Birth Plan or Letter

Dear Hospital Staff:
Thank you for working as a team to care for our family during and after the birth of our daughter.  We would like very much to have a vaginal birth with a minimum of medical intervention.  We understand that certain circumstances may require various approaches to care.  Our request is that in these circumstances you engage us in making decisions about our care and be open to discussing whatever options are available to us.  Thank you in advance for your care and support during this time.
                                                Sincerely Annie and Jeff
 Environment     We would prefer a calm, quiet and soothing environment in our room
      We prefer that no students, interns, residents or other non-essential personnel be present.
      *** will take photographs
Labor       Do not ask Annie to rate her pain.
      Do inform us of all vital signs taken – this should be done without our having to continuously ask for the information.
      We request not to have Annie’s cervix checked unless the information is critical for decision making.  If an exam becomes necessary please advise us of the findings.
      Annie would like to labor and deliver in whatever position is most comfortable and natural
      Annie will stay hydrated by drinking liquids, and will eat lightly for energy.
      Please do not put any medications or fluids into Annie’s IV without her full knowledge and consent.
      We prefer intermittent or hand held fetal monitoring if possible.
      Annie will push when she feels the urge to push
      Annie will receive labor support from Jeff, Amber or Nicole, Aszani or Carrie
Medications      We would prefer not to artificially augment labor with pitocin or other medications.
      Please do not offer medications that are not necessary from a clinical standpoint.  If Annie desires any form of pain relief or pharmaceutical intervention she will discuss this with her care providers.
Delivery      Annie would like to catch the baby if possible
      Do not clamp the umbilical cord until it has stopped pulsing
      Jeff will cut the cord
Immediate Post-partum      Immediate skin-to-skin contact between Annie and the baby
      Baby to be held by Annie or Jeff at all times unless separation is clinically necessary
      Please delay the newborn assessment until we are ready, we will advise staff when we are ready to separate for assessment.
Baby care      Do not offer the baby artificial nipples of any kind
      We waive antibiotic eye ointment
            We waive hepatitis B shot – we will do this at the 2-month well child