Birth Choices, take #2 - Mothering Forums

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#1 of 29 Old 04-13-2007, 04:16 PM - Thread Starter
 
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Ok, here's a copy of what I've written up for my birth choices letter. It's longer than I wanted it to be - I might split it into two pages so I can have one posted on the bassinet once Baby is born, and also taped to my bed, the chart, the door, etc.
============

FOR THE MOTHER

1.NO PAIN MEDICATION
This is a natural/pain medication free/drug free childbirth process. Please do not offer me any pain medication at any time. If I want it, I’ll ask for it myself.

2.NO EPISIOTOMY
In the unlikely event that an episiotomy should be considered, please obtain consent from myself or my husband prior to doing so.

FOR THE BABY

1.NO BATH FOR THE BABY
Vernix is a valuable substance. It provides protection, lubrication and antibacterial properties for baby both in utero AND after delivery. It is unnecessary to remove this substance from Baby’s skin after delivery. Please DO NOT BATHE MY BABY without written consent from either myself (the mother), my husband, Thomas L Davis, or my mother, Shirley A Jones.

2.NO VACCINATIONS
Please do not give my baby any vaccinations. There are no exceptions to this request. This includes, but is not limited to, the hepatitis and vitamin K shots.

3.NO CIRCUMCISION
My son will not be circumcised. There are no exceptions to this request.
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#2 of 29 Old 04-13-2007, 04:27 PM
 
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Looks good.

natural living, cloth diapering, babywearing, intactalactivist mama to 2 beautiful boys both born at homehomebirth.jpg ~ ds1 July 8,2007 and ds2 born December 31,2009 and loving my awesome dh!! mdcblog5.gif
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#3 of 29 Old 04-13-2007, 04:48 PM
 
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Awesome! Looks completely reasonable to me!

Clara

Mama to a beautiful little girl, born July 18, 2007
Eager for a VBAC some time around April 10, 2010!
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#4 of 29 Old 04-13-2007, 05:04 PM
 
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Everything looks good. I would recommend taking out the last sentence (I put it in bold)
Quote:
Originally Posted by bdavis337 View Post
1.NO PAIN MEDICATION
This is a natural/pain medication free/drug free childbirth process. Please do not offer me any pain medication at any time. If I want it, I’ll ask for it myself.
This is leaving a hole for the nurses and you should just leave it as do not offer. End of story.
Just my 2cents.

Mama to my own amazing children..student midwife..home birth activist..and gestational surrogate-twin boys weighing 7lbs3oz & 8lbs4oz...vaginal, unmedicated forced induction @ 38w5d
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#5 of 29 Old 04-13-2007, 06:14 PM
 
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I think that looks good Bethany.. very informative and prompt not long winded.

Nic, loving mama to 5 with a SURPRISE 6th on the way.

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#6 of 29 Old 04-13-2007, 08:18 PM - Thread Starter
 
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Good! I want it short and easy to read, like "The Idiot's Guide To Letting A Mother Labor And Delivery Normally". I doubt I'd get very far if I titled it like that though.

I have a very long list of "choices", but I'm handling most of them by staying home as long as possible. My biggest issues this time around are what I"ve listed in the initial post, and I want them obvious to everyone. Thanks for critiquing me!
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#7 of 29 Old 04-13-2007, 08:40 PM
 
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Looks good! You don't want too much info, but you want to get your point across.

My dh and I are working on a code. I want to have to ask him for drugs (not using the word drugs) 3 times. If I really want them/need them, I want to have a safecheck. This is what a friend of mine did, and it worked really well for her. She got to 2. I don't want to let the nurses know that asking is an option, but my dh and I can have that as a last resort option. He is really nervous about me doing this all without help, but I just remember how bad all the stuff was on my system the first time. I just want someone to remind me how bad all that was on me the first time.
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#8 of 29 Old 04-13-2007, 11:08 PM - Thread Starter
 
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My dh caves every. single. time. I didn't want anything with either baby, and I got the full house with my first, and dh was staking out the nurses for an epi when I was in transition with my second - he's doing things like "oh my gosh is there time to get someone in here to give her something", being all crazy and scared....all I did was say "HOLY HELL THIS HURTS AND I REALLY WISH I'D THOUGHT ABOUT AN EPI". Triggered a huge mad rush for him to find someone....not that it mattered, I was at 9 cm and ended up pushing about 15 minutes later. He is FORBIDDEN to speak about pain relief this time.
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#9 of 29 Old 04-13-2007, 11:45 PM
 
