Birth Plan

My Wishes for Childbirth - Nicole Ann Massie

Due Date: 03/25/2010
Patient of Dr. Misty Day
Scheduled to deliver at St. Johns Mercy Medical Center


01/20/2010
To Whom it May Concern

I am creating this birth plan prior to my labor in order to make my wishes clear to my doctor, and the nurses at the hospital where I am delivering. These are the items I consider important in the birth of my unborn baby and I would like them to be followed as closely as possible whenever able. I understand that a circumstance might come up where either I may change my mind or that my doctor may feels that it is in my best interest to deviate from my birth plan. I will be flexible, although I ask to be kept informed ahead of time of every aspect of my labor.

Sincerely,
Nicole Massie



Labor
•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 able to have fluids by mouth throughout the first stage of labor.
•I will be bringing my own music to play during labor.
•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 like to wear contact lenses or glasses at all times when conscious.

Monitoring •I do not wish to have continuous fetal monitoring unless it is required by the condition of My daughter.
•I do not want an internal monitor unless My daughter 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 labor is not progressing, I would like to have the amniotic membrane ruptured before other methods are used to augment labor.

Anesthesia/Pain Medication
•I realize that many pain medications exist. I'll ask for them if I need them.

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.
•I would like My Fiance present at all times if My daughter requires a Cesarean delivery.
•So I can view the birth, I would like the screen lowered just before delivery of My daughter.
•If My daughter is not in distress, My daughter should be given to My Fiance immediately after birth.

Episiotomy
•I would prefer not to have an episiotomy unless absolutely required for My daughter's safety.

Delivery
•I would like My Fiance and/or nurses to support me and my legs as necessary during the pushing stage.
•I would like a mirror available so I can see My daughter's head when it crowns.
•I would like the chance to touch My daughter's head when it crowns.
•Even if I am fully dilated, and assuming My daughter is not in distress, I would like to try to wait until I feel the urge to push before beginning the pushing phase.
•I would like to have My daughter placed on my stomach/chest immediately after delivery.

Immediately After Delivery •I would like to have My Fiance cut the cord.
•I would prefer that the umbilical cord stop pulsating before it is cut.
•I would like to hold My daughter while I deliver the placenta and any tissue repairs are made.
•I would like to hold My daughter for at least 15 minutes before (he/she) is photographed, examined, etc.
•I would like to have My daughter evaluated and bathed in my presence.
•I would prefer to hold My daughter rather than have (him/her) placed under heat lamps.
•I do not want a routine injection of Pitocin after the delivery to aid in expelling the placenta.
•I would like to donate the umbilical cord blood if possible.

Postpartum
•I would like a private room, if available.
•Unless required for health reasons, I do not wish to be separated from my baby.
•I would like to have My daughter "room in" and be with me at all times.

Breastfeeding
•I plan to breastfeed My daughter and would like to begin nursing very shortly after birth.
•Unless medically necessary, I do not wish to have any bottles given to My daughter (including glucose water or plain water).
•I do not want My daughter to be given a pacifier.

Photo/Video •I would like to take still photographs during labor and the birth.

Other
•My support person(s) is/are (support people) and I would like them to be present during labor and/or delivery.
•I would like my other child/ren to be able to visit me and My daughter in the hospital.
•I would prefer that no students, interns, residents or non-essential personnel be present during my labor or the birth.