English birth certificate to be given.

제 방에 들어 오시기전에 항상 노크를 부탁드립니다.
To preserve my privacy and dignity, I would prefer that everyone knock before entering.

분만실 조명은 조도 조절 가능하게 해 주세요-너무 밝지 않게 I would prefer the lights to be dimmed 분만 실에 꼭 필요한 분이 아닌 인턴이나 실습생, 특히 남자분들을 들여 보내지 말아 주세요.
No males, students or non-essential personnel to be in the room.

저희 남편 아마르가 분만 전 과정에 항상 참여할 수 있도록 허락해 주세요.
My husband must be allowed at all times for any procedure, please.

저희는 IV 보다는 Heparin lock을 원합니다. 꼭 필요한 경우가 아니라면 4cm 전에는 관장을 하지 말아 주세요. 꼭 필요한 경우가 아니라면 catheter를 하지 말아 주세요. 면도는 하지 말아 주세요.
Not to have an IV fluid line, although a Heparin lock is acceptable. No enema unless requested until 4 cm dilated. No catheter unless requested. No shaving of pubic area.

꼭 필요한 상황이 아니면 양수를 인위적으로 터트리지 말아 주세요. 분만 과정 중 아기의 건강이 염려되는 필요한 경우가 아니라면 어떠한Augmentation, Pitocin주입이나 양수 터트리기 혹은 회음부 stripping자극등을 하지 말아 주세요
I wish to avoid having my membranes ruptured unless medically indicated or discussed with us. Please, no augmentation of labour, no pitocin, amniotomy, or stripping of the membrane unless deemed necessary for the babies health.

모니터링은 매 시간 첫 20분간만 해서 제가 분만 각 시기 동안 몸을 움직일수 있게 해 주세요.
EFM only for first 20 minutes of every hour to enable mother to have mobility during each phase of labor.

경막외 마취 무통 분만(에피듀럴)을 제게 시술 부탁 드립니다. 제가 원할 경우 샤워를 하게 해 주세요.분만 공, 핫팩, 마사지 등을 사용하겠습니다
I intend to have pain relief with epidural anesthesia. We would like to use of a shower, if desired for pain relief. We would like to use a birth ball, cold/hot therapy, massage for pain relief.

의학적인 처치나 작업을 하시기 전에 미리 저희에게 왜 이것이 필요한 지를 말씀하고 설명해 주시면 감사하겠습니다.
Before doing any procedure, please let us know and explain to us why it is necessary.

꼭 필요하거니 제가 원할 때에만 내진을 해 주세요.
To avoid internal vaginal examinations unless they are medically necessary or I request them.

분만 과정 동안 가능한 한 움직일 수 있고 자세를 바꿀 수 있도록 도와주세요.
To be allowed to move around as much as possible and assume labour positions of choice (squatting, on all fours, lying on my side).

제가 요구가 많더라도 노여워 마시고 들어주시고 이해해 주시길 부탁드립니다.
 Allow me to vocalize as desired during labour and birth without comment or criticism

아기와 제가 괜찮다면 힘주기때 너무 급하게 재촉하지 말아 주세요.
To be allowed to rest and wait if I do not have the urge to push straight away, if the baby and I are fine.

힘주기때 제가 스스로 알아서 할 수 있도록 너무 코치를 하지 말아 주세요.
To push instinctively rather than be coached or told when to push.

의학적인 응급 상황이 아니라면 인위적으로 배를 누르며 힘주기를 도와주는 작업을 하지 말아 주세요.
No one put their hands on my abdomen to “push the baby down” unless it is a medical emergency.

Perineum이 제 역할을 잘 할 수 있도록 따뜻한 마사지나 지압을 좀 해 주시고 아기 머리가 너무 빨리 나오는 것을 방지하도록 아기 머리를 부드럽게 눌러 주세요.
Measures taken to try and ensure an intact perineum (warm compress, massage with lubricant, gentle pressure on baby’s head to stop it coming too quickly

분만시 조용한 분위기를 유지해 주세요.
Voices to be soft within room.

