Liba
05-17-2004, 11:49 AM
What am I leaving out? I want to keep this to one page. It isn't incredibly crunchy, but my fist two hospital births were quick and easy and very empowering. I did leave cloth diapers out, but I figure if they do manage to get a sposie onto my kids bottom (which they didn't last time) it can come right off without premanant damage ;)
My Name: Liba Z
My Due Date: July 24, 2004
My Doctor: Dr Star
My Husband: Pinchas Z
I trust that my practitioner will seek out my opinion concerning all of the issues directly affecting my birth before deviating from my plan.
I request the following people to be present during my labor and/or 2nd stage labor:
My Husband: Pinchas
My Relatives: Mrs Sharone Z (mother in law)
My Friends: Jen
I would like for people to speak softly.
I would like to wear my glasses unless removal becomes medically necessary.
Please only offer pain medications if I ask for them.
I am prepared to try to handle pain with natural and alternative methods.
I prefer the baby to be monitored externally, continuously.
I prefer to have no episiotomy and risk tearing.
Please use a local anesthetic for repairs.
After Baby is Born I want the baby to be with me at all time. I prefer the baby to be weighed and measured in the room and will go with the baby to the nursery for blood and hearing tests.
Placenta:
I would prefer for the placenta to be born spontaneously without the use of pitocin, and/or manual extraction.
I would like to have routine pitocin given to me after the placenta is born.
I would like for the cord not to be cut until it stops pulsating.
If the baby has any problems, I would like my husband to be present with the baby at all times, if possible.
I would like all newborn routine procedures to be performed in my presence.
Administration of Eyedrops:
I would like no administration of eyedrops to my baby and am willing to sign a formal waiver if need be.
Vitamin K:
I would like to delay the administration of vitamin K up to 2 hours after birth unless medically necessary.
Immunizations:
I prefer any immunizations be postponed to a later time.
My baby is to be exclusively breastfed.
Do not offer my baby the following without my consent:
Formula.
Pacifiers.
Any artificial nipples.
Sugar water.
Full rooming in, no separation, no exceptions, unless my baby is sick.
My Name: Liba Z
My Due Date: July 24, 2004
My Doctor: Dr Star
My Husband: Pinchas Z
I trust that my practitioner will seek out my opinion concerning all of the issues directly affecting my birth before deviating from my plan.
I request the following people to be present during my labor and/or 2nd stage labor:
My Husband: Pinchas
My Relatives: Mrs Sharone Z (mother in law)
My Friends: Jen
I would like for people to speak softly.
I would like to wear my glasses unless removal becomes medically necessary.
Please only offer pain medications if I ask for them.
I am prepared to try to handle pain with natural and alternative methods.
I prefer the baby to be monitored externally, continuously.
I prefer to have no episiotomy and risk tearing.
Please use a local anesthetic for repairs.
After Baby is Born I want the baby to be with me at all time. I prefer the baby to be weighed and measured in the room and will go with the baby to the nursery for blood and hearing tests.
Placenta:
I would prefer for the placenta to be born spontaneously without the use of pitocin, and/or manual extraction.
I would like to have routine pitocin given to me after the placenta is born.
I would like for the cord not to be cut until it stops pulsating.
If the baby has any problems, I would like my husband to be present with the baby at all times, if possible.
I would like all newborn routine procedures to be performed in my presence.
Administration of Eyedrops:
I would like no administration of eyedrops to my baby and am willing to sign a formal waiver if need be.
Vitamin K:
I would like to delay the administration of vitamin K up to 2 hours after birth unless medically necessary.
Immunizations:
I prefer any immunizations be postponed to a later time.
My baby is to be exclusively breastfed.
Do not offer my baby the following without my consent:
Formula.
Pacifiers.
Any artificial nipples.
Sugar water.
Full rooming in, no separation, no exceptions, unless my baby is sick.