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Old 12-05-2012, 06:51 AM   #1
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EmilyA874
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Join Date: Feb 2010
Location: NW Maine
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Can you critique/offer any pointer on my birth plan please?

*another revision is in post 15, thank you all for your input and help!*

I'm aiming for a natural hospital birth. Some of you might know a bit or my story already since I have posted before, we are expecting a boy with the heart defect Tetralogy of Fallot and I will be induced sometime in my 39th week because we live 3 hours from the hospital he needs to be at. So, this is what I have for my birth plan! Can you help me add/take away as needed? Thanks
The dashes are just where peoples names are, I blocked them out for privacy

I feel like it is too long, but I am not sure what to take out.

Birth Preferences for A----- ------
Due Date: 1/14/2013
Patient of ------


We are looking forward to sharing our birth experience with you. We have created this birth plan in order to outline some of our preferences for birth. We would appreciate your reviewing this plan, and would be happy to do so with you. We understand that there may be situations in which our choices may not be possible, but we hope that you will help us to move toward our goals as much as possible and to make this labor and birth a great experience. We do not want to replace the medical personnel, but instead want to be informed of any procedures in advance, and to be allowed the chance to give informed consent. Please feel free to ask if you have any questions or comments.
Thank you!
A----- and S--- ------

Please Note
Our baby boy has been diagnosed with the heart defect Tetraogy of Fallot.
Despite this diagnosis our cardiologist, Dr. -----, has said we can have time to hold and bond with our baby before he is taken to the NICU. Please allow us time to hold and bond with our baby as long as he is not showing any signs of distress. Thank you.

Labor
I expect that doctors and hospital staff will discuss all procedures with me before they are performed.
I would like to be free to walk, change positions and use the bathroom as needed or desired.
I prefer to eat and drink throughout labor, as desired.
I will remain hydrated by drinking moderate amounts of fluids (water, juice, ice chips).
I would prefer to have a heparin lock administered instead of an IV.
Please limit the number of vaginal exams as much as possible.
I wish to labor freely in the tub or shower.
I prefer that fetal heart tones be monitored intermittently with an external monitor or doppler.
Do not offer anesthesia/analgesia unless I ask for it.
If I ask for pain relief, please feel free to offer nonmedical choices for coping and/or remind me how close I am to the birth.
I would rather tear than have an episiotomy unless there is a medical indication.
Please suture tears only if necessary and administer local anesthesia when repairing.

Delivery
Even if I am fully dilated, and assuming our baby is not in distress, I would like to wait until I feel the urge to push before beginning the pushing phase.
I prefer to not be guided or coached to push.
I would like the freedom to push and deliver in any position I like.
I would like to touch our baby's head as it crowns.
I would like a soothing environment during the actual birth, with dim lights and quiet voices.
I would like to help catch our baby.
Please place our baby on my stomach/chest immediately after delivery.
Please allow the umbilical cord to stop pulsating before it is cut.
My husband S--- would like to cut the cord.
I prefer to wait for spontaneous delivery of the placenta and do not want a routine injection of pitocin or cord traction to be used.
Please remove my IV/Heparin lock/catheter as soon as possible after delivery.

Newborn Care
I would like to hold our baby skin-to-skin as long as possible after birth and attempt breastfeeding.
My husband Sean will accompany our baby for all evaluations and medical treatments.
I do not consent to administration of eye antibiotics. I will sign a waiver if necessary.
I would like Vitamin K administered orally. I do not consent to the administration of the Vitamin K injection.
I do not consent to the administration of the Hepatitis B vaccine.
We are not having our baby circumcised. Please do not retract his foreskin.

Postpartum Care
I would prefer not to be catheterized until I've had some private time to attempt urination on my own.
I would like my other child to have free visitation access.
I would like baby to room with me at all times once he is released from the NICU.

Breastfeeding
I plan to breastfeed and want to nurse immediately following the birth.
Do not give our baby supplements (including formula, glucose, or plain water) without my consent.
I would like to meet with the staff lactation consultant.

*In the Event of a Cesarean Section Delivery*
I feel very strongly that I would like to avoid a cesarean delivery, however if a cesarean becomes necessary, I expect to be fully informed of all procedures and actively participate in decision-making.
I would like my husband Sean to be present during the surgery.
Please explain the surgery to me as it happens.
I would prefer general anesthesia in an emergency only.
I would like to have a respectful atmosphere without chatter during any part of the surgical procedure.
If possible, please do not strap my arms to the table during the procedure.
If conditions permit, I would like to be the first to hold our baby after the delivery.
If possible, I would like to breastfeed our baby immediately after the birth.
I would like our plans outlined here for after the birth to be followed as closely as possible.
Please lower the screen just before delivery so I may see the birth of the baby.
I prefer a low transverse incision
Please use double-layer uterine suturing to close my incision.


