Plan, Sample 2
BIRTH PLAN FOR __________
We have prepared this Birth
Plan to help you understand our philosophy and the kind of care
we hope to have for the birth of our child. The pregnancy has
gone very well thus far. We have been careful to eat well and
stay fit, and have done everything we can to prepare for a healthy
and uncomplicated birth.
We have chosen our obstetrician,
Dr. _________, because she shares our desire for a low-intervention
birth and respects our need for good communication. We wish
for as natural a birth as possible, avoiding unnecessary procedures
and medications. However, if medications or procedures become
necessary, we ask that you discuss them with us in advance so
that we can participate in the decision making process.
It is important to us that
we remain together at all times during the labor and delivery
(vaginal or cesarean). We would like to have our labor coach,
____, stay with us throughout, as well.
We hope to avoid routine
procedures (e.g., prep, enema), to delay introduction of an
IV feed unless needed, and to keep the number of vaginal examinations
to a minimum. If procedures or medications are proposed, we
ask that you discuss them with us and suggest alternative therapies
or comfort measures so that we can make well-informed decisions.
We would like to have the
option of sucking on ice chips, and may also want to try walking,
different labor positions, and perhaps a hot shower for pain
relief in labor.
As long as things are progressing
well, we prefer intermittent monitoring with an external fetal
monitor. We very much want to avoid internal fetal monitoring
unless it is specifically medically indicated.
Because we want labor to
progress at a natural pace, we hope to avoid artificial induction
or augmentation of labor (e.g., amniotomy, stripping of membranes,
pitocin). We would also like to avoid an episiotomy and try
perineal support o r hot compresses instead.
We would like to have a mirror
placed so that mother can watch the birth, and, if things are
progressing well, mother would like to be allowed to touch the
baby's head as it begins to crown.
It is very important to us
to hold and nurse our baby immediately after birth, and to have
the weighing and bathing done in our room so that we can watch.
If this is not possible, we would like to have the father stay
with the baby at all times. Also, we ask that you discuss any
routine neonatal procedures with us before they are performed.
We plan to exclusively breastfeed
our baby, and therefore request that s/he not be given bottles,
water, or a pacifier without our prior approval. We also would
like to have a private maternity room with 24 hour rooming in,
and a cot or comfortable chair for father.
We thank you for taking the
time to go over this Birth Plan, and appreciate your cooperation
in getting our new family off to great start.