To my birth
attendants:
As a mother, I
understand and accept the fact that I am ultimately responsible for my
own health and the health of my baby. I have made every effort to gain
the knowledge and information that I need to make informed decisions.
After a careful consideration of this knowledge as well as my own values
and priorities, I have established some guidelines to help you care for
me in a way which is not only the safest for me and my baby, but also
honors my needs and beliefs about birth.
I have complete
faith in my body's ability to give birth normally. I believe my body
was designed to give birth, and that it can do so with very little
assistance. I have prepared myself for what the birth experience will
be like by taking classes and talking with mothers who have had a
positive birth experience to find out what they did that was helpful. I
do not expect to have a short labor or to have no discomfort. But I do
expect to be allowed to labor in the way that is most helpful to me,
even if that way is in conflict with routine procedures. With help from
my labor support person, I will require very little of your time and
attention.
I have chosen a
labor support person to be my birth advocate, and I authorize this
person to see that my preferences as stated in this birth plan are
carried out as closely as possible. This person will also provide
physical and emotional support throughout the whole process of labor and
delivery. If at any time a physician feels that medical conditions
warrant an intervention into the birth process, I am willing to discuss
the proposed intervention as well as the possible alternatives.
After discussing
the situation, I will expect my final decision to be respected and
honored, even if it is in opposition to the opinions of others.
The following
guidelines are designed to help my birth attendants know what kind of
birth experience I desire for myself and my baby. No deviations should
be made from this plan without my consent:
1. I will not be
separated from my support persons for any reason unless I request it.
2. I will have
no perineal shave-prep.
3. My amniotic
membranes will be allowed to rupture spontaneously
4. Pelvic exams
will be performed only at my request.
5. Because of my
belief that ultrasound is an unproven and possible unsafe technology, no
electronic monitors or dopplers will be used. Monitoring of fetal heart
tones will be done through fetoscope only.
6. I will be
upright and active throughout my labor, walking as much or as little as
I feel necessary, and assuming whatever position is most comfortable for
me and helps assist the progress of labor.
7. I will eat
light, non-constipating foods during early labor and clear liquids
during active labor, if desired.
8. No drugs of
any kind will be administered during the labor and delivery process. I
request that no offers for anesthesia be made to me by any doctor,
nurse, or other hospital staff person. In the event that a cesarean
section becomes necessary, I will decide at that time what kind of
anesthesia will be used.
9. No episiotomy
will be performed on me under any circumstances. Perineal massage with
oil, hot compresses, and perineal support will be used instead to
prepare the perineal tissues to stretch. In the event that tearing of
these tissues seems likely, I would prefer to allow the tissues to tear
rather than be cut.
10. In order to
allow the perineal tissues time to fan out so that no tearing takes
place, and in order to reduce the risk of damage to the muscles of the
pelvic floor, I will allow the baby to descend through the birth canal
slowly and without sustained pushing efforts from me. Only exhale
pushing will be used, and only when I feel the urge to do so. As long
as fetal heart tones are good, delivery will not be rushed, but allowed
to occur slowly and naturally.
11. It is my
choice to give birth in the squatting position because of the obvious
advantages it offers. If squat bars are not available, I will have two
labor support persons with me to physically support me in this position
while I give birth. I will require very little help from doctors or
nurses to give birth because the squatting position encourages proper
rotation, as well as quick and painless expulsion of the baby.
12. During labor
and delivery I will be using vocalization as one of my tools for coping
with labor. I find that it helps me to cope with the intensity of
contractions while remaining totally relaxed. Hospital staff need to be
aware that these vocalizations are constructive and that I am not making
them because I am in pain, am distress, or need assistance.
13. It is my
desire to receive no assistance of any kind with my birth unless I
specifically ask for that assistance. I am at the hospital only so that
emergency help is available if necessary. I will require no routine
care of any kind.
14. The delivery
will take place in a quiet, respectful atmosphere with dimmed lights,
soft music, and quiet, calm speaking if speaking is necessary.
15. As soon as
the infant is delivered it is to be placed on my chest and observed for
APGAR there. The infant will be allowed to nurse as desired so as to
hasten the detachment and delivery of the placenta.
16. If the body
temperature of the baby is of concern, the baby will be placed
skin-to-skin with me and a warmed blanket will be spread over us both.
At no time will the baby be separated from me and placed in a warmer.
17. At no time
will my baby be separated from me. All newborn care will be done in the
same room with me and preferably with the baby in my arms.
18. Since I have
been tested for Gonorrhea, and my husband and I are in a monogamous
relationship, I prefer that no eye drops or ointment be used in my
baby's eyes.
19. My baby will
be given no substance by mouth other than my breastmilk or colostrum.
At no time will sterile water, glucose water, or formula of any kind be
given. The baby will be allowed to nurse on demand, and no rubber
nipples or pacifiers will be given. If the baby's blood sugar level is
of concern, more frequent nursing will be encouraged, since maternal
colostrum provides a healthier and more stable blood sugar level than
processed glucose.
20. When one
gives birth in the squatting position, suctioning of the baby is rarely
necessary due to the natural drainage of fluids. If suction does prove
to be necessary, deep suctioning of the infant will be done only if
suction with a bulb syringe proves to be inadequate.
21. I request
that a warm Leboyer bath be provided within one hour after birth to
allow the baby to make a smooth and comfortable transition into the
world. No soaps or disinfecting agents will be used to wash the baby,
and vernix on his skin will be massaged into the skin rather than
removed through washing.
22. Absolutely
no procedure will be performed on my baby without my authorization and I
will be present for any procedure that is performed.
23. The
umbilical cord will not be cut until it has stopped pulsating, usually 3
to 4 minutes or longer.
24. Vitamin K
shot will not be given under any circumstances. No hepatitis B shot. If
the baby is a boy, there will be no circumcision.
25. No PKU test
will be administered in the hospital because the baby must nurse for at
least two days before this is done. It will be my responsibility to see
that the test is performed by a pediatrician at a later time.
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