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i think you should leave the pain section as it is.....while the other poster brought up a good point here is a story from a friend i know who said they did not want pain meds.....

she had her baby pain med free but had a tear that needed to be stitched up (10 stitches if i recall correctly)....sence the nurse had read her birth plan, and knew she did not want to be offered any pain medication she passed on the valuable info to the doc that she wanted a natural birth with no medication HE STITCHED HER UP WITHOUT A LOCAL!!!!!!

b/c her birth plan said not to offer any pain medication they never offered her a local

she screamed and begged for something while he was stitching her back together and the nurse and doc just ignored her b/c she had it clearly stated she didn't want any pain medication!!

so i think leaving in the part of if you want it you'll ask for it is wise......i can only begin to imagine how much that had to hurt!
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#10 of 29 Old 04-14-2007, 02:49 PM
 
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are you also refusing the eye ointment? you might want to mention that.
and delayed cord clamping.. those are two BIG things that unless they are brought up before hand, will just automatically be done, the quick clamp, and the ointment..

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#11 of 29 Old 04-14-2007, 05:04 PM
 
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Wow. I need to think about all of this if I will be birthing in an unfarmiliar envirment.

The plan looks well worded to me.

Mom of 5 boys- 13, 10, 8, 2 : and newbie Aug. 24th, '09 . babywearing advocate . Cook, baker, homemaker, wife to a man with another woman's kidney (live altruistic, unknown donor).
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#12 of 29 Old 04-14-2007, 06:32 PM - Thread Starter
 
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Oh yeah...I forgot about the eye ointment. Blech.
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#13 of 29 Old 04-14-2007, 10:46 PM
 
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Are you concerned about someone retracting your son's forskin? This may be overly cautious, but I've never had a son, so I don't know how careful I need to be. I was thinking of including this on my papers. I am not planning on letting anyone examine him or take him without dh or me there, but I don't know if it's important to include in the circ section. Anyone?

I think your plan is great...I may steal some of it if you don't mind!

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#14 of 29 Old 04-15-2007, 12:02 AM - Thread Starter
 
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Retraction is more of an issue during the well baby visits after you've left the hospital. The pedi will come do a once-over to "certify" your baby as healthy and ready for discharge. THAT is the time to be vigilant. It's really, IMO, not worth putting in the birth choices list, b/c it doesn't apply to the nurses and dr's there during your birth and thereafter. They aren't going to mess with your son's foreskin. Of course, you could put it in if you want to, and the folks on the circ forum might encourage you to do so. I just want mine as simple and concise as possible so there's no way anything can be missed or skimmed over.
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#15 of 29 Old 04-15-2007, 02:49 AM
 
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Quote:
Originally Posted by bdavis337 View Post
Ok, here's a copy of what I've written up for my birth choices letter. It's longer than I wanted it to be - I might split it into two pages so I can have one posted on the bassinet once Baby is born, and also taped to my bed, the chart, the door, etc.
============

FOR THE MOTHER

1.NO PAIN MEDICATION
This is a natural/pain medication free/drug free childbirth process. Please do not offer me any pain medication at any time. If I want it, I’ll ask for it myself.

2.NO EPISIOTOMY
In the unlikely event that an episiotomy should be considered, please obtain consent from myself or my husband prior to doing so.

FOR THE BABY

1.NO BATH FOR THE BABY
Vernix is a valuable substance. It provides protection, lubrication and antibacterial properties for baby both in utero AND after delivery. It is unnecessary to remove this substance from Baby’s skin after delivery. Please DO NOT BATHE MY BABY without written consent from either myself (the mother), my husband, Thomas L Davis, or my mother, Shirley A Jones.

2.NO VACCINATIONS
Please do not give my baby any vaccinations. There are no exceptions to this request. This includes, but is not limited to, the hepatitis and vitamin K shots.

3.NO CIRCUMCISION
My son will not be circumcised. There are no exceptions to this request.
I just recently took out my birthplan from ds's birth to revise for the next one. I kept the explainations simple and had my requests in 4 bulleted sections; labor, pushing/delivery, after the birth, and for the baby.

