Name: Toni Carrigain
Midwife or OB: Dr. Johnson
Professional Labor Assistant:
Birth Center or Hospital: Women’s East Approximate Due Date: 03/29/2009
Personal Statement:We understand that birthing can be unpredictable. We are presenting this birth plan to encourage dialogue and to help us achieve a safe and satisfying birth. Our baby’s health and well-being is of utmost importance to us. We look forward to working with you and appreciate your cooperation in helping our family to achieve our personal birthing goals.
BEFORE LABOR BEGINS:
I expect, and trust, that my practitioner will seek my opinion, and that of my partner, on all issues that may affect my birth experience or that deviate from this plan.
If the baby and I are fine, and if I go past my estimated due date, I would like to wait until I go into labor naturally.
FIRST STAGE OF CHILDBIRTH:
LABOR First Stage, Phase I – Latent Labor:
Upon entering my hospital or birth center, it is crucial for me that I will not be separated from my partner(s) at any point during labor or birth.
While I understand and can appreciate the need for training and teaching, I may prefer not to have residents or students walking in and out during my labor and delivery. Please respect my wishes as I state them while laboring and delivering.
Ideally, I would like my environment to:
have dimmed lights
to have voices respectfully lowered
I would like the opportunity to wear my own clothing.
I would like my partner to have the opportunity to film and/or photograph labor and delivery.
I would like the hospital or birthing staff to know that I may have my own personal style to birthing — from walking, moaning, or grunting. I would be grateful for the personal space to do this comfortably without feeling hushed or rushed.
Upon being admitted, I would like to avoid a routine enema.
I am uncomfortable having my pubic area shaven unless it becomes medically necessary to do so. Please explain such a procedure beforehand.
First Stage, Phase II – Active Labor – Getting to 10 cm:
I would like to keep internal vaginal exams to a minimum.
If an IV prep becomes necessary I would like a heparin/saline lock to be considered. A heparin/saline lock is ….
Since mobility is important to me, I would like Intermittent Monitoring (ACOG Standards), using:
I feel comfortable with continuous fetal monitoring, using:
My birth partner and I would like to take a few moments to privately discuss my pain-relief options before a decision is made.
Ideally, I’d like a drug-free birth. Only offer medications if I ask.
Please suggest medications if you see I am uncomfortable.
I would like the opportunity to try non-medical, non-invasive pain-relief methods. Some therapies I feel would be useful for me include:
If bath or shower, I would like my partner to join me.
Change in position
Ideally, I would like to be allowed freedom of movement — to walk, rock, use the bathroom and move as my body dictates.
First Stage, Phase III – Transition:
I understand that transition is unpredictable. I may throw-up, my water may break if has not already, and/or I may expel other bodily fluids. I am appreciative of help that reduces my anxieties and my sense of vulnerability.
At this point, my body may be most sensitive. If I am feeling that my support person’s or staff member’s voice and/or touch feels too much, I will indicate so.
SECOND STAGE OF CHILDBIRTH:
PUSHING AND DELIVERYPushing:
As long as it is clear that my baby’s heart tones are good and that she/he is receiving sufficient oxygen, I would like to be free of time limits on pushing. It is important to me to allow my body to operate in its natural rhythm and time-table.
If my doctor or midwife feels that pushing may not be progressing efficiently, I would like to be reminded that sometimes changing positions helps. Because I may be very internally-focused, I would like to be encouraged to try one or more of the following delivery positions:
Hands and knees on floor
Kneeling, resting arms on bed/chair
Semi-reclining on bed, knees pressed to chest with support person behind me, providing counter-pressure
Whatever feels right in the moment Vaginal Delivery:
I would like local anesthesia for repairs (stitches).
I would like to be given the option to view my baby’s entry into the world by using a mirror.
I would like to touch my baby’s head as it crowns.
I would like for my baby to hear our voices first.
I would like my baby to be placed on my abdomen immediately following the birth.
If warming is necessary, please allow baby to be warmed on my abdomen, covered by blankets.
If Complications Lead to a Cesarean Delivery:
Please keep communication open. If, at all possible, please wait for my express consent, or that of my partner, before initiating any procedure.
It is important to me that my partner(s) be present with me at all times during the birth.
Ideally, I would like to remain awake and aware, avoiding general anesthesia if possible.
Please discuss anesthesia options with me.
Please use a low-transverse incision on my uterus and abdomen.
I would like the screen to be lowered, or be able to use a mirror, so I can witness my baby’s entrance into the world.
Please leave at least one of my hands free so I may touch my baby when he or she is born.
Ideally, I would like the opportunity to videotape and/or photograph my baby’s birth.
Assuming the baby is well, I would like to hold my baby on my chest and/or nurse my baby as soon as possible.
Please remove my IV and catheter as soon as possible following my baby’s birth.
Please discuss options for postpartum medication, if needed, with me.
Please provide me with nutritious food and drink as soon as possible.
IMMEDIATE NEWBORN CARE:
Suction and Cord Care:
In my ideal world, my healthy baby will be immediately placed on my chest. If this is the case, he or she will be above the placenta and I would therefore like to wait until the cord stops pulsating before it is clamped and cut.
would like the opportunity to cut, or have my partner cut, the baby’s umbilical cord.
Eyedrops, Vitamin K and other Procedures:
I understand that it is routine to administer antibiotic drops or ointment, such as erythromycin, to newborn baby’s eyes to protect against gonorrhea and chlamydia, as well as other more common bacterial infections.
I understand that in the United States, it is routine procedure to give newborns a one-time injection of vitamin K.
Ideally, with either a vaginal or cesarean birth, I would like to postpone routine newborn procedures until I have had a chance to bond with my baby.
I would like to have any additional newborn procedures thoroughly explained to us.
I would like for my birth partner(s) or me to be present during all newborn procedures.
I would like to postpone any immunizations until a later time.
Bathing and Circumcision:
I prefer that the baby be gently wiped down to remove fluids, and wrapped in a receiving blanket. Please do not bathe, to allow my baby’s natural vernix to continue to soften and protect skin.
If the baby is a boy,
I would like anesthesia used for pain relief during the circumcision.
Rooming-In and Feeding:
My preference for in-hospital infant care is:
Please do not offer my baby the following:
My feeding preference is: breast feeding
I would like my older children to visit with my newborn and me as soon as possible.
Sick Baby and Postpartum Care:
If my baby is not well, I would like to:
accompany my baby, or have my partner accompany the baby if transported to another facility.
breastfeed, or provide my expressed milk for my baby.
have unlimited visitation for my partner and myself.
hold, rock and care for my baby, if possible.
I would like my hospital/birth center stay to be as short as possible.