My Birth Plan Name: Partner's name: My delivery is planned as a: Vaginal delivery Cesarean delivery Trial of labor after cesarean Before Labor: I would prefer to go into labor on my own rather than be induced. If the baby and I are doing well, I would prefer not to be induced until 41 weeks. During Labor: I do not want to receive an enema or be shaved. I would like to be free to move around and find positions or places that are most comfortable for me. I would like to wear my own clothes. I am interested in using a labor tub or shower. As long as the baby is doing well, I would prefer to have intermittent fetal monitoring (every 15 minutes). If I need continuous monitoring, I would prefer wireless monitoring so that I can move around. I would prefer not to have any internal monitors unless absolutely necessary. I would prefer to not have observers or students without my permission. Pain Management: Please don't offer me any pain medications. I plan to use non-medical pain relief techniques. I'll decide whether to use pain medication as my labor progresses. I plan on using IV pain medications. I plan on getting an epidural. I would like the lights kept low in my room. I plan on bringing music to play while I'm in labor. Delivery: I would like to be able to photograph and/or film my delivery. I would like to have a mirror avaliable to view my baby's birth. I would like to touch my baby's head as I crown. I would like to be coached on when to push. I would prefer to push instinctively. I do not want an episiotomy. I would like to choose the position I deliver in. Right After Delivery: I'd like to hold my baby skin-to-skin immediately after delivery. I would prefer delayed cord clamping as long as the baby is doing well. My partner would like to cut the cord. I'd like to delay bathing and other newborn procedures for at least an hour so that I can feed and bond with my baby. Neonatal care: I plan to exclusively breastfeed my baby while in the hospital. I plan to formula feed my baby. I plan to breastfeed and use formula. Please do not give my baby a bottle or pacifier. I would like my baby to stay in the room with me. I would like my baby to stay in the room with me only when I'm awake. I would prefer that my baby is examined in the room with me. If my baby is a boy, I want him to be circumcised in the hospital. If my baby is a boy, I want him to be circumcised later. If my baby is a boy, I do not want him to be circumcised. If I need a Cesarean: I would like a spinal anesthestic. I would prefer clear drapes so that I can see the cesarean delivery. I would like my baby skin-to-skin while still in the operating room. I would like to breastfeed in the recovery room. I want my parter to stay with me at all times. Going home: I'd like to leave the hospital as soon as possible after delivery. I'd prefer a longer stay in the hospital. Anything else: Loading...
