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Old 01-25-2013, 02:28 PM   #1
KLadyBugMama's Avatar
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Formerly: faithfulorangekids
Join Date: Dec 2010
Location: Laurel, MD
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Birth Plan for Hospital

Hi, I have researched about UC, Homebirths, and hospitals and decided it would be best/easier for me and for my future child to do it at Mercy hospital which have a natural childbirth option including water births!! So I'll do it there. However, I know hospitals can be.....an interesting experience so I was wondering if anyone had a hospital birth with a birth plan drawn up. I have written up one and will hand one to my OB when I become pregnant but I was wondering if any hospitals will follow your wishes?

I have attached my birth plan so criticism, and advice/tips are welcome!



I have prepared this Birth Plan to help you understand my philosophy and the kind of care I hope to have for the birth of my child. I wish for as natural a birth as possible, avoiding unnecessary procedures and medications. I would like to direct, but know I cannot control, my childbirth experience. When this Birth Plan is respected, then, if I need to deviate from its general guidelines, I will feel better about the change. Let me know right away if you think I need to change plans, and why the change is necessary. I would like to be part of the decision-making team and to be consulted about and asked for our consent before any medical procedure is performed. In addition, I would like any medical procedure explained as it is performed. I fully realize that emergencies can happen, and that in the case of an emergency, the health care team will take the best steps for me and my baby.


It is important to me that me and the baby remain together at all times during the labor and delivery (vaginal or cesarean).
While I understand and can appreciate the need for training and teaching, I highly value my privacy and would like to keep the birth team to the minimum necessary number, which excludes residents, trainees, and other nonessential personnel. The people that may visit are my immediate family members and selected friends.

No routine enema
No shaving or removal of pubic hair
No IVs/Hep Block


Lights dimmed
Voices respectfully lowered, no loud signing
Prefer option to film and/or photograph

Prefer freedom to choose positions and activity level in labor as long as cord prolapse is not an issue. No restricted activities unless medically necessary.

Pain relief through breathing, massage, counter-pressure, changes in position, water (tub/shower) and emotional support.
No pain medications to be offered unless requested. That includes epidurals.
If available, I would like access to a tub, squatting bar, birthing ball, and rocking chair.

Unlimited eating/drinking preferred but ice chips or light beverages upon request. (due to food allergies, I will provide my own foods or request foods that I am able to eat (no dairy, casein, any nuts)

External fetal monitoring only as required by the condition of the baby. No constant monitoring and that includes internal fetal monitoring unless baby is in distress.

Internal exams for specific medical indication, when labor changes, or by request.

Prefer to walk to the bathroom when needed.
If catheterization becomes necessary, I prefer to have it removed as soon as possible after bladder is empty, but dont offer.

As long as the baby and I are fine, I would like to be free of time limits and not have my labor augmented. DO NOT OFFER!
If ROM occurs at onset of labor, I prefer to wait 12 hours or more before inducing if my condition permits.
If necessary, I would like to try walking, nipple stimulation, and pelvic rocking.


Position in pushing phase to be determined by me at the time (using gravity enhanced positioning if possible) includes the possibility of full/partial squatting positionsnot flat on back). Preferred to do pushing phase in water is my highest priority.
Pillows, wedge, elevated table back for support at delivery, if necessary.

Pain relief through breathing, massage, counter-pressure, changes in position, water (tub/shower) and emotional support.
No pain medications to be offered unless requested.

Desire to try for intact perineum with massage, support, and hot compresses.
If necessary, we prefer a pressure episiotomy when baby's head is crowning. (Small tear is preferable to a large incision.)
Local anesthetic is permissible for performing & repairing an episiotomy.