Other than what you have listed I also had:
  • minimal vag exams
  • no IV and freedom to drink and eat lightly
  • intermittant fetal monitoring
  • no artificial rupture of membranes
  • freedom to move around in labor
  • no pitocin or labor induction
  • freedom to choose position for delivery
  • delay cord cutting
  • local anestetics for any tears
  • delay standard evaluation procedures until after first nursing
  • no bottles, sugar water or pacifier for baby

I also made a cute sign for the bassinette that read something like this: "Hi, my name is *****. While I am learning to breastfeed please don't try to give me any bottles, sugar water or pacifiers. My mommy will be happy to nurse me at any time! Please don't take me to be circumcised. I am going to be keeping all of my parts!"

The nurses got a kick out of it.
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#16 of 29 Old 04-15-2007, 02:02 PM
 
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Originally Posted by Emma's_Mommy View Post
i think you should leave the pain section as it is.....while the other poster brought up a good point here is a story from a friend i know who said they did not want pain meds.....

she had her baby pain med free but had a tear that needed to be stitched up (10 stitches if i recall correctly)....sence the nurse had read her birth plan, and knew she did not want to be offered any pain medication she passed on the valuable info to the doc that she wanted a natural birth with no medication HE STITCHED HER UP WITHOUT A LOCAL!!!!!!

b/c her birth plan said not to offer any pain medication they never offered her a local

she screamed and begged for something while he was stitching her back together and the nurse and doc just ignored her b/c she had it clearly stated she didn't want any pain medication!!

so i think leaving in the part of if you want it you'll ask for it is wise......i can only begin to imagine how much that had to hurt!

I promise, promise, promise I am not being nit picky... but my guess is that this nurse was only being spiteful because your friend actually had a birth the way that she wanted. When you have a tear then the doc is supposed to get your permission to even sew it up because that is what informed consent is all about! They were only doing this to be mean is my guess.

Mama to my own amazing children..student midwife..home birth activist..and gestational surrogate-twin boys weighing 7lbs3oz & 8lbs4oz...vaginal, unmedicated forced induction @ 38w5d
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#17 of 29 Old 04-15-2007, 09:49 PM
 
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Originally Posted by AddysMama View Post
are you also refusing the eye ointment? you might want to mention that.
and delayed cord clamping.. those are two BIG things that unless they are brought up before hand, will just automatically be done, the quick clamp, and the ointment..
Yes eye prophylaxis and vitamin K are two of the newborn procedures that will just be done unless someone from your camp is physically standing over the baby, observing the newborn exam, instructing the nurse not to do it because often the baby nurse has not heard of or seen the "birth plan." So I always recommed dad or other person accompany baby for any exams.

I also agree about cord clamping, and if I were planning to have my baby in the hospital this would be one of my top priorities. Even if it is only a 30 second delay that is more of your baby's blood going to your baby than she would otherwise recieve if the cord was clamped immediately.
IME though this is one of the tougher issues to "win over" docs on, and requires a LOT of homework and persistance to help it happen.
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#18 of 29 Old 06-10-2007, 11:39 PM - Thread Starter
 
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bumping this....I needed to print it out again (lost my original!!!!) and we're all soooooo close now I thought it might be worth re-visiting.
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#19 of 29 Old 06-11-2007, 10:15 AM
 
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Originally Posted by bdavis337 View Post
Retraction is more of an issue during the well baby visits after you've left the hospital. The pedi will come do a once-over to "certify" your baby as healthy and ready for discharge. THAT is the time to be vigilant. It's really, IMO, not worth putting in the birth choices list, b/c it doesn't apply to the nurses and dr's there during your birth and thereafter. They aren't going to mess with your son's foreskin. Of course, you could put it in if you want to, and the folks on the circ forum might encourage you to do so. I just want mine as simple and concise as possible so there's no way anything can be missed or skimmed over.
That's not true. ALL intact males in our area hospitals are retracted (they say 'only slightly retracted') at birth to make sure they don't have hypospadias. I was pi$$ed none the less b/c my dr. knew not to retract, he's the one who instructed me not to retract, then goes and slightly pulls it back... pi$$ me off!!!

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#20 of 29 Old 06-11-2007, 11:32 AM
 
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Bethany- do you want anything about breastfeeding in your plan?

