so sorry mama. i had a hard time coming up with ours. so much i wanted to include, but wanted to keep it to one page (and not overwhelm the hospital staff too much). here's mine. if anything, it could be a jumping off point for you. i recommend including the things that are absolute MUSTS or MUST NOTS. be sure to review it with your care provider(s) ahead of time. i also made sure i had several copies with me (and printed it up on pretty paper). just a thought.
Our Birth Plan
Mom: mama Dad/Coach: papa Care Provider: doc
Thank you for your assistance and participation in the birth of our baby. We’ve prepared for an un-medicated, intervention-free birth with the Bradley Method. We appreciate your support. We understand that our plan is subject to change in the event of an emergency.
Labor – First Stage
I would like to return home if I am less than 4 cm dilated upon arrival to the hospital.
It is my goal to have an un-medicated labor – please do not offer pain medications.
If I decide pain relief is necessary, I would only like epidural or spinal anesthesia.
Please avoid any use of artificial means to augment labor.
Saline or Heparin lock is to be used in place of IV. I would like fluids by mouth.
I prefer a minimum of vaginal exams.
I plan to move around, walk and change position throughout the entire labor.
I would like to use the tub and/or shower as desired.
I prefer intermittent monitoring to be used. If continuous monitoring becomes necessary, I prefer to use a telemetry unit to allow movement to continue.
I prefer to not have my waters artificially ruptured. If the staff or the doctor feels that it would be to my benefit or that of our baby, we would like to be given a few minutes in private to discuss it.
Labor – Second Stage
If I am fully dilated and our baby is not in distress, I would like to wait to push until I feel the urge.
I want to use various positions during pushing, including sitting upright, squatting and the hands and knees position. I do not want to be lying down.
I do not want an episiotomy. I prefer the use of massage, warm compress and controlled pushing to avoid tearing. A tear is preferable to episiotomy.
I would like to have our baby placed on my chest immediately after delivery.
In the event of a Cesarean
If the doctor determines that a Cesarean is indicated, we would like time in private to discuss it.
I prefer epidural for anesthesia if a Cesarean is necessary.
I prefer a double layer closure of my uterus.
I want my husband and our baby to remain in recovery with me and for our baby to be put to the breast to feed as soon as possible.
Please do not use sleep inducing drugs during recovery.
Labor – Third Stage (and immediately after delivery)
Please wait to clamp the cord until after it has stopped pulsating. Papa would like to cut the cord.
I prefer natural methods to help deliver placenta, rather than drugs.
I would like to hold our baby while I deliver the placenta and while any tissue repairs are made.
I prefer to hold our baby rather than have him/her placed under heat lamps.
Please delay all tests, baths, medications and injections for at least one hour and until after we have breastfed. NO silver nitrate drops please! Any routine procedures should be discussed with us prior to administering.
If our baby is a boy, he will not be circumcised.
I plan to breastfeed and would like to begin nursing immediately or as soon as possible after birth.
I do not wish to have any bottles or pacifiers given to our baby. Absolutely no formula or glucose water.
Postpartum and baby care
If I tear and need stitches, I would like pain relief.
We would prefer as few interruptions as possible during our postpartum stay.
Baby will room with us for our entire stay. If s/he needs to be take from our room, Papa will accompany him/her.
Do not administer the Hepatitis B Vaccine. We have chosen to delay this vaccination.
btw - i birthed my 9lb 1oz son naturally in a hospital 13 days past my due date (and i was a vbac). so, yes, you can get the birth you want in a hospital.