Please this is my Birth Plan and every one should think of doing their own. It can be a template for your birth plan. It can help you and give you an idea of how to write a birth plan but please don’t copy it. Thank you for your cooperation!
Home Birth Plan
Mother: Valerie Partner/ Support: Andrew
Due Date: 05/20/11
Practitioner: Commercial Midwives Place of Birth: Home
I have given careful thought to my preferences during and after labor and have outlined them below. I understand that these are guidelines only and that under certain circumstances, they may not be followed.
I hope that you will honor these wishes and allow me to experience the birth I hope for.
Thank you.
Labor and Delivery
- I would like a Home Birth
- I would like a Waterbirth
- My preference would be to be monitored using the waterproof Doppler. I don’t want to have to get out of the pool for monitoring.
- I would like to be free to walk around during labor.
- I wish to be able to move around and change position at will throughout labor.
- I would like to be allowed to choose the position in which I give birth, including squatting.
- I would like to be able to drink and eat during labor.
- I will like to listen my own music during labor.
- I would like the environment to be kept as peace and quiet as possible.
- I would like a dim light in the room during my labor with candles and essentials oils.
- I would like use some relaxation techniques (breathing, focusing, etc.), Heat or Cold packs and Massage (back, foot, counter pressure, etc.).
- I do not want an IV unless I become dehydrated.
- Please do not offer me pain medications, I will ask for them if I want them.
Monitoring
- I do not wish to have continuous fetal monitoring unless it is required by the condition of my baby.
- I do not want an internal monitor unless my baby has shown some sign of distress.
- I would prefer to keep the number of vaginal exams to a minimum.
Immediately After Delivery
- I would like to have my partner cut the cord.
- I would like a delay the cord cutting
- I would like No separation of Mother & Baby
- I plan to breastfeed my baby and would like to begin nursing as soon as possible after birth.
- I would like to keep the placenta
Photo/Video
- I would like to take still photographs during labor and the birth.
- I would like to make a video recording of labor and the birth, if possible.
Labor Augmentation/Induction
- I would prefer to use natural methods to start labor – No Induction
- I do not wish to have the amniotic membrane ruptured artificially unless signs of fetal distress require internal monitoring.
- If labor is not progressing, I would like to have the amniotic membrane ruptured before other methods are used to augment labor.
- I would prefer to be allowed to try changing position and other natural methods (walking, nipple stimulation) before Pitocin is administered.
Cesarean
- NO C-Section, unless absolutely necessary – I would like to avoid completely a Cesarean.
- If I have to have a C-Section, I want to breastfeed my baby while the incision is being stitched up, or in the recovery room right afterwards.
Episiotomy
- NO episiotomy unless absolutely required for my baby’s safety
- Please use compresses, perinea massage and positioning to help avoid the need for an episiotomy
- NO use of forceps or a vacuum extractor
If I have to transfer to hospital, I want Andrew to come with me. I do not want to be separated from him. I want to keep my baby with me at all times in the hospital and to have him in bed with me.
Thank you for all your help.
Valerie and Andrew