Mama to James 4-05 and Leland 7-07, and feeling so privileged to be growing kiddo #3 due in September!
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#21 of 29 Old 06-11-2007, 01:16 PM - Thread Starter
 
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Nah. My hospital doesn't provide formula or bottles unless Baby is put in the nursery, and Baby will stay with me so that's not an issue. I'd have to ask for them to take Baby out of the room - rooming in is assumed and expected unless there are medical reasons otherwise. And in that situation, they provide Mama's with a pump to use during her stay. Actually, they provide a pump during the post-partum stay anyway, now that I think about it.
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#22 of 29 Old 06-11-2007, 01:18 PM - Thread Starter
 
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Originally Posted by jee'smom View Post
That's not true. ALL intact males in our area hospitals are retracted (they say 'only slightly retracted') at birth to make sure they don't have hypospadias. I was pi$$ed none the less b/c my dr. knew not to retract, he's the one who instructed me not to retract, then goes and slightly pulls it back... pi$$ me off!!!
I've come to realize that our definition of retraction differs dramatically from the pedi's definitions of retratction. And in all honesty, at risk of being flamed and I would NEVER post this on the cac board, something like that wouldn't make me mad.
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#23 of 29 Old 06-11-2007, 01:35 PM
 
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Looks great! I need to shorten mine up a LOT.
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#24 of 29 Old 06-11-2007, 02:33 PM - Thread Starter
 
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Brevity is exactly why I've omitted things about breasfteeding and intact penis care. Presuming that both Baby and I are ok after the birth, I'll be around to deal with those things on my own terms, and without the need for written instructions. If for some reason Baby or I need emergency medical care, I'll be honest here and say that formula vs. breastmilk is not high on my list of things to manage, nor is possible foreskin retraction. I picked the things most important to me, and stuck with those.
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#25 of 29 Old 06-11-2007, 04:40 PM
 
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Originally Posted by bdavis337 View Post
I've come to realize that our definition of retraction differs dramatically from the pedi's definitions of retratction. And in all honesty, at risk of being flamed and I would NEVER post this on the cac board, something like that wouldn't make me mad.
It made me upset b/c retraction of any kind can introduce microscopic tears, which can become infected (plus other reasons not to do it). I didn't want to risk him getting an infected foreskin in a VERY high-circumcision-rate area, where no urologists understand how to care for an intact penis. Then the whole "you need to get him circumcised" thing comes up, not to mention that it can be painful and I become upset when people cause my children pain.

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#26 of 29 Old 06-11-2007, 05:03 PM - Thread Starter
 
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Keri, I totally understand what you're saying. From my perspective, I'd be pissed if they did it, but that's about it. Then gain, you're talking to a mother of 2 already circumcised boys. While this might not be popular, I'm just happy to have realized I don't need to circ.
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#27 of 29 Old 06-11-2007, 10:39 PM
 
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I am so thankful that we are birthing at a waterbirth center. All of these things are no nos unless I specifically ask for them.

GL!
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#28 of 29 Old 06-11-2007, 11:05 PM
 
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I copied mine from a website I found when searching for "natural birth plan" - since we are planning a homebirth and will only be going to the hospital for an emergency - mine is very lengthy - I plan on making a shorter bullet point one - but wanted all the important stuff on there. Considering we will be strangers to the hospital - I want them to know our views on everything...though in an emergency I know a lot of these requests will be unrealistic...


To Our Birth Team: After researching different methods of childbirth, we have selected a natural, drug-free delivery where the mother is encouraged by her coach to relax and work with her body. We feel that we are well prepared and educated, and have done everything possible to remain healthy and low risk during this pregnancy. We would appreciate all of the kind, encouraging care you can provide and thank you for assisting us during this miraculous event.

We would like to have the most natural birth experience possible, so we would like to request the following:

1. We would like to have a nurse who is both familiar with and supportive of natural, unmedicated childbirth methods, comfort measures, etc.

2. Please do not offer us any medication during labor or delivery unless it is absolutely necessary, due to a medical emergency. This includes all pain medication and other medication used to induce or augment labor.

3. Please do not artificially rupture the membranes.

4. We do not wish to have an IV at any time, unless a medical emergency necessitates it. We prefer for Chelsea to have food and drink orally during labor as she desires.

5. We would like our child to be intermittently monitored via Doppler or Fetoscope, not by EFM. We do not wish to have continuous fetal monitoring unless it is required by the condition of our child.

