Birth Plan for a Natural Hospital Birth

If a homebirth or clinic birth isn't an option for you, you may want to put together a written birth plan to give to your doctor so you can achieve what you are wanting in a natural birth. This was written by a friend of mine who did an amazing job with her birth plan. The couple things I would also suggest are putting a sign on your L&D room that says "Natural Birth in place. Please do not offer an epidural. Thank you for your support and encouragement." The reason for this is that nurses are almost programed to come in and offer an epidural or pain meds. It's routine and they don't think about which mom wants them and which has said in a plan that she doesn't. Keep your birth plan as short and to the point as you can. When you fill it with too much information, it runs the risk of being thrown in a file and not ever really read by the staff.

Also, sitting down with your doctor or midwife around the time of your 36 week appointment and going over your birth plan is also advisable. This will let your doctor/midwife actually hear your desires and review them with you. Continue to push for the things that you want in your labor and delivery. Remember, this is about YOU, the patient/client, not the doctors stop watch or hospital.

This is my birth plan:
My wishes for Childbirth - Insert Name
Estimated Due Date: Insert Due Date
Patient of Insert Dr Name
Scheduled to deliver at Hospital Name

Dear Doctor/Midwives Name,

This birth