We have prepared this Birth Plan to help you understand our philosophy and the kind of care we would supply to you. We have experienced midwives and obstetricians who share your desire for a low-intervention birth and respects your need for good communication. We serve you for as natural a birth as possible, avoiding unnecessary procedures and medications. However, if medications or procedures become necessary, we will discuss them with you in advance so that you can participate in the decision-making. We will discuss all procedures with you before they are performed. We plan to have up to 2 labor support people present during labor and delivery. We plan for them to give comfort, encouragement, and generally support you. One is a doula, the other is a midwife.


Special Requests:
-- I would like my husband and I to catch the baby in the waster and pass him directly to me.

-- I would like my husband to cut the cord only when it has stopped pulsating.

-- I do not want our baby to be washed straight away, but placed as soon as he is born directly on my chest for bonding and feeding.

-- I plan to have my husband present during labor and delivery. 

-- I prefer that people present in the labor room not wear surgical masks. 

LABOR   

-- Please allow me to vocalize as desired during labor and birth without comment or criticism. 

-- To preserve my privacy and dignity, I would prefer that everyone knock before entering. 

-- I would like to be free to walk around during labor, and use the restroom, if needed. 

-- I wish to be able to move around and change position at will throughout labor. 

-- I would like to be able to have fluids by mouth throughout the first stage of labor. 

-- I would like the environment to be kept as quiet as possible. 

-- I would like the lights in the room to be kept low during my labor. 

-- I would prefer to keep the number of vaginal exams to a minimum. 

--I do not want an IV unless I become dehydrated. 

-- I would my husband join me in the birth tub. 

MONITORING 

-- Electronic fetal monitor: external and only for an initial 20 minute strip if needed, after that I would prefer intermittent Doppler monitoring.
 
-- I do not wish to have continuous fetal monitoring unless it is required by the condition of the baby. 

-- I do not want an internal monitor unless the baby has shown some sign of distress. 

LABOR AUGMENTATION/INDUCTION   

-- I do not wish to have the amniotic membrane ruptured artificially unless signs of fetal distress require internal monitoring. 

-- If my labor needs augmentation, I would prefer to be allowed to try changing position and other natural methods (walking, nipple stimulation) before pitocin or other medical augmentation methods or artificial rupture of membranes are administered. 

ANESTHESIA/PAIN MEDICATION 

-- I would like the option of Gas & Air for pain relief. I realize that many pain medications exist I'll ask for them if I need them. 

ACTUAL BIRTH 

--  I want to breathe and push my baby out -- I don't want my baby pulled out in any way 

-- I would like to avoid forceps and ventouse to pull the baby out.

CESAREAN 

-- Unless absolutely necessary, I would like to avoid a Cesarean. 

-- If a Cesarean delivery is indicated, I would like to be fully informed and to participate in the decision-making process. We prefer that the anesthesia take effect.before the catheter is inserted and that there are no "hot spots" (areas which are not yet numb) before the surgery begins. 

-- I would like my husband present at all times if the baby requires a Cesarean delivery. 

-- Please explain the surgery to me as it happens. 

-- So I can view the birth, please ask me if I would like the screen lowered just before delivery of the baby. 

-- 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 the baby after the delivery. 

-- If possible, I would like to breastfeed the baby immediately after the birth.
 
EPISIOTOMY 

-- I would prefer not to have an episiotomy unless absolutely required for the baby's safety. 

I would rather tear than have an episiotomy. One possible exception to this is "buttonholing", where a cut would be performed to direct 3rd degree tearing away from the anus and rectum; or situations of severe fetal distress, where the baby needs to come out extremely quickly. 

-- I would like a local anesthetic to repair a tear or an episiotomy. 

DELIVERY 

-- I would like to give birth in the water, and I would like to be able to deliver in any position in the water that I feel comfortable in. 

-- I may want to have the room lights turned low for the actual delivery and we may want to light candles to put around the room. 

-- My husband and I would like to be the person who catches the baby at birth. 

-- I would appreciate having the room as quiet as possible when the baby is born. 

-- I would like to have the baby placed on my stomach/chest immediately after delivery, and the two of us wrapped up warmly together, if necessary, if we are out of the water. 

IMMEDIATELY AFTER DELIVERY 

-- I would prefer that the umbilical cord stop pulsating before it is clamped and cut (or wait at least 3 minutes after birth before clamping and cutting) (There is considerable research that links early cord clamping with infant anemia, autism, brain hemorrhaging, and mental impairment.) 

-- I would like to have my husband cut the cord. 

-- Unless it is particularly indicated, I would like to avoid routine suctioning of the baby's nose and mouth. 

-- I would like to hold the baby while I deliver the placenta and any tissue repairs are made. 

-- I would like to hold the baby skin-to-skin during the first hours to help regulate baby's body temperature. 

-- I would prefer to bathe the baby myself, at my discretion. 

-- Please delay eye medication (do not use silver nitrate), examinations and treatments for the baby until we are well past the initial bonding period (a couple hours after the birth). Please do not take the baby away from me for any examination or treatment.   

-- I plan to keep the baby near me following birth and would appreciate if the evaluation of the baby can be done with the baby on my abdomen, with both of us covered by a warm blanket, unless there is an unusual situation. 

-- If the baby must be taken from me to receive medical treatment, my husband will accompany the baby at all times. 

-- I would prefer to hold the baby rather than have him placed under heat lamps.
 
-- I would like a routine injection of pitocin after the delivery to aid in expelling the placenta.  I will have the baby breastfeed as soon as possible and as frequently as possible after birth. 

-- I do not need to see the placenta after it is delivered.
 
-- I would like our baby to be given vitamin K as an injection.

POSTPARTUM  

-- Unless required for health reasons, I do not wish to be separated from my baby. 

-- If baby must be taken from room, I would like myself and/or my husband to accompany the baby at all times. 

-- If medical procedures must be performed on the baby, I would like for myself and/or my husband to be present at all times. 

-- I would like to have the baby "room in" and be with me at all times. 

-- If baby needs to be incubated, I would prefer to administer kangaroo care instead. 

BREASTFEEDING   

-- I plan to breastfeed the baby and would like to begin nursing very shortly after birth. 

-- I do not wish to have any pacifiers or bottles given to the baby (including glucose water or plain water). 

PHOTO/VIDEO 

-- I would like to take still photographs after the birth.

-- I would like to make a video recording of labor and/or the birth and would like a nurse to do so. 

OTHER   

-- I would prefer that no students, interns, residents or non-essential personnel be present during my labor or the birth. 

-- I would like to be released home at as early a date as possible.