6. We wish for Chelsea to be able to move around and change position at will throughout labor and delivery.

7. We prefer keep vaginal exams to a minimum to avoid unnecessary discomfort and discouragement.

8. Unless absolutely necessary, we wish to avoid an episiotomy and the use of forceps or vacuum extraction.

9. Unless absolutely necessary, we wish to avoid a Cesarean delivery. If a Cesarean is indicated, we would like to be fully informed and participate in the decision-making process. We would like Joe (the father) present at all times during a Cesarean. If our child is not in distress, s/he should be given to Joe immediately after birth.

10. We would like our child to be born when s/he is ready, with no time limit placed on the labor or pushing stages, unless a medical emergency arises.

11. Even if Chelsea is fully dilated, and assuming our child is not in distress, we would like to wait until Chelsea feels the urge to push before beginning the pushing phase.

12. We would like the freedom to choose a delivery position, including squatting or water birth.

13. We would like Joe (the father) to be the one to catch our child as s/he is born if he so desires. Also, please do not announce the sex of the baby upon delivery - the parents wish to discover the sex on their own.

14. We would like Joe (the father) to cut the umbilical cord once it has stopped pulsing; we request that the umbilical cord NOT be clamped or cut until pulsing has stopped.

15. If there are no medical reasons to do otherwise, we would like our child to be placed directly on Chelsea’s stomach after birth until the cord has stopped pulsing and Joe has cut the cord, then given directly to Chelsea for nursing and cuddling (we would appreciate warm blankets to be on hand for placing over the baby). We do not wish our child to be bathed. Vernix is a valuable substance, providing protection, lubrication, and antibacterial properties before and after delivery. It is unnecessary to remove this substance from the baby's skin after delivery.
*(totally copied from the OP - thanks for the idea!)

16. We would like to allow Chelsea’s body to expel the placenta on its own, without pitocin or pulling on the cord.

17. We do NOT want our child to be circumcised or given any vaccinations or injections and expressly withhold consent for these procedures. This includes, but is not limited to the Hep B vaccination, the vitamin K shot, and the antibiotic eye ointment. We have discussed the legal issues with our family lawyer and are prepared to sign any waivers necessary to ensure these DO NOT take place.

18. Unless required for health reasons, we do not wish our child to be separated from Chelsea and Joe at all and ask that our child ‘room in’ with the parents at all times; we ask that evaluation or testing of our child take place in the room with the parents present at all times. We also ask that any testing or evaluations be postponed until after the baby has nursed for the first time.

19. If our child must be taken from the room to receive emergency medical treatment, Joe (the father) will accompany our child at all times.

20. We do not wish to have any pacifiers or bottles given to our child (including glucose water or plain water). Chelsea plans to breastfeed our child exclusively and would like to begin nursing immediately after birth. Please DO NOT give this baby formula of any kind.

Our goal is to provide the healthiest possible start in life for our new baby. We understand that unexpected medical complications may occur, in which case we would, of course, be flexible regarding our above requests. We expect to be consulted and fully informed about any interventions. We are looking forward to a positive birth experience.


yeah - I know it is very wordy - and chances that someone will read the whole thing (especially in an emergency) is almost laughable - but it makes me feel better to have everything written out...

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#29 of 29 Old 06-11-2007, 11:08 PM
 
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Originally Posted by jee'smom View Post
That's not true. ALL intact males in our area hospitals are retracted (they say 'only slightly retracted') at birth to make sure they don't have hypospadias. I was pi$$ed none the less b/c my dr. knew not to retract, he's the one who instructed me not to retract, then goes and slightly pulls it back... pi$$ me off!!!

Keri, I'm shocked. I've never heard of this before (as being common), although you may have brought it up on CAC and I've forgotten. Certainly something to bring up in the CAC forum in case it is more common than one would think.From my ignorant and naive perception, I think this is VERY rare and that maybe it is due to one person making the poilicy (or an old policy that has never been changed).

I'll be asking about this one because it is honestly not something I thought of before. It never occured to me that it would occur that early.

As for keeping it brief, which I agree very much, it might be as simple editing the statement to say
"My son will not be circumcised or retracted" to the birth plan-- adding 2 wordswouldn't significantly effect the length, but I agree with Bethancy about reasons for keeping it simple, short, and brief.

Jessica

Jessica..lady.gifintactlact.gif Falling in love all over again..... 
Dhprivateeyes.gif, Joshua rolleyes.gif Rebeccagrouphug.gifand dog2.gif.    candle.gif for Laura
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