Sample Birth Plan One
We are looking forward to the birth of our fourth child, a son, at the Hospital this fall. Our labors have been short and uneventful, so we are not anticipating any problems. We ask that the following wishes be respected during this birth.
We plan to have present at this birth our Midwife, the Father and one friend for support. We ask that ALL other visitors and unnecessary staff be turned away until we (the parents) have had time alone with our new son.
The birth environment is very important to us. For that reason we ask that the lights be kept dim, noise be avoided and the door closed for privacy. We will bring our own music, and The mother would like to wear her own clothes during the birth.
This is our fourth child, and we have seen differences in our babies who were born using drugs, and those that were not. For this reason we are attempting to have a natural birth, which we believe to be birth without medical and/or chemical intervention. We do understand that there are procedures which may be necessary. Except in the case of an extreme emergency, we ask that we be given the opportunity to accept or refuse any procedure. We also request that the least invasive or restricting versions of procedures (i.e. walking epidural, external monitor) be used.
If induction becomes necessary, we ask that non-chemical induction methods (walking, breast stimulation, castor oil, sexual intercourse) be tried before chemical methods. If chemical methods do become necessary, we prefer to use the cervical cream before trying pitocin.
We plan to handle pain with relaxation, massage, and water. Please do not offer chemical pain relief.
We plan to use the squatting or semi-squatting position for pushing. The mother would like to push at her own pace. And if time permits, The mother would like to feel our son's head as he descends. We prefer to not have an episiotomy.
The father would like to be included fully in the "catching" of our son and cutting of the cord.
After the birth, we wish to nurse our son immediately. We ask that any evaluations be done while The mother is holding him. We also ask that the cord not be cut until it stops pulsing.
If Cesarean becomes necessary, The mother would like to be conscious, The father would like to be present at all times and we still prefer for our son to be nursed immediately.
We prefer that our stay at the hospital be extended to the longest our insurance will allow so The mother may recover fully before returning home. We ask that The father and our son both room in. We ask that our other children be allowed to visit.
We thank you for taking the time to help us achieve a natural birth for our son.