EDITOR’S NOTE: Physicians, providers, and administrative staff who practice at Maui Health hospitals and clinics answer questions from the public in Healthwise Maui, which appears in The Maui News. Maui Health operates Maui Memorial Medical Center, Maui Memorial Medical Center Outpatient Clinic, Kula Hospital & Clinic and Lana’i Community Hospital and accepts all patients. To submit a question, go to the website at mauihealth.org/healthwise.

Q: What should I include in my birth plan?

Dr. Tiffinie Mercado, Maui Memorial Medical Center Chief of Medical Staff and Ob-Gyn, Kaiser Permanente: Creating a written birth plan helps get everyone on your care team on the same page. You’ll spend less time trying to navigate key decisions, reducing stress and anxiety on the day you give birth. That way, you can focus more on taking care of yourself and your baby. Your plan should cover your preferences and what you would like to happen during labor and delivery. Think about:

• Who you want to be with you

• What kind of pain management you prefer, such as natural approaches or medical options, and whether you want to make those choices step by step

• What kind of coaching you want from your care team

• What you want to happen in the moments after birth, such as skin-to-skin contact, delayed cord clamping, a prayer, or other religious or cultural practices

• How you want to navigate breastfeeding your baby

• Where you want your baby to stay while you recover — this may depend on how your labor goes and the time of day; remember, it’s okay to use the nursery so you can rest and recover after an emotional and physically demanding experience

• How soon you would like to see visitors and who you want to see first; this can include cultural and traditional practices around welcoming a newborn

Even with a great birth plan, sometimes labor doesn’t go the way you or your doctor expects. Your plan should include backup situations and your preferences — for example, think about your preferences if labor needs to be induced or if a C-section becomes necessary. Know that your labor and delivery team wants to do everything they can to make sure you have a safe birth and a healthy baby while also accommodating your preferences.

Share your birth plan with your doctor and/or certified nurse-midwife at least a month or two before your due date, so they understand your goals and can go over any questions or concerns. It’s also important to share your plan with your partner or support person, so they can help advocate for you while you’re in labor. Taking a tour of our birthing center can help you prepare for your delivery on Maui so you know what to expect and get any questions answered. Call 808-242-2352 to book a tour at Maui Memorial Medical Center or visit mauihealth.org/maternity.

Q: Do you have any tips for sleeping better after hip replacement surgery?

Dr. Vic Ayers, Orthopedic Surgeon, Pacific Permanente Group: It’s not unusual to have trouble sleeping after a total hip replacement. Pain, discomfort, and concern about protecting your new joint can all make it harder to rest. The good news is that with anterior hip replacement, there are no strict restrictions on sleep position after surgery. You can lie on your back, on either side, or even on your stomach — whatever feels most comfortable to you.

Many patients still find it helpful to use pillows for added support. For example, placing a pillow between your knees or under your legs can help keep your hips comfortable and reduce strain. You can also use pillows to cushion your body and create a position that feels stable and secure throughout the night.

Pain can also affect sleep, especially in the early days after surgery. Be sure to follow your surgeon’s instructions and take pain medication as prescribed. Some patients find it helpful to time their medication so it begins working as they settle in for the night. Keeping ice packs nearby can also help if discomfort wakes you up.

Practicing good sleep habits can make a difference as well. Try to avoid caffeine later in the day, limit screen time before bed, and keep your sleeping environment quiet and dark.

Sleep is an important part of healing. By finding positions that feel comfortable and using simple strategies to manage discomfort, you can give your body the rest it needs as you recover.

Maui Health’s orthopedic services offer exceptional orthopedic care with access to a large team of specialists, including board-certified surgeons and clinical staff. Our orthopedic surgeons are experienced in performing hip replacement surgery, as well as many other orthopedic procedures and treatments. Visit mauihealth.org/ortho to learn more.