Does anyone have a link to a good birth plan template? I can't find the one I used with DD but wanted to make sure I get how I want my birthing process to go down in writing for the hospital staff. TIA!
I picked and chose from multiple birth plan templates to create a one page birth plan that addresses all my most important issues...i found that not one of them was 100% good enough
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Here is my birth plan...i pasted it from word.
Birth Preferences: _________(name)
Due Date: ___________ ? _________
OB/GYN ?
Spouse: ______________ ? Doula: _____________
Labor
I would appreciate being assigned a nurse who
enjoys natural births
I wish to be able to change
position at will throughout labor.
I would like to be able to eat and drink as I
desire.
I would like the lights in the room to be kept low during my
labor.
I would appreciate a minimum
of vaginal exams and only to be done
by nurses or doctors. Please allow 3-4 hours between each centimeter dilation
before declaring "stalled progress".
Please no
IV or Saline-Lock unless absolutely necessary.
Monitoring
I would prefer intermittent fetal monitoring as opposed to
continuous fetal monitoring; as required by the condition of baby.
I wish to avoid an internal monitor unless absolutely
necessary.
Labor
Augmentation/Induction
I do not wish to have the amniotic membrane
ruptured artificially.
I would prefer to be allowed to try changing
position and other natural methods (walking, nipple stimulation) before artificial
induction is suggested or insisted upon.
Pain Medication/ Pain
Relief
I realize that many pain medications exist. I'll ask for them if I
need them. I do not wish to have these offered to me.
I'd like to manage my pain naturally through the
bath and showers; and would appreciate coaching as needed for using the
birthing ball, spousal massage, and ice/heat packs as required.
Please
refrain from any medical interventions not previously agreed upon. I am
happy to discuss any measures which may be deemed medically necessary prior to their implementations
Cesarean
I would like to avoid a Cesarean unless absolutely
necessary and would prefer to try alternatives to cesarean without pressure.
If a Cesarean delivery becomes necessary, I would
like to be fully informed and to participate in the decision-making process
with my spouse present at all times.
Episiotomy
I do not want
an episiotomy and wish to protect the perineum, I would prefer a natural tear...but
I am willing to discuss this should the need arise.
I am practicing ahead of time by squatting, doing
Kegel exercises and perineal massage. I would appreciate guidance in when to
push and when to stop pushing to allow the perineum to stretch.
Delivery
I would like to be allowed to choose the position
in which I give birth, including squatting, on hands and knees etc.
Even if I am fully dilated, and assuming baby is
not in distress, I would like to try to wait until I feel the urge to push
before beginning the pushing phase.
I would appreciate the room lights turned low for
the delivery.
I would like to have baby placed on my stomach/chest
immediately after delivery as long as baby is okay.
Immediately After
Delivery / Postpartum
Please allow the umbilical cord to stop pulsating before it is cut. I would like my spouse to
be offered the option to cut the cord.
I would like to hold baby while I deliver the
placenta and any tissue repairs are made.
I would like to have baby evaluated and bathed in
my presence or my spouse's presence.
If baby must be taken from me to receive medical
treatment, my spouse will accompany baby at all times.
I appreciate your patience in waiting for the
placenta to detach
naturally...I do not want a routine injection of Pitocin after the delivery to aid
in expelling the placenta, unless absolutely necessary (as long as there is no
heavy bleeding).
I'd like to delay baby's eye medication for a few
hours after birth.
I do not
wish to have the baby injected with Hepatitis B vaccine.
Unless required for health reasons, I do not wish
to be separated from my baby.
Breastfeeding
I plan to breastfeed baby and would like to begin
nursing very shortly after birth.
I would like to meet with the staff Lactation Consultant as soon as possible following
birth to assess breastfeeding progress.
I do not wish to have any bottles (including
glucose water or plain water) or pacifiers given to baby.
I used birthplan.com, then copied and pasted into a word document, took out the headings, and shortened a lot of the sentences. My birthing instructor recommended that it not be longer than one typed page and not too small of a font or most medical staff won't take the time to read it.
It didn't copy perfectly...but i have it bulleted and set up in two columns on one page in word...i felt it was best to keep it all on one side of a page!
Re: Birth plan template
Birth Preferences: _________(name)
Due Date: ___________ ? _________ OB/GYN ?
Spouse: ______________ ? Doula: _____________
Labor
Monitoring
Labor Augmentation/Induction
Pain Medication/ Pain Relief
Cesarean
Episiotomy
Delivery
Immediately After Delivery / Postpartum
Breastfeeding
Birth plan for _________ and ________
Care provider:
Our desire is to have a natural, non-medicated and intervention free birth. We fully appreciate your support in our decision.
Labor
Birth
After Delivery
Cesarean Section
Thank you for understanding; we know that you will do everything possible to make our stay in the hospital a pleasant one!
Neena Mae. 1/7/10
"A baby nursing at a mother's breast is an undeniable affirmation of our rootedness in nature." - David Suzuki
I liked the advice here:
https://nursingbirth.com/2009/07/23/top-ten-dos-for-writing-your-birth-plan-tips-from-an-ld-nurse-part-2/