Here is the finished product, it took me forever. I hope I included everything. Linda will send it over to the hospital so it will be in my file, I am so happy that I have such a supportive person delivering the baby! The midwives do a plan with everyone they deliver. Here is a link to the Midwives if you want to check them out (www.vanderbiltnursemidwives.org). I am praying for a much easier labor and birth. I feel I am much more prepared emotionally this time. With Emery Jai I read tons of medical model type of books. I knew everything about the stages/phases of labor, the interventions, the complications, the medications. What I was not prepared for the emotional toll that labor takes. This time I have read less medical books and more books that Linda recommended about the miracle of birth and the normalcy of it. I am confident that this will make a huge difference.
Our Birth Choices Jessica & Josh Anderson
Due Date: 8/2/07
Patient of Linda Hughlett, Nurse-Midwife
6/25/07
Dear Hospital Staff, We're looking forward to sharing our birth experience with you. We have created this birth plan in order to outline some of our preferences for birth. We would appreciate you reviewing this plan, and would be happy to do so with you. We understand that there may be situations in which our choices may not be possible, but we hope that you will help us to move toward our goals as much as possible and to make this labor and birth a great experience. We want to be informed of any procedures in advance, and to be allowed the chance to give informed consent. Please feel free to ask if you have any questions or comments. Thank you!
Dear Hospital Staff, We're looking forward to sharing our birth experience with you. We have created this birth plan in order to outline some of our preferences for birth. We would appreciate you reviewing this plan, and would be happy to do so with you. We understand that there may be situations in which our choices may not be possible, but we hope that you will help us to move toward our goals as much as possible and to make this labor and birth a great experience. We want to be informed of any procedures in advance, and to be allowed the chance to give informed consent. Please feel free to ask if you have any questions or comments. Thank you!
Labor
-Please perform no routine prepatory tasks (shaving, enema, etc.), unless requested. -I expect that doctors and hospital staff will discuss all procedures with me before they are performed. -I would like to be free to walk, change positions and use the bathroom as needed or desired. -I prefer to wear my own clothes, rather than a hospital gown. -I prefer to eat and drink throughout labor, as desired. -I will remain hydrated by drinking moderate amounts of fluids (water, juice, ice chips). -Please do not administer an IV or heparin lock unless there is a clear medical indication that such is necessary. -I would like a quiet, soothing environment during labor, with dim lights and minimal interruptions. -I would like to play my own music. -Please limit the number of vaginal exams. -I wish to labor freely in the birthing tub or shower. -As long as our son is doing well, I prefer that fetal heart tones be monitored intermittently with an external monitor or doppler, even if the membranes have ruptured. -If fetal distress is suspected and time permits, I would like confirmation of this with a fetal scalp blood sample before proceeding with other interventions. -Please allow me to vocalize as desired during labor and birth without comment or criticism. -Please do not permit observers such as interns, students or unnecessary staff into the room without my permission. -To preserve my privacy and dignity, I would prefer that everyone knock before entering.
Labor Induction/Augmentation
-Please perform no routine prepatory tasks (shaving, enema, etc.), unless requested. -I expect that doctors and hospital staff will discuss all procedures with me before they are performed. -I would like to be free to walk, change positions and use the bathroom as needed or desired. -I prefer to wear my own clothes, rather than a hospital gown. -I prefer to eat and drink throughout labor, as desired. -I will remain hydrated by drinking moderate amounts of fluids (water, juice, ice chips). -Please do not administer an IV or heparin lock unless there is a clear medical indication that such is necessary. -I would like a quiet, soothing environment during labor, with dim lights and minimal interruptions. -I would like to play my own music. -Please limit the number of vaginal exams. -I wish to labor freely in the birthing tub or shower. -As long as our son is doing well, I prefer that fetal heart tones be monitored intermittently with an external monitor or doppler, even if the membranes have ruptured. -If fetal distress is suspected and time permits, I would like confirmation of this with a fetal scalp blood sample before proceeding with other interventions. -Please allow me to vocalize as desired during labor and birth without comment or criticism. -Please do not permit observers such as interns, students or unnecessary staff into the room without my permission. -To preserve my privacy and dignity, I would prefer that everyone knock before entering.
