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I think I've got my birth plan done. I was told by the Nurse manager to be very direct about vac's and circ, so if they sound kinda out there that's why. I've taken other advice and shortened the part about circ to what it is now. This will be my 3rd cesarean.
Can you think of anything that I might have forgotten?
Birth Plan
Patient: Crystal L. Wilson
Baby: Rohnin Turner Wilson
The following birth plan is for the birth of my 3rd child through cesarean section. I would like to be treated as an informed decision maker in this process, as I know my body better than anyone else, and I want the birth experience to be as comforting as it can for myself and my child. The following will outline what I would like upon admission to the hospital for the birth of my child. Please take the time to thoroughly look it over. I look forward to a lovely experience with your staff at the birth of my son.
Mother:
~ Adhesives…I have an extreme sensitivity to adhesives. Any alternatives would be wonderful.
~ IV…I will not consent to an IV in the back of hand, wrist or inside elbow. Placement would be preferred in the back of the forearm.
~ IV catheter…I have an extreme sensitivity to IV catheters, so if I tell you it hurts, please do not just assume that it does not. Please help to correct the situation.
~ Urinary Catheter…I request that the smallest sized catheter be used due to prior complications.
~ Urinary Catheter Anesthetic…I request that a topical lidocaine anesthetic be applied 5 minutes before any urinary catheter is inserted.
~ Pain Medication…ABSOLUTELY NO SEDATIVES are to be administered prior to, during, or post op.
~ Placenta…I will be taking the placenta home due to religious reasons. I would like it to be stored on ice until my husband can take it home.
Baby Wilson:
~ Vitamin K…I do not consent to administration of Vitamin K in any form to Rohnin, including but not limited to injectable or oral.
~ Eye Drops…I do not consent to administration of antibiotic eye drops in any form to Rohnin, including but not limited to Erythromycin and Silver Nitrate.
~ Hep B…I do not consent to any vaccinations for my child.
~ First Feeding…I want to initiate breastfeeding within the first 30 minutes after delivery.
~ Circumcision…I do not consent to circumcision under any circumstances.
~ Foreskin Care…Foreskin is not to be manipulated, or retracted in any way or for any reason.
~ Bottles, Pacifiers, Sugar Water, Formula…I do not consent to any of these being given to my son.
~ Breastfeeding…We will be exclusively breastfeeding on demand.
~ Rooming In… I plan on having the baby with me at all times. I do not want him taken to the nursery for an "Observational Period."
Either myself or my husband (when I am not able) will accompany Rohnin at all times while at your hospital.
Thank you for taking time to learn about our needs, and for making the birth of our son as enjoyable as possible
Think I forgot anything? (It all comes to less than 1 page)
TIA
Can you think of anything that I might have forgotten?
Birth Plan
Patient: Crystal L. Wilson
Baby: Rohnin Turner Wilson
The following birth plan is for the birth of my 3rd child through cesarean section. I would like to be treated as an informed decision maker in this process, as I know my body better than anyone else, and I want the birth experience to be as comforting as it can for myself and my child. The following will outline what I would like upon admission to the hospital for the birth of my child. Please take the time to thoroughly look it over. I look forward to a lovely experience with your staff at the birth of my son.
Mother:
~ Adhesives…I have an extreme sensitivity to adhesives. Any alternatives would be wonderful.
~ IV…I will not consent to an IV in the back of hand, wrist or inside elbow. Placement would be preferred in the back of the forearm.
~ IV catheter…I have an extreme sensitivity to IV catheters, so if I tell you it hurts, please do not just assume that it does not. Please help to correct the situation.
~ Urinary Catheter…I request that the smallest sized catheter be used due to prior complications.
~ Urinary Catheter Anesthetic…I request that a topical lidocaine anesthetic be applied 5 minutes before any urinary catheter is inserted.
~ Pain Medication…ABSOLUTELY NO SEDATIVES are to be administered prior to, during, or post op.
~ Placenta…I will be taking the placenta home due to religious reasons. I would like it to be stored on ice until my husband can take it home.
Baby Wilson:
~ Vitamin K…I do not consent to administration of Vitamin K in any form to Rohnin, including but not limited to injectable or oral.
~ Eye Drops…I do not consent to administration of antibiotic eye drops in any form to Rohnin, including but not limited to Erythromycin and Silver Nitrate.
~ Hep B…I do not consent to any vaccinations for my child.
~ First Feeding…I want to initiate breastfeeding within the first 30 minutes after delivery.
~ Circumcision…I do not consent to circumcision under any circumstances.
~ Foreskin Care…Foreskin is not to be manipulated, or retracted in any way or for any reason.
~ Bottles, Pacifiers, Sugar Water, Formula…I do not consent to any of these being given to my son.
~ Breastfeeding…We will be exclusively breastfeeding on demand.
~ Rooming In… I plan on having the baby with me at all times. I do not want him taken to the nursery for an "Observational Period."
Either myself or my husband (when I am not able) will accompany Rohnin at all times while at your hospital.
Thank you for taking time to learn about our needs, and for making the birth of our son as enjoyable as possible
Think I forgot anything? (It all comes to less than 1 page)
TIA
