Birth Plan for the baby of Carol and Roger
Primary healthcare provider: Dr. XXX and XXX OB/GYN
Other support staff: Maureen XXX, doula, to be present during labor and delivery
Name of Hospital/Center where delivery is planned: St. Peter’s Hospital
Due date: March 31 or April 1, 2004
We’re looking forward to sharing the upcoming birth of our child with you. We’ve created the following birth plan to help you understand our preferences for Carol’s upcoming labor/delivery. We fully understand that in certain emergency circumstances, these guidelines may not be followed, but it’s our hope that you will assist us in making this the experience we hope for.
· No students, interns, residents or non-essential personnel during labor/birth.
· Carol free to walk around, move around and change position at will throughout labor.
· We’re considering a water birth for part or all of the labor process.
· Fluids by mouth throughout the first stage of labor.
· Carol would like to wear contact lenses or glasses at all times when conscious.
· Lights in the room to be kept low during labor; we'll be bringing our own music
· Keep the number of vaginal exams to a minimum.
· No IV unless it becomes medically necessary; no Heprin lock.
· No continuous fetal monitoring or internal monitor unless warranted by baby’s condition
· No rupture of amniotic membrane artificially unless signs of fetal distress warrant.
· Carol will try changing position and other natural methods, such as walking, before pitocin is administered. She’s been practicing squatting and doing Kegel exercises
· Carol will ask for pain medications if she needs them.
· No episiotomy unless absolutely required for the baby's safety.
· Carol will choose the position in which she gives birth, including squatting, and will wait until she feels the urge to push before beginning the pushing phase, even if totally dilated
· The baby should be placed on Carol’s stomach/chest immediately after delivery. Carol should hold the baby rather than have the baby placed under heat lamps.
· The umbilical cord should stop pulsating before it is cut. Roger wishes to cut the cord.
· Carol to hold the baby while she delivers the placenta and any tissue repairs made. No routine injection of pitocin after delivery.
· If the baby must be taken from Carol to receive medical treatment, Roger or some other person Carol designates will accompany the baby at all times.
· Delay the eye medication and Vitamin K for baby until a couple hours after birth.
· If the primary care provider determines that it is indicated, we would like to obtain a second opinion from another physician if time allows.
· If a Cesarean delivery is indicated, we would like to be fully informed and to participate in the decision-making process. Carol would like Roger to be present at all times if the baby requires a Cesarean delivery.
· Carol wishes to have an epidural for anesthesia. So that Carol can view the birth, she would like the screen lowered just before delivery of the baby. If the baby is not in distress, the baby should be given to Roger immediately after birth.
· The baby should "room in" and be with Carol at all times.
· As Carol plans to breastfeed the baby and would like to begin nursing very shortly after birth, no bottles (or pacifiers) given to the baby (including glucose water or plain water).
When Carol gets contractions:
· Call Roger (if he’s not home)
· Roger will time Carol’s contractions (length, time between)
· Roger will remind Carol to drink and pass liquids
· Roger will call Maureen to give her heads-up; Maureen will arrive in due course
· Carol will call XXX OB/GYN to give them heads-up
· Before leaving for hospital, Roger will call [Carol's parents], [Roger's mother], and Emily [our Bradley instructor]
· Maureen will take Carol and Roger to St. Peter’s, elevator A, 3rd floor