Labor Induction/Augmentation
-I would like to avoid induction unless it is medically necessary. -As long as our son and I are healthy, I do not want to discuss induction prior to 42 weeks. -If my pregnancy progresses past 40 weeks, I would prefer to base the decision to induce on the results of the baby's biophysical profiles, not on my own personal discomfort or impatience. -I would like to try alternative means of labor augmentation, like walking or nipple stimulation, before pitocin or artificial rupture of membranes is attempted. -If induction is necessary, I would like to attempt it with prostaglandin gel or another means before pitocin is administered. -If induction is attempted, but fails, I would like to come back at another time rather than pursue further intervention (assuming my membranes are intact and that waiting presents no danger to our son or myself). -Please do not rupture my membranes artificially unless medically indicated. Anesthesia/Pain Medication -Please do not offer anesthesia/analgesia .-If I ask for pain relief, please feel free to offer nonmedical choices for coping and/or remind me how close I am to the birth. -I would like to avoid all narcotics.
Cesarean Section Delivery
Cesarean Section Delivery
-I feel very strongly that I would like to avoid a cesarean delivery. -If a cesarean is necessary, I expect to be fully informed of all procedures and actively participate in decision-making. -I would like my husband to be present during the surgery. -Please explain the surgery to me as it happens. -I would prefer epidural anesthesia, if possible, in order to remain conscious through the delivery. -If possible, please do not strap my arms to the table during the procedure. -If conditions permit, I would like to be the first to hold our son after the delivery. -If possible, I would like to breastfeed our son immediately after the birth. -If conditions permit, our son should be given to my husband immediately after the birth. -I would like our plans outlined here for after the birth to be followed as closely as possible. -Please lower the screen just before delivery so I may see the birth of the baby. Perineal Care -I prefer not to have an episiotomy unless it is medically indicated. -To avoid episiotomy or tearing, my husband or my labor assistant will perform perineal massage with oil and apply hot compresses. -I would rather tear than have an episiotomy. -Please suture tears only if necessary.
Delivery -
Delivery -
Even if I am fully dilated, and assuming our son is not in distress, I would like to wait until I feel the urge to push before beginning the pushing phase. -I prefer to push or not push according to my instincts and would prefer not to have guidance or coaching in this effort. -I do not want to use stirrups while pushing. -I would like the freedom to push and deliver in any position I like. -I would like to have a mirror available and adjusted so I can see the baby's head crowning. -I would like the opportunity to touch my baby's head as it crowns. -I would like a soothing environment during the actual birth, with dim lights and quiet voices. -I would like my husband to help catch the baby. -I would like to have the birth recorded with photographs, video tape and/or tape recording. After birth -Please place our son on my stomach/chest immediately after delivery. -I would like to breastfeed our son immediately. -My husband would like the option to cut the cord. -Please allow the umbilical cord to stop pulsating before it is cut. -I prefer to wait for spontaneous delivery of the placenta and do not want a routine injection of pitocin.
Newborn Care
-I would like to hold our son skin-to-skin during the first hours to help regulate baby's body temperature. -I would like to hold our son through delivery of the placenta and any repair procedures. -Please evaluate and bathe our son at my bedside. -If possible, please evaluate our son on my abdomen. -If our son must go to the nursery for evaluation or medical treatment, my husband, or someone I designate, will accompany our son at all times. -Please delay eye medication for our son until we are well past the initial bonding period (a couple hours after the birth). -If available, would prefer erythromycin eye treatment or other antibiotic eye drops instead of silver nitrate. -I would prefer to have Vitamin K administered orally. -I am not planning to have our son circumcised.
-I prefer that our son wears the cloth diapers that we provide.
Postpartum
-I would prefer not to be catheterized until I've had some private time to attempt urination on my own. -I would like to have our son room-in with me at all times. -I would like my husband to room-in with me. -Assuming I feel up to it and our son is healthy, I would like to be released from the hospital as soon as possible following the birth. -I would like permission for access to my chart and the baby's chart. Breastfeeding-I plan to breastfeed and want to nurse immediately following the birth. -Please do not give our son supplements (including formula, glucose, or plain water) without my consent, unless there is an urgent medical necessity. -Unless I am unable to give my consent, please do not give our son any supplements without first informing me of the reason(s) and seeking my consent. -Please do not give our son a pacifier.
-I prefer that our son wears the cloth diapers that we provide.
Postpartum
-I would prefer not to be catheterized until I've had some private time to attempt urination on my own. -I would like to have our son room-in with me at all times. -I would like my husband to room-in with me. -Assuming I feel up to it and our son is healthy, I would like to be released from the hospital as soon as possible following the birth. -I would like permission for access to my chart and the baby's chart. Breastfeeding-I plan to breastfeed and want to nurse immediately following the birth. -Please do not give our son supplements (including formula, glucose, or plain water) without my consent, unless there is an urgent medical necessity. -Unless I am unable to give my consent, please do not give our son any supplements without first informing me of the reason(s) and seeking my consent. -Please do not give our son a pacifier.
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