birth plan
Birth Plan for Cristina XXXXX
Scheduled to deliver at XXXXX Hospital with XXXXX
Others attending the birth - MXXXXX (Husband), CXXXXX (Doula), SXXXXX (Sister)
We are planning an unmedicated natural birth, avoiding unnecessary procedures and medications. I realize that a birth plan is a list of preferences and things don't always go as expected. My primary request is to be fully informed and part of the decision-making process. Should I become incapacitated or unable to fully participate in the decision-making process, please consult my husband and my doula regarding any matters related to this birth plan, labor, and delivery.
------------------------------------------------------
Preliminary Notes
- Please do not permit observers such as interns, students or unnecessary staff into the room without my permission, prior to transition.
- To preserve my privacy, I ask that everyone knock and wait a reasonable time before entering.
First Stage Labor- I prefer:
- to eat and drink, as desired. I will self-hydrate and decline routine IV prep.
- my own music, minimal interruptions, and voices respectfully lowered.
- to keep internal vaginal exams kept to a minimum and to remain mobile for intermittent fetal monitoring.
- to freely walk around, use the shower and/or laboring tub, birthing ball, and change position at will.
Labor Augmentation/Anesthesia/Pain Medication
- I would like to be free of time limits and labor augmentation.
- I prefer to allow the amniotic membrane to rupture naturally.
- We are striving for a drug free childbirth, please do not offer pain medication. I'll ask for it if I need it and will make such a decision together with my husband, doula, and midwife.
Second Stage Labor & Delivery- I prefer:
- to choose my birthing position; including but not limited to: squatting or on my hands and knees.
- to wait to push until I feel the urge, even if there is a delay after full dilation.
- that everyone please refrain from coaching or counting; using calm tones, free from “pushing” and “breath holding” prompts.
- guidance, however, in when to stop pushing so the perineum can stretch naturally.
- NOT to have an episiotomy.
- to have the opportunity to touch my baby’s head as it crowns and I would like to help catch my baby.
- that the baby be placed on my stomach/chest immediately after delivery.
- to allow the umbilical cord to stop pulsating before it is clamped.
- that my husband, MXXXXX, is given the option to cut the umbilical cord.
- to deliver the placenta naturally without cord traction or a routine pitocin injection.
- to hold my baby while I deliver the placenta and any tissue repairs are made.
Postpartum
- I’d appreciate if the evaluation of my baby can be done on my abdomen, with both of us covered by a warm blanket. If this is not possible, please delay the evaluation for several minutes and then evaluate my baby at my bedside.
- We decline the Hepatitis B vaccine at this time. And we wish to delay antibiotic eye drops and the Vit. K shot for at least 1 hour after birth so that bonding is not interrupted.
- We request that the Vit. K only be given while the baby suckles at my breast.
- We do not intend to circumcise our baby if it is a boy.
- We request to room in full-time with our baby and desire no separation unless medically required.
- We request that all pediatric exams are done in my room.
- My husband is to accompany our baby at all times if he/she must be taken to receive essential medical treatment.
Breastfeeding
- I will be breastfeeding exclusively and would like to begin nursing shortly after birth.
- Please do not give my baby anything by mouth - including pacifiers, glucose water, or formula - without our expressed verbal consent.
- I would like to meet with a Lactation Consultant during my hospital stay.
We thank you in advance for your support and kind attention to our wishes.
We are excited to work with you during this very special time for our growing family!
[[and then i have this addendum printed separately if needed:]]
Cesarean
- I feel very strongly that I want to avoid a Cesarean delivery unless absolutely necessary.
- My husband must be present at all times if my baby requires a Cesarean delivery.
- Please do not tie down both of my arms during the Cesarean.
- I would like the sheet lowered during delivery.
- I request that my uterus be re-sewn in two layers, not one.