Birth Plan
Mother: Katie Whiddon
Father: Cole Greene
Today’s date:
Due date: July 25th, 2017
Baby’s name: Jaxton Cole Greene
Doctors name:
Hospital name:
My delivery is as planned:
•VBA2C
•Repeat cesarean ONLY if mother or baby’s life is at risk
During labor I would like for my children, family and friends to enter the room as long as I am comfortable enough for visitors.
I would like the following people present during birth:
•Father/partner: Cole Greene
•Maternal Grandmother/support person: Toni Bender
During labor I would like:
•music played
•lights dimmed
•room quiet as possible
•as few interruptions as possible
•vaginal exams only as requested, unless medically necessary
•no residents, students, or interns present during labor or birth
•to wear my own clothes
•support person to film and/or take pictures
•my partner and support person to be present at all times
•to stay hydrated with clear liquids and/or ice chips
•to eat and drink as approved by my doctor
I would like to spend the first stages of labor in any position that I am comfortable and progressing in:
•standing
•laying down
•walking
•in shower
•in tub
I am not interested in:
•Urinary catheter
•an IV, unless I am dehydrated. Saline lock IS okay, but only in arm so mobility isn’t restricted.
Fetal monitoring:
•intermittent
•external
Labor augmentation:
•preformed only if baby is in distress
•first attempted by most natural methods
•preformed with pitocin ONLY if most natural methods fail
•NEVER to include artificial rupture of the membrane, unless dilated to 6cm
Pain relief:
•acupressure
•breathing techniques
•distraction
•massage
•meditation
•hydrotherapy
Birthing positions:
•squat
•semi-recline
•lie on my side
•be on my hands and knees
•stand
•lean on my partner or support person
•use people for leg support
•use a birth bar for support
•use a birthing stool
As the baby is delivered, I would like to:
•allow body to push naturally
•push without time limits, as long as the baby and I are not at risk
•use a mirror to see baby crown
•touch the head as it crowns
•avoid forceps usage
•avoid vacuum extraction
•let partner catch the baby
Episiotomy:
•used only after perineal massage, warm compress, and positioning
•preformed ONLY with my consent
•preformed as my doctor deems necessary
•preformed with local anesthesia
After delivery:
•my partner is to cut the umbilical cord
•the umbilical cord cut only after it stops pulsating
•no pitocin, unless deemed medically necessary by my doctor.
If cesarean is necessary:
•make sure all other options have been exhausted
•I am to stay conscious, unless at immediate risk
•my partner is to remain with me the entire time, even if unconscious
•screen lowered so I can watch delivery of baby
•my hands left free so I can touch baby, unless limbs become uncontrollable
•surgery explained as it happens
•spinal block for anesthesia
•my partner to hold baby as soon as possible
•breastfeed in the recovery room
I would like to hold and breastfeed baby immediately after delivery.
Baby’s medical exam and procedures:
•given in my presence
•given only after both parents have bonded
Please do not give baby:
•vitamin K, unless visible sign of bruising or surgery is needed
•sugar water
•pacifier
•formula
•any artificial nipple
Baby’s first bath given:
•given by me and my partner
I’d like to feed baby:
•only breastmilk
•on demand
Baby is to stay in my room at all times.
I’d like my partner:
•to stay in my room
•to have unlimited visiting
As needed post-delivery:
•stool softener
•laxative
After birth I would like to stay at the hospital:
•as long as possible
If baby is not well:
•my partner and I are to accompany baby to NICU
•only give breastmilk from my breast, pumped milk or donor breastmilk via syringe/spoon/cup/tube
•to hold him whenever possible
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