here's mine so far... not the homebirth plan that I'd have if I was having an uncomplicated pregnancy, but hopefully helpful for having a nice delivery. My son's birth was a joyful, beautiful experience despite being highly medically managed and I'm hoping for the same again.
- I know that I am a medically complex patient and that birth is a dynamic process, and am prepared to be flexible about all plans.
- Except in emergencies, it is important to me to be part of all significant decision-making. I am a physician and am comfortable with technical language.
- My husband, <name>, is a great partner and dad. However, he is sometimes anxious and uncomfortable in hospital settings. Please respect his boundaries and don't push him to be more involved with labor and delivery than he chooses to be.
- I prefer no medical students be involved in my care.
- I would like for my wheelchair to stay in my room if there is space.
· During induction/labor:
- As planned (see note), I will need an epidural before induction or ASAP for spontaneous labor until 24 hours after birth, and frequent or continuous vital sign monitoring.
- I have a history of decubitus ulcers and had a shearing injury during my previous labor. As planned (see note), I need a regular hospital mattress until in transition, and then should transfer to a delivery bed with a hovermat. I will need assistance to change positions regularly as long as I have an epidural. Please make sure I am aware of your plans if you are planning to transfer or reposition me.
· During delivery:
- I WANT TO AVOID A CESAREAN SECTION IF AT ALL POSSIBLE. I expect recovery would be especially hard for me, potentially resulting in extended hospitalization and/or rehabilitation and difficulty with everyday mobility and baby care. Please do not recommend cesarean section if it's medically a soft call.
- If I need to be coached during pushing, I'd like it to be done calmly and quietly.
- If the baby is stable, I'd like skin to skin contact immediately after delivery.
- If the baby and I are stable, I'd like to delay clamping and cutting the umbilical cord for 1-3 minutes after delivery. If possible, I'd like to cut the cord. My husband does NOT wish to cut the cord.
- If possible, I'd like to see the placenta and umbilical cord after delivery.
· After delivery and during recovery:
- If the baby appears healthy, please do as many of the routine evaluations and procedures as possible near me or while I’m holding her. If she needs to leave our room, her dad would like to accompany her.
- Please support us in breastfeeding, including early and frequent feedings, even if we end up with a cesarean section. Please don't use any artificial nipples, even if the baby needs glucose for hypoglycemia. Please don't give any formula without previous discussion, even if the baby is in special care/NICU.
- We wish to defer the hepatitis B vaccine until our well-baby visits. Other standard neonatal tests and interventions are fine.
- Please don't bathe the baby. Her dad would like to do it the first time.
- As mentioned previously, please continue to assist me in protecting my skin from pressure and shearing during recovery.