Saturday, July 11, 2009

Sample Birth Plan

This is the birth plan I used, with some editing done to it since my daughter was born (so there is a voice of experience here too!)

Birth Preferences

Mother-to-be: Me Father-to-be: My husband Practitioner: Our doctor

This birth plan is intended to express the preferences we have for the birth of our baby. The basic idea here is we want as few interventions as possible. If situations arise where this plan cannot be followed for the safety of mom and baby, we understand. Please keep us informed and aware of our options. Thank you.

Overall, we prefer:
  • No restrictions on eating and drinking
  • No continuous IV infusions
  • No artificial rupture of the membranes
  • No augmentation of labor
  • No episiotomy
Throughout labor and birth, we prefer:
  • Dim lights
  • Calming environment
  • Intermittent fetal monitoring
  • Limited conversation and questions directed toward mom
  • Please attempt placement of IV in arm first, not wrist or hand
  • Frequent change of positions
  • Vaginal exams kept to a minimum
  • Maintain mobility as long as possible (walking, birth ball, shower, bath, up to bathroom, etc.)
  • We may not be open to having students in room, please ask first
  • Pain management: non-pharmacological comfort measures preferred for as long as possible
  • Likely no epidural until transition
  • Prefer lower dose epidural
Throughout second stage, we prefer:
  • Labor down, delay pushing until I feel pressure or fetal head visible in perineum
  • Position for birth – 1st choice: side-lying, other positions may work better though, we want to do what is best for mom and baby
  • If I’m able to feel need to push, allow spontaneous pushing
  • Encourage breathing out while I push
  • Prefer to tear than have an episiotomy
  • Support perineum to control birth and prevent tearing
  • Third stage and immediate baby care preferences:
  • Place baby on my abdomen
  • Evaluation of baby on my abdomen
  • Delay cord clamping if possible
  • Allow dad to cut cord (if he’s up to it!)
  • Skin to skin and breastfeed
  • No separation of mother and baby if possible
1st hour postpartum:
  • Limit visitors. We want this time to bond with baby.
Newborn care:
  • Breastfeeding only
  • No pacifiers or bottles
  • Sugar water ok during painful procedures
  • Pediatrician: ______________

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