One thing to keep in mind with a hospital birth is that different people do different things... meaning the nurse who will facilitate your eating or bug you about monitoring isn't the midwife/ob who actually catches the babe and cuts the cord and that midwife/ob isn't the person who "controls" the pacifier and so on. So I find it's really helpful to break a birth plan up into 3-4 things that you want in each stage of labor. That way the staff can refer directly to "just" the part that applies to them instead of wading through the whole plan (which they may not be inclined to do, depending on their personality and/or what else is going on).
Also, make sure you add some description and go over those definitions with your providers... delayed cord clamping can be a minute, or 4-5 minutes, or 15-20 minutes. So you want to be sure everyone is using the same definitions!
This is the plan I used last time and (with a change in pronouns) will use again. Other than the pronouns, the only thing not on this version is a bulleted point that said - "Our son will remain intact. Please do not retract his foreskin."
Parents: xxxxx & xxxxx
Attended by: xxxx
XXXXX and I are anticipating a natural birth for our fourth child. We value your encouragement and support in making this possible!
--Freedom of movement is very important to me as I plan to employ a variety of natural pain management techniques. I appreciate your assistance in making this possible through the use of a heplock and flexible monitoring.
--Please wait for me to request pain medication.
--I prefer to avoid routine vaginal exams.
--I intend to follow my natural urge to push but welcome assistance in finding effective positions.
--I welcome your support in preventing a tear but prefer a natural tear over an episiotomy. I do not consent to an episiotomy.
--Please remind me to touch my daughter's head as she is born.
AFTER THE BIRTH:
--Please place my daughter directly on my chest/stomach after birth.
--XXXX would like to cut the cord once it stops pulsating (4-5 minutes after the birth).
--Please allow the placenta to birth without traction or routine medication.
--To enhance bonding, we will delay NYS required procedures until the 1 hour limit.
--We will room in. Routine procedures (bath, etc) can be done in our room/with our assistance. We will accompany our daughter on nursery visits.
--We will be breastfeeding and do not consent to the use of artificial nipples or supplements (including glucose solution and/or formula).
IN THE EVENT OF A REPEAT CESAREAN:
--I would prefer a spinal for surgery and a double layer closure of the uterine incision.
--I would like to see my child as she is born and for XXXX to hold her after she is examined.
--I would like one arm free so I can "hold" my child with assistance. I am aware of the need to maintain a sterile field and will not reach into it.
--I will initiate breastfeeding as soon as possible and appreciate your support in this.
--XXXX will go with our child if she needs to be taken to the nursery.