As long as the baby and I are fine, I would like to be free of time limits on pushing.
Prefer option of self-directed pushing to help ease the baby out slowly and avoid tearing the perineum.
If pushing is not progressing efficiently, I would like to be reminded that sometimes changing positions helps. I would like to be encouraged to try one or more of the following delivery positions: squatting, side-lying, standing
upright, hands and knees on floor, kneeling with arms resting on bed/chair, or semi-reclining on bed-knees pressed to chest with support person behind providing counter-pressure.
Forceps preferable to vacuum extraction, but prefer to avoid as last resort.
Mother would like to be allowed to touch the baby's head as it begins to crown if labor is normal.
Mother would like to catch the baby if babys condition permits.

Baby placed on my chest upon delivery.
Grandmother would like to cut the cord.
Would like to nurse immediately after delivery.
Prefer newborn procedures completed after initial bonding time.
No eye agents such as silver nitrate or antibiotic ointments in eyes. Only breastmilk allowed.
Prefer spontaneous placenta separation with breast stimulation/nursing the baby after delivery rather than inducing with pitocin, uterine massage or cord traction. If a procedure is necessary, please explain it to me.
Perineum ice packs if requested immediately after birth.
If fundal massage is necessary I'd like to try it myself, with someone else instructing how.
Prefer freedom of movement after birth.
No routine administration of pitocin after the birth unless told to.
Recovery with baby in private
24-hour rooming in
Breastfeeding on demand with assistance only as requested
Prefer to have person of choice in my room at any time of day
I would like the option being discharged as soon as possible once my midwife has approved it.
If the baby is a boy, there will be NO circumcision.
No disposable diapers; I will bring and provide cloth diapers/natural wipes. I will bring a wet bag for dirty diapers.

Prefer to postpone routine newborn procedures until I have had a chance to bond with my baby.
Baby held by grandmother and nursed by mother.

Breastfeeding exclusively on demand
NO supplementation of any kindpacifier, sugar water, formula, etc.

Suctioning if necessary, if not, DONT DO IT!

Prefer all routine procedures done in our room after initial bonding time.
If this is not possible, I would like to have grandmother stay with the baby at all times.
I prefer that the baby be gently wiped down with a soft cloth to remove fluids, and wrapped in a blanket.
Please do not bathe, to allow our baby's natural vernix to continue to soften and protect the skin.
No Vitamin K injections (oral is fine) (Will breastfeed which will provide natural Vitamin K), and No Hep B vaccine. PKU test is fine and beneficial for the baby.
I ask that you discuss any additional newborn procedures with me before they are performed.

NO eye agents such as silver nitrate, or antibiotic ointments. Will use breastmilk.

If warming is necessary, prefer mother holding baby, with soft cloth/blanket covering both.


Please keep communication open. If at all possible, please wait for my express consent, or that of my mother, before initiating any procedure.
It is important to me that my mother be present with me at all times during the birth.
Ideally, I would like to remain awake and aware, avoiding general anesthesia if possible.
Prefer regional anesthesia with little or no premedication or discuss further anesthesia options with me.
I prefer that the anesthesia take effect before the catheter is inserted and that there are no "hot spots" (areas which are not yet numb) before the surgery begins.
Prefer to have the obstetrician explains events as they occur.
Please use a low-transverse incision on my uterus and abdomen.
Please leave at least one of my hands free so I may touch our baby when he or she is born.
Assuming the baby is well, I would like to hold our baby on my chest.
Breastfeeding as soon as possible.
I would like the baby's health to be judged on its own merits - no special nursery care unless necessary.
Please remove my IV and catheter as soon as possible following our baby's birth.
Please provide me with nutritious food and drink as soon as possible.

If my baby is not well, I would like to:
accompany my baby, or have the grandmother accompany our baby, if transported to another facility.
breastfeed exclusively, or provide my expressed milk for our baby.
have unlimited visitation.
hold, rock and care for our baby, if possible.
Visit NICU as much as possible.
Have all procedures explained before/as they are performed as our babys condition permits.
I thank you for taking the time to go over this Birth Plan, and appreciate your cooperation in getting the new family off to great start!


Tiffany, Mama to my lil ladybug, Kianna, 11/10/13!
Babywearing fanatic, cloth diapering guru, CPST, cosleeping gal, full term nursing supporter!
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