아기가 태어나자마자 제 가슴에 올려 주세요.
Please place the baby immediately upon the mother’s abdomen.

탯줄이 스스로 pulsating이 멈출 때까지 자르지 말아 주세요.
To wait until the umbilical cord stops pulsating before it is clamped and cut.

남편이 탯줄을 자를 수 있게 해 주세요.
Umbilical cord is to be cut by the husband.

태반이 자연적으로 잘 배출될 수 있도록 아기가 바로 젖을 빨 수 있도록 해 주세요. 가능한 한 태반을 억지로 당겨 내거나, 피토신을 사용하거나 자궁 마사지를 하지 않도록 해 주세요. Please allow the baby to be breast feed immediately to assist with the natural delivery of the placenta. Please no pulling, pitocin, or uterine massage unless deemed necessary.

스티치(봉합)를 하기 전에 제가 아기에게 먼저 수유할 수 있도록 해 주세요.
To wait until after I have fed my baby before having stitches, if possible.

아기가 항상 저희와 같이 있을 수 있도록 해 주세요.
The newborn is to stay with parents at all times, please.

아기를 위한 모든 검사나 과정은 항상 저희 중 한 사람이 있을 때 꼭 해주세요.
Please perform all physical exams and procedures with one parent present at all times.

아기에게 젖병이나 고무 젖꼭지, 분유, 글루코스나 물을 주지 마시고 꼭 모유수유만 하게 해 주세요.
Breast feeding only, please no bottles, artificial nipples, formula, glucose, or water.

만약 아기가 탈수 증세가 있을 경우 저희에게 먼저 말씀을 해 주신다음 글루코스나 물을 젖병이 아닌 스푼을 통해 먹여 주세요.
If the baby is dehydrated, please ask our permission before giving any glucose or water, and please use a spoon rather than bottle.

꼭 필요한 경우가 아니라면 회진시 산모와 아기가 잘 경우 깨우지 말아 주세요.
Please don’t wake mother or baby for routine vitals and check-ups unless immediately medically necessary.

분만 직후 아기를 바로 목욕시키지 말아 주세요. 아기 머리나 얼굴 부분에 있는 묻어있는 피나 양수, 분비물 등만 부드럽게 닦아 주세요. 태지는 제발 제거하지 마시고 놔둬 주세요. Please don’t bath the baby immediately post-birth – excess blood, material and fluids can be gently removed from the face and head area mainly. Do not remove excess vernix.

분만 그 다음날 아기의 아빠가 아기의 첫 목욕을 사진 혹은 비디오로 찍을 수 있도록 해 주세요.
We request that the first bath to be given – father to be present and video tape/photograph this.This can occur 1 day after birth


예방접종 & 신생아대사이상검사에관하여 
Vaccinations and screening 

간염 B 접종은 제가 퇴원하기 하루 전 쯤에 접종해 주세요. 비타민 K외에 다른 예방접종은 분만 직후에 바로 주고 싶지 않습니다. 분만 직후 비타민 K를 병원 규칙대로 저희 아이에게 접종해 주세요.
Vitamin K shot to be given as per routine protocol immediately post-birth. Don’t give any vaccinations directly after birth – postpone until one day before discharge: only Hep B.

C-Section

만약의 경우 제왕절개를 해야 한다면 저의 남편이 죽 제 옆에 같이 있을 수 있도록 해 주세요. 가능한 한 epidural c-section 원함.
If a C-section is necessary, my husband to be present the whole time. I would prefer epidural anesthesia, if possible, in order to remain conscious through the C-section.

마취과 선생님께 말씀 드려서 수술준비시 제 팔을 수술대에 묶지 않도록 해 주세요 If possible, please do not strap my arms to the table during the procedure.-ask the anesthesiologist.

가능한한 아이가 태어나자마자 제게 안겨 주세요.
 If conditions permit, I would like to be the first to hold the baby after the delivery.

분만 직후 아기에게 바로 수유하게 해 주세요.
If possible, I would like to breastfeed the baby immediately after the birth.

저희는 닥터 ___________ 선생님의 __________________병원에서 저희 아이를 낳기로 결정했습니다. 선생님의 저의 분만에 대한 의견에의 존중과 저희 아이에 대한 탁월한 보살핌과 염려가 이 아름다운 분만의 여정에서 가장 중요하다고 믿었기에 여기 (성 바오로 병원에 = St. Paul's Hospital 오게 되었습니다. 저희는 가장 기억에 남고 행복한 분만을 맞이하기 위한 소망으로 심사숙고하며여러 전문가들과 이야기를 나누고 연구한 끝에 아래 저희의 바램과 부탁을 기술한 분만 플랜을 만들었습니다. 이러한 저희의 소망을 이루는 데 있어 여러분께서 도움을 주신다면 저희는 진심으로 감사를 드리겠습니다. 비록 저희 분만 계획서에서 요청되었다 할 지라도 만의 하나 어렵거나 위급한 상황이 닥칠 시에 저희는 저희 담당 선생님과 함께 의논한 후에 그 결정에 따르도록 할 테니 너무 걱정은 안 하셔도 됩니다. 저희 분만 플랜은 다음과 같습니다.저희를 늘 도와 주시고 저희의 선택을 존중해 주심을 미리 감사 드리고 싶습니다. 멋진 분만을 기대해 보며 제 글을 마칩니다. 감사합니다.

This basically says (at least that's what I understand from Google Translate) that they've chosen this hospital due to the excellent care and concern they believe that they'll get. It's a very memorable time. They've consulted many experts about birthing and have drawn up this birth plan. We want to work together. We'd really like to follow our birth plan unless there's an emergency. We'd like to thank you in advance for respecting our choices. We look forward to having a great labor. Thank you.


Signature:

Doctor                                                       Date
______________________________                 ____________________________


Head Nurse                                                Date
______________________________                 ____________________________


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Tender Embrace Birthing offers childbirth, breastfeeding, and newborn care classes and support.



Thursday, 21 November 2013

A Completely Hands Off Birth Plan for the 121 (American military hospital in Yongsan, Korea)

Introduction
Birth plans are very helpful and even more so if you're birthing in Korea where you may not speak the language and the culture may be very different. Here in Korea, the doctor is all-knowing and patients don't ask questions. The doctor is the expert and does whatever he or she sees fit. Sitting down with your doctor and having them read, sign, and stamp your birth plan will help you both.

Get at least two copies (one for you and one for your doctor) and have them in both English and Korean (get a friend to help or if all else fails use Google Translate). Bring it to the hospital with you. If necessary, when you're in labor you can point out (in Korean) what the doctor has agreed to when the nurse comes over and tries to do something that you don't want.

You might decide to change hospitals if your doctor doesn't agree most of your requests. Enemas, shaving, episiotomies, laboring on your back with IVs and epidurals are common here. As are C-sections, with the national average around 30%, which is similar to the USA.

Every hospital is different and even within hospitals, doctors have different ideas. If you're trying to avoid a C-section, knowing your doctor's C-section rate is important. Also ask about your hospital C-section rate since you might not always get your doctor for the birth.

Useful Links and Sample Birth Plans
Here's a list of hospitals and clinics that foreigners have gone to. Here's a list of doulas, breastfeeding counselors, and childbirth educators. Below you can find A Completely Hands Off (for the 121) Birth Plan. I also have more sample birth plans on my birthing plans for Korea post. I don't deserve credit for any of them as I haven't written any of them. I've linked to them as well as copied and pasted them in the posts.

A Completely Hands Off Birth Plan for the 121 (American military hospital at Yongsan)
This was taken from Facebook.

Parents:
Guess Date:

Pre Labor: 
• Attendants will be: husband, doulas, and children.
• Please, no vaginal checks. (This is to decrease risk of infection, premature rupture of waters and unconsented membrane stripping.)

 Labor Stage 1
• Attendants will be present with mother at all times, through all stages of labor.
• My goal is to labor outside of the hospital as long as possible and request to be sent home if labor is not progressing quickly.
• Please allow me to use my birthing ball and I would request showers for pain relief.
• No IV or Hep Lock will be consented too.
• Please, no internal monitoring at all. o If you feel fetal heart monitoring is necessary please use a Doppler. (External monitoring will be allowed intermittently and if medically necessary.)
• No vaginal exams, for the reasons stated above.
• No pitocin or otherlabor inducing drugs.
• No epidural.
• Please do no try to restrict my food or drink intake.
• No premature breaking of waters, or membrane stripping. This will not be consented too, and may be considered assault.
• Please, no movement limitations. I change positions very often in labor.
• No stir-ups will be needed.
• No hospital gowns, please. I will bring my own.
• Lights off or dimmed. Please allow me to have a quiet, dark environment for my birth.
• Please no extra staff.
• Please allow me to decide when to push. Please do not yell at me or count while I am pushing. And please do not put time restrictions on pushing.

Labor 2nd Stage 
• No episiotomy will be consented to. (Massage with oil brought from home and a warm wash cloth will be fine.)
• Please do not use forceps.
• If you can see that it is a nuchal cord I request that you leave him or if you are well versed in the somersault technique you may try that, you may not pull, tug or try to unwrap the cord.
• If he is born with a nuchal cord, this is not a cause to cut the cord, so please do not.
• Please do not put a time limit on my delivery.

After Birth 
• No pitocin, uterine massage, or cord pulling to deliver placenta
• Please place baby immediately on my chest. o This is for skin to skin contact and it's known benefits as well as to help initiate breast feeding.
• Do not cut the cord, we will be leaving the cord intact until it stops pulsating. We feel this is the easiest and healthiest way to help our baby transition into the world and request you respect our decision.
• Do not bathe our baby, do not wipe the baby down, do not towel off the baby. We would like to leave the vernix on the baby. This is to help with temperature regulation, to protect against infection and to help the baby regulate his skin PH. Thank you for respecting our decision.
• If tearing happens and stitching is needed, please use a local anesthetic.
• Our baby will stay with parents at all times. No nursery visits.
• We request that you delay all routine exams for a minimum of 1 hour to allow for family bonding.
• Please perform all exams in the room with parents present.
• Do not give our baby any shots. We choose not to vaccinate and therefore do not consent to the Hep B shot, Vit. K shot or antibiotic ointment eye jelly.
• We will be exclusively breast feeding. Please do not give baby, bottles, pacifiers, artificial nipples, formula or water. Please do not suggest nipple shields.
• Please expedite our discharge as soon as possible. As long as there are no complications we would like to leave within 24 hours. This will help us start to settle quickly and will help you by providing more room.

I understand this plan may be inconvenient for you and your staff. Please be assured that we have researched everything in great detail. Know that I have birthed two other healthy babies and am very familiar and comfortable with my own birth process. Please respect our wishes, even if they are against your hospital policies, these are the decisions we have made, and we know our Patients Bill of Rights. Please know that we will be forced to consider any unconsented interventions an assault on mother and baby. Thank you for taking the time to read our wishes, and for respecting our decisions as parents.


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Tender Embrace Birthing offers childbirth, breastfeeding, and newborn care classes and support.



Wednesday, 20 November 2013

Mama Seoul's Birth Plan for Korea

Introduction
Birth plans are very helpful and even more so if you're birthing in Korea where you may not speak the language and the culture may be very different. Here in Korea, the doctor is all-knowing and patients don't ask questions. The doctor is the expert and does whatever he or she sees fit. Sitting down with your doctor and having them read, sign, and stamp your birth plan will help you both.

Get at least two copies (one for you and one for your doctor) and have them in both English and Korean (get a friend to help or if all else fails use Google Translate). Bring it to the hospital with you. If necessary, when you're in labor you can point out (in Korean) what the doctor has agreed to when the nurse comes over and tries to do something that you don't want.

You might decide to change hospitals if your doctor doesn't agree most of your requests. Enemas, shaving, episiotomies, laboring on your back with IVs and epidurals are common here. As are C-sections, with the national average around 30%, which is similar to the USA.

Every hospital is different and even within hospitals, doctors have different ideas. If you're trying to avoid a C-section, knowing your doctor's C-section rate is important. Also ask about your hospital C-section rate since you might not always get your doctor for the birth.

Useful Links and Sample Birth Plans
Here's a list of hospitals and clinics that foreigners have gone to. Here's a list of doulas, breastfeeding counselors, and childbirth educators. Below you can find Mama Seoul's Birth Plan. I also have more sample birth plans on my birthing plans for Korea post. I don't deserve credit for any of them as I haven't written any of them. I've linked to them as well as copied and pasted them in the posts.

Mama Seoul's Birth Plan
This was taken from Cairo Mama's blog.

This is L's actual birth plan so you may have some differences, but this should get you started if you are planning to give birth at a Korean hospital. I do not read Korean and did not write this (just cut and pasted), so please double check this before you use it.

BIRTH PLAN FOR THE ~ FAMILY 
~ 패밀리를 위한 분만 계획서

I prefer a natural, vaginal birth. Please help me achieve this in the following ways.
저는 가능한 한 자연 분만을 원합니다. 아래에 적힌 내용을 참조해 주세요.

1st stage of labour (분만 1기) I prefer . . .
1. No males, students or non-essential personnel to be in the room.
분만실에 꼭 필요한 분이 아닌 인턴이나 실습생, 특히 남자분들을 들여 보내지 말아 주세요.

2. To avoid internal vaginal examinations unless they are medically necessary or I request them.
꼭 필요하거니 제가 원할 때에만 내진을 해 주세요.

3. To avoid having my membranes ruptured unless medically indicated or discussed with us.
꼭 필요한 상황이 아니면 양수를 인위적으로 터트리지 말아 주세요.

4. To manage my pain on my own. Please do not offer drugs for pain relief. I will ask for it if I need it.
진통 경감을 위한 약을 쓰지 말아 주세요. 필요 시엔 제가 말씀 드리겠습니다.

5. If the baby and I are fine, to be free of time limits.
저와 아기만 건강하다면 너무 진통 시간에 연연하지 말아 주세요.

2nd stage of labour (분만 2기) I prefer . . .
1. Not to lie on my back.
똑바로 눕지 않게 해 주세요.

2. To adopt whatever position feels right for me at that time (for example, squatting, side lying, on all fours.
진통 중 가능한 한 제가 마음대로 자세를 바꿀 수 있게 해 주세요.

3. To be allowed to rest and wait if I do not have the urge to push straight away, if the baby and I are fine.
아기와 제가 괜찮다면 힘주기때 너무 급하게 재촉하지 말아 주세요.

4. To push instinctively rather than be coached or told when to push.
힘주기때 제가 스스로 알아서 할 수 있도록 너무 코치를 하지 말아 주세요.

5. Measures taken to try and ensure an intact perineum. (warm compress, massage with lubricant, gentle pressure on baby’s head to stop it coming too quickly)
perineum이 제 역할을 잘 할 수 있도록 따뜻한 마사지나 지압을 좀 해 주시고 아기 머리가 너무 빨리 나오는 것을 방지하도록 아기 머리를 부드럽게 눌러 주세요.

6. To risk a tear rather than have an episiotomy (unless a medical emergency).
위급한 상황이 아니라면 회음부 절개보다는 자연적인 tearing을 원합니다.

After birth (분만 이후) I prefer . . .
1. To wait until the umbilical cord stops pulsating before it is clamped and cut.
탯줄이 스스로 pulsating이 멈출 때까지 자르지 말아 주세요.

2. Skin to skin contact with my baby.
아기와 제가 스킨십을 바로 할 수 있도록 해 주세요.

3. Not to have my baby’s nose and mouth suctioned unless it is medically necessary.
응급상황이 아니라면 아기의 코와 입에 suction을 하지 말아 주세요.

4. Time to allow the placenta to deliver spontaneously.
(태반이 자연적으로 배출되도록 기다려 주세요.

5. To avoid injection to help control bleeding and deliver the placenta, unless medically necessary.
의학적으로 꼭 필요한 경우가 아니라면 지혈이나 태반출산을 돕는 주사나 약물을 사용하지 말아 주세요.

6. To delay newborn procedures (weighing and measuring, etc) until I have had time to breastfeed my baby.
제가 충분히 아기에게 수유를 한 후에 아기 체중 측정이나 키 측정 같은 신생아 관리를 스케줄대로 해 주세요.

7. To wait until after I have fed my baby before having stitches, if possible.
스티치(봉합)를 하기 전에 제가 아기에게 먼저 수유할 수 있도록 해 주세요.

In case of a C-section (만약 제왕 절개가 필요시) I prefer . . .
1. Regional anesthesia (epidural or spinal block) if possible.
전신 마취가 아닌 경막외 마취를 해 주세요.

2. To avoid a chest X-ray.
X-ray는 찍지 말아 주세요.

3. If a chest X-ray is necessary, please cover my baby with a lead apron.
꼭 X-ray가 필요시엔 앞치마나 천으로 제 배를 가려 주세요.

4. To hold my baby after the C-section, if possible.
가능하면 수술뒤 바로 아기를 제게 안겨 주세요.

5. To delay newborn procedures (weighing and measuring, etc) until I have had time to breastfeed my baby, if possible.
제가 충분히 아기에게 수유를 한 후에 아기 체중 측정이나 키 측정 같은 신생아 관리를 스케줄대로 해 주세요.

Other breastfeeding support (모유 수유시)
1. I would like a lactation consultant to check the progress of breastfeeding my baby during the days after birth.
분만후 모유 수유 전문가가 일정한 시간마다 저를 방문해서 모유수유를 도와 주시기를 바랍니다.

2. Please provide a breast pump, if needed.
유축기가 필요 시엔 좀 준비해 주세요.

Infant vaccination (신생아 예방접종)
1. Please vaccinate our baby against Hepatitis B.
간염 B 예방 접종을 해 주세요.

Thank you!
감사 드립니다!


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Tender Embrace Birthing offers childbirth, breastfeeding, and newborn care classes and support.



Tuesday, 19 November 2013

Birth Plans for Korea

Updated 19 February 2016

Birth plans are very helpful and even more so if you're birthing in Korea where you may not speak the language and the culture may be very different. Here in Korea, the doctor is all-knowing and patients don't ask questions. The doctor is the expert and does whatever he or she sees fit. Sitting down with your doctor and having them read, sign, and stamp your birth plan will help you both.

Get at least two copies (one for you and one for your doctor) and have them in both English and Korean (get a friend to help or if all else fails use Google Translate). Bring it to the hospital with you. If necessary, when you're in labor you can point out (in Korean) what the doctor has agreed to when the nurse comes over and tries to do something that you don't want.

Do Your Research
You might decide to change hospitals if your doctor doesn't agree most of your requests. Enemas, shaving, episiotomies, laboring on your back with IVs and epidurals are common here. As are C-sections, with the national average around 30%, which is similar to the USA.

Every hospital is different and even within hospitals, doctors have different ideas. If you're trying to avoid a C-section, knowing your doctor's C-section rate is important. Also ask about your hospital C-section rate since you might not always get your doctor for the birth.

Useful Links and Sample Birth Plans
Here's a list of hospitals and clinics that foreigners have gone to. Here's a list of doulas, breastfeeding counselors, and childbirth educators.

Here are the birth plans that I've found. Most of them are specifically for Korea. Two of them: Birthing Miracles and Earthy Mama Angel Baby aren't for Korea, but they bring up a lot of options so I've decided to include them. I don't deserve credit for any of them as I haven't written any of them. I've linked to them as well as copied and pasted them in the posts.


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Tender Embrace Birthing offers childbirth, breastfeeding, and newborn care classes and support.



Wednesday, 30 October 2013

Types of Birth Control Available in Korea

Updated 21 September 2016

There really are a lot of birth control options available here in Korea. If you're looking to breastfeed, you have to be careful about estrogen that is in some birth control pills. The mini pill isn't available here, but there are pills with low amounts of estrogen. Most lactation consultants advise waiting at least 8 weeks after giving birth (though 12 weeks is ideal) to start taking birth control pills with estrogen. The reason for this is that it can affect your milk supply.

If you are trying to breastfeed remember that there is a lot of English speaking help available out there here in Korea. Here's a list of birthing professionals in Korea who can help you.

Birth Control Options Available in Korea
Here are what people use as birth control (preventing getting pregnant and/or terminating an early pregnancy) methods here in Korea. Many women recommend the book, Taking Charge of Your Fertility (TCOYF) by Toni Weschler. Whether you think these options are right or wrong is up to you, I'm just letting you know what options are out there.

Some of these methods are more effective than others, so please do your research accordingly! Perfect-use failure rate is very different than typical-use failure rate. Some are permanent, others are not. Some need to be done daily, others months, others yearly. Some will require a visit to a doctor or pharmacy, others can be done on your own. Here are some hospitals and clinics in Korea.

Medical and Barrier Methods
  • Abortion
  • Cervical caps
  • Condoms, male
  • Diaphragms
  • Implants (such as Implanon or Jadelle)
  • Injections (such as Depro)
  • IUD, Cooper 
  • IUD, Hormonal (such as Mirena or Skylar)
  • NuvaRing
  • Patch
  • Pill, birth control (피임약) Here's a list of what's available in Korea. You can buy birth control in bulk so many women just stock up here. In addition to the ones listed on the link you can now also find Alesse (에이리스), Meliane (멜리안), Minivlar (미니버러), and Qlaira. Birth control pills are usually 6,000-10,000 won and many are available over-the-counter. Yaz and Yasmin are not available over the counter and require a prescription. They cost about 30,000.
  • Pill, morning after 
  • Tubal ligation
  • Vasectomy

Natural Family Planning Methods 
  • Apps for smartphones (SheKnows and ABC News have lists of good ones)
  • Breastfeeding (Lactation Amenorrhea Method (LAM) and Ecological Breastfeeding)
  • Calendar Methods (Rhythm Method and Standard Days Method)
  • Fertility Monitoring (such as Baby-Comp, Clearblue (Easy) Fertility Monitor, Lady-Comp, Marquette Method, OvaCue, OvaGraph, Ovulation Prediction Kits (OPK), Persona, and Sympto-Thermal )
  • Mucus Methods (Billings, Creighton, and TwoDay Methods)
  • Salivia Ovulation Predictor Tests (such as Fertile-Focus*)
  • Sympto-Thermal Method (Combines mucus and temperature methods. See NFP and the Couple to Couple League for more info)
  • Temperature (Woman takes her BBT (basal body temperature) daily and charts the results)
  • Withdrawal method
Sources: Mothering and Wikipedia.


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Tender Embrace Birthing offers childbirth, breastfeeding, and newborn care classes and support.


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