I wrote a rough draft up a few days ago and went over it with our doctor today at our prenatal visit.
It doesn't have anything she has any problem with, but some of my requests are definitely in the way of flouting standard hospital policy, so I wanted her to be aware of them and on board before the time comes.
(Though I should note that the hospital's birthing center generally doesn't have a problem with flouting standard policy in birthing, but they like to be aware ahead of time so the nurses can be prepared . . . our FP office actually hands out a packet with a 5-page bullet point list by category of what is standard policy or offered at the hospital, followed by a blank birth plan to fill in that they send to the hospital a month before your due date. It's a pretty cool system.)
Some of the things I wanted clarified before we get there:
*I don't want a heplock; it was distracting last time
*same thing with the periodic monitoring belts; I'd prefer the newer waterproof, wire-free kind if they have it or intermittent handheld Doppler monitoring
*I plan to eat and drink freely during labor
*I don't want pain meds offered to me; at certain points in labor, I'd probably take them up on that offer, but I know I'd regret it
*episiotomy is not an option unless there's an extreme emergency (our lovely doc said, "Well, duh")
*if there is a life-threatening emergency and I need a C-section, I want double-layer stitching of my uterus, not single-layer
*likewise in that situation, I don't want my arms tied down during surgery
*and I want the baby to go to dh asap for skin-to-skin and to me asap(2) for nursing and skin-to-skin (or vice versa if the C-sectioning allows for it)
*let the cord stop pulsing before cutting and dh wants to cut it
*NO circumcision!!!! No retraction of our son's foreskin!!!!
*no eye goop or Hep B vax; probably oral vitamin K instead of the injection (I need to do some more reading on that one)
Some of the standard policy I was fine with and it didn't need to be specified in our birth plan. For example, it's SOP at the hospital for the baby to go straight onto Mama's chest for skin-to-skin time and nursing barring need for medical attention; they don't weigh the baby or interfere with bonding in any way for at least an hour, more if requested. Rooming in of both baby and partner is standard. Changing positions frequently during labor is encouraged; some of the nurses are also trained in massage therapy and can lend a hand during labor.
There are a couple items on the list I also asked my doctor to check out, because I don't remember seeing them offered last time and they sound good to have: aromatherapy and perineal massage during pushing. She's going to find out what the scoop is there and get back to me.