Birth Plan of Danielle T.
Mother-To-Be:Danielle T., Father-To-Be: Darin T.
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 you 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!
Please Note
My bloodtype is Rh- (Rhesus Negative) however so is the baby's Father.
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 you 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!
Please Note
My bloodtype is Rh- (Rhesus Negative) however so is the baby's Father.
Labor
Please perform no routine prepatory tasks (shaving, enema, etc.)
I expect that midwifes, 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 wear my own clothes, rather than a hospital gown.
I prefer to eat and drink throughout labor, as desired.
I will remain hydrated by drinking moderate amounts of fluids (water, juice, ice chips).
Please do not administer an IV or heparin lock unless there is a clear medical indication that such is necessary. I wish to labor freely in the birthing 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 the membranes have ruptured.
Please allow me to vocalize as desired during labor and birth.
Please do not permit observers such as interns, students or unnecessary staff into the room without my permission.
To preserve my privacy and dignity, I would prefer that everyone knock before entering.
I would like Isabella & Darin Tassin to stay though-out the Labor as they Desire, unless there is a medical emengency in which case. Isabella will be pick up and Darin would to stay with me the baby.
Labor Augmentation/Induction
I would like to avoid induction unless it is medically necessary.
If my pregnancy progresses past 40 weeks, I would prefer to base the decision to induce on the results of our baby's biophysical profiles, not on my own personal discomfort or impatience.
I would like to try alternative means of labor augmentation, like walking or nipple stimulation, before pitocin or artificial rupture of membranes is attempted.
Anesthesia/Pain Medication
Please do not offer anesthesia/analgesia unless I ask for it, by name.
If I ask for pain relief, please feel free to offer non-medical choices for coping and/or remind me how close I am to the birth.
Cesarean Section Delivery
I feel very strongly that I would like to avoid a cesarean delivery
If a cesarean is necessary, I expect to be fully informed of all procedures and actively participate in decision-making.
I would like Darin Tassin to be present during the surgery.
Please explain the surgery to me as it happens.
I would prefer epidural anesthesia, if possible, in order to remain conscious through the delivery.
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 the baby after the delivery.
If possible, I would like to breastfeed our baby immediately after the birth.
Please lower the screen just before delivery so I may see the birth of the baby.
Perineal Care
I prefer not to have an episiotomy unless it is medically indicated.
To help my perineum stretch, please help guide my pushing efforts by letting me know when to push and when to stop.
I would rather tear than have an episiotomy.
Please administer local anesthesia when repairing any episiotomy or tear(s).
Please suture tears only if necessary.
Delivery
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 to help catch our baby.
I would like to have the birth recorded with photographs, video tape and/or tape recording.
I would like to deliver in a birthing pool.
Immediately after the birth
Please place the baby on my stomach/chest immediately after delivery.
I would like to breastfeed the baby immediately.
I would like the option 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.
I would like to take the placenta home with me.
Newborn Care
I would like to hold our baby skin-to-skin during the first hours to help regulate baby's body temperature.
I would like to hold our baby through delivery of the placenta and any repair procedures.
If possible, please evaluate our baby on my abdomen.
If our baby, must go to the nursery for evaluation or medical treatment I or someone I designate, will accompany our baby, at all times.
I would prefer to bathe our baby, myself, at my discretion.
I would like to waive the administration of eye antibiotics.
I would like to waive the administration of Vitamin K.
I do not want any vaccination giving to our baby at the time of birth.
I will follow up with our baby's pediatrician after being released from the hospital.
Postpartum Care
I would prefer not to be catheterized. Please allow me some private time to attempt urination on my own.
If available, I would prefer a private room.
I would like to have our baby room-in with me at all times.
I would like Darin & Isabella T. to room-in with me.
I would like my other children to have free visitation access.
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 first informing me of the reason(s) and seeking my consent from me or Darin T.
I would like to meet with the staff lactation consultant.
Sick baby
If Our baby is sick and needs to be in the NICU, Darin Tassin will stay with our baby.
If Our baby needs to be transported to another hospital, Darin Tassin will go with our baby.
Please Allow Breastfeeding and kanagaroo care as soon as baby is able.
Allow unlimited visits from parents.
Please allow access to a hospital grade pump so that milk may be expressed for our baby.
Additional notes
I would like to take still photographs and/or Video during labor and the birth. I am not planning to have our baby, Mattheus Ayden circumcised.
Please perform no routine prepatory tasks (shaving, enema, etc.)
I expect that midwifes, 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 wear my own clothes, rather than a hospital gown.
I prefer to eat and drink throughout labor, as desired.
I will remain hydrated by drinking moderate amounts of fluids (water, juice, ice chips).
Please do not administer an IV or heparin lock unless there is a clear medical indication that such is necessary. I wish to labor freely in the birthing 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 the membranes have ruptured.
Please allow me to vocalize as desired during labor and birth.
Please do not permit observers such as interns, students or unnecessary staff into the room without my permission.
To preserve my privacy and dignity, I would prefer that everyone knock before entering.
I would like Isabella & Darin Tassin to stay though-out the Labor as they Desire, unless there is a medical emengency in which case. Isabella will be pick up and Darin would to stay with me the baby.
Labor Augmentation/Induction
I would like to avoid induction unless it is medically necessary.
If my pregnancy progresses past 40 weeks, I would prefer to base the decision to induce on the results of our baby's biophysical profiles, not on my own personal discomfort or impatience.
I would like to try alternative means of labor augmentation, like walking or nipple stimulation, before pitocin or artificial rupture of membranes is attempted.
Anesthesia/Pain Medication
Please do not offer anesthesia/analgesia unless I ask for it, by name.
If I ask for pain relief, please feel free to offer non-medical choices for coping and/or remind me how close I am to the birth.
Cesarean Section Delivery
I feel very strongly that I would like to avoid a cesarean delivery
If a cesarean is necessary, I expect to be fully informed of all procedures and actively participate in decision-making.
I would like Darin Tassin to be present during the surgery.
Please explain the surgery to me as it happens.
I would prefer epidural anesthesia, if possible, in order to remain conscious through the delivery.
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 the baby after the delivery.
If possible, I would like to breastfeed our baby immediately after the birth.
Please lower the screen just before delivery so I may see the birth of the baby.
Perineal Care
I prefer not to have an episiotomy unless it is medically indicated.
To help my perineum stretch, please help guide my pushing efforts by letting me know when to push and when to stop.
I would rather tear than have an episiotomy.
Please administer local anesthesia when repairing any episiotomy or tear(s).
Please suture tears only if necessary.
Delivery
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 to help catch our baby.
I would like to have the birth recorded with photographs, video tape and/or tape recording.
I would like to deliver in a birthing pool.
Immediately after the birth
Please place the baby on my stomach/chest immediately after delivery.
I would like to breastfeed the baby immediately.
I would like the option 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.
I would like to take the placenta home with me.
Newborn Care
I would like to hold our baby skin-to-skin during the first hours to help regulate baby's body temperature.
I would like to hold our baby through delivery of the placenta and any repair procedures.
If possible, please evaluate our baby on my abdomen.
If our baby, must go to the nursery for evaluation or medical treatment I or someone I designate, will accompany our baby, at all times.
I would prefer to bathe our baby, myself, at my discretion.
I would like to waive the administration of eye antibiotics.
I would like to waive the administration of Vitamin K.
I do not want any vaccination giving to our baby at the time of birth.
I will follow up with our baby's pediatrician after being released from the hospital.
Postpartum Care
I would prefer not to be catheterized. Please allow me some private time to attempt urination on my own.
If available, I would prefer a private room.
I would like to have our baby room-in with me at all times.
I would like Darin & Isabella T. to room-in with me.
I would like my other children to have free visitation access.
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 first informing me of the reason(s) and seeking my consent from me or Darin T.
I would like to meet with the staff lactation consultant.
Sick baby
If Our baby is sick and needs to be in the NICU, Darin Tassin will stay with our baby.
If Our baby needs to be transported to another hospital, Darin Tassin will go with our baby.
Please Allow Breastfeeding and kanagaroo care as soon as baby is able.
Allow unlimited visits from parents.
Please allow access to a hospital grade pump so that milk may be expressed for our baby.
Additional notes
I would like to take still photographs and/or Video during labor and the birth. I am not planning to have our baby, Mattheus Ayden circumcised.
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