-----------original below---------


Birth Preferences for A----- ------
Due Date: 1/14/2013
Patient of ------


We are looking forward to sharing our birth experience with you. We have created this birth plan in order to outline some of our preferences for birth. We would appreciate your reviewing this plan, and would be happy to do so with you. We understand that there may be situations in which our choices may not be possible, but we hope that you will help us to move toward our goals as much as possible and to make this labor and birth a great experience. We do not want to replace the medical personnel, but instead want to be informed of any procedures in advance, and to be allowed the chance to give informed consent. Please feel free to ask if you have any questions or comments.
Thank you!
A----- and S--- ------

Please Note
Our baby boy has been diagnosed with the heart defect Tetraogy of Fallot.
Despite this diagnosis our cardiologist, Dr. -----, has said we can have time to hold and bond with our baby before he is taken to the NICU. Please allow us time to hold and bond with our baby as long as he is not showing any signs of distress. Thank you.

Labor
I expect that doctors and hospital staff will discuss all procedures with me before they are performed.
I would like to be free to walk, change positions and use the bathroom as needed or desired.
I prefer to eat and drink throughout labor, as desired.
I will remain hydrated by drinking moderate amounts of fluids (water, juice, ice chips).
So I can stay as mobile as possible, I would prefer to have a heparin lock administered instead of an IV.
I would like a quiet, soothing environment during labor, with dim lights and minimal interruptions.
Please limit the number of vaginal exams as much as possible.
I wish to labor freely in the tub or shower.
As long as our baby is doing well, I prefer that fetal heart tones be monitored intermittently with an external monitor or doppler, even if my membranes have ruptured.

Anesthesia/Pain Medication
Please do not offer anesthesia/analgesia unless I ask for it.
If I ask for pain relief, please feel free to offer nonmedical choices for coping and/or remind me how close I am to the birth.

Perineal Care
I would rather tear than have an episiotomy unless there is a medical indication.
Please suture tears only if necessary and administer local anesthesia when repairing.

Delivery
Even if I am fully dilated, and assuming our baby is not in distress, I would like to wait until I feel the urge to push before beginning the pushing phase. I prefer to not be guided or coached to push.
I would like the freedom to push and deliver in any position I like.
I would like the opportunity to touch our baby's head as it crowns.
I would like a soothing environment during the actual birth, with dim lights and quiet voices.
I would like to help catch our baby.

Immediately after the birth
Please place our baby on my stomach/chest immediately after delivery.
I would like to breastfeed our baby immediately.
My husband S--- would like to cut the cord.
Please allow the umbilical cord to stop pulsating before it is cut.
I prefer to wait for spontaneous delivery of the placenta and do not want a routine injection of pitocin.
Please show me the placenta after it is delivered.
Please remove my IV/Heparin lock/catheter as soon as possible after delivery.

Newborn Care
I would like to hold our baby skin-to-skin as long as possible after birth.
My husband S--- will accompany our baby for all evaluations and medical treatments.
I would like to waive the administration of eye antibiotics.
I would prefer to have Vitamin K administered orally or not at all if orally is not an option.
I would like to defer the following vaccinations: hep B

Postpartum Care
I would prefer not to be catheterized until I've had some private time to attempt urination on my own.
I would like my other child to have free visitation access.
I would like baby to room with me at all times once he is released from the NICU.

Breastfeeding
I plan to breastfeed and want to nurse immediately following the birth.
Please do not give our baby supplements (including formula, glucose, or plain water) without my consent, unless there is an urgent medical necessity.
I would like to meet with the staff lactation consultant.

Additional notes
We are not planning to have our baby circumcised. Please do not retract his foreskin.

*In the Event of a Cesarean Section Delivery*
I feel very strongly that I would like to avoid a cesarean delivery, however if a cesarean becomes necessary, I expect to be fully informed of all procedures and actively participate in decision-making.
I would like my husband Sean to be present during the surgery.
Please explain the surgery to me as it happens.
I would prefer general anesthesia in an emergency only.
I would like to have a respectful atmosphere without chatter during any part of the surgical procedure.
If possible, please do not strap my arms to the table during the procedure.
If conditions permit, I would like to be the first to hold our baby after the delivery.
If possible, I would like to breastfeed our baby immediately after the birth.
I would like our plans outlined here for after the birth to be followed as closely as possible.
Please lower the screen just before delivery so I may see the birth of the baby.
I prefer a low transverse incision
Please use double-layer uterine suturing to close my incision.
__________________
A, wife to S Mama to DD W born at home in the water on 3/23/11!
And my heart warrior DS N born 1/11/13!
<3 Did you know 1 in 100 babies are born with a heart defect? 1 of them is mine <3

Last edited by EmilyA874; 12-05-2012 at 06:59 PM. Reason: added revision for comparision
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