Wow, that's a short one!
Here's mine. Most of it is routine for my midwife and a home birth. It's mainly for if I get transfered to a hospital.
The P Family Birth Plan
Mother-to-be: CPHusband: DP
Midwife: BCDoula: SB
Other Support People: GZ and MF, grandmothers-to-be
Place of Birth: HomeDue Date: 02/16/2010
This is our first baby and we are looking forward to having a natural birth at home. We fully realize that situations may arise such that our plan cannot and should not be followed. However, we ask for your help in keeping our birth as natural as possible and involving us as partners in this very important event. Thank you in advance, for honoring our family’s wishes whenever possible.
C's Priorities:
C wants to do everything possible to avoid a cesarean section. She prefers a natural birth without medication or interventions as much as possible. Barring an emergency, she wishes to try non-medicated methods first in the event of complications. (sweeping, vacuum extractor, oxygen, etc.)
* Pain Medication Preference: -7 (Strongly desires natural birth, do not offer pain medications.)
* During labor, she wants to maintain her mobility.
* During birth, she wants to spontaneously bear down and have no restriction on duration.
* After birth, she wants no separation between her and the baby until after the first breastfeed.
First Stage (Labor):
* C wishes to be mobile, choose positions, and have unrestricted food and drink.
* She would prefer to keep vaginal exams to a minimum.
* She requests intermittent monitoring.
* Please do not offer her pain medications, she will ask for them if she wants them.
* She prefers to use natural pain relief, particularly massage and touch.
* She would prefer to use natural methods to induce and augment labor.
Second Stage (Birth):
* C wishes to choose position and equipment for pushing and birth.
* She wants to spontaneously bear down and have no restriction on duration.
* Please use compresses, etc, to avoid tearing, but she would prefer to tear than have an episiotomy.
Baby Care:
* No oro-nasal suction unless necessary. No gastric tube or gastric suction.
* C prefers no separation between her and the baby until after the first breastfeed.
* She would like immediate skin-to-skin contact before bathing.
* She would prefer baby to be in mother's arms for observation and Apgar test.
* Please delay cord cutting until cord has stopped pulsating.
* She wants to breastfeed only; no pacifiers or glucose water.
* She prefers to allow baby to initiate breastfeeding within first hour. (breast crawl)
* Please delay until after the first breastfeed:
eye medication, vitamin K dose, blood draw, hepatitis B shot, weighing, measuring, wrapping.
In the event of a Cesarean Birth:
* Spinal/epidural anesthesia.
* Doula present, husband and/or other support people present if they wish.
* Screen lowered to view the birth or mirror.
* During surgery, we’d like to kept informed of why the surgery was necessary. Please let us know what you find, when you find it.
* C wants minimal separation. She would prefer to hold the baby during surgical repair and incisions, and breastfeed as soon as possible.
In the event of a Sick Baby:
* We would like as much contact and breastfeeding as possible. Kangaroo care if possible.
* We want to kept informed and involved in decision-making and procedures.
In the event of the Death of the Baby:
* C would like a memento, probably photographs and hand and foot prints.
* Autopsy and cremation of baby.
* We would both like non-religious grief counseling.
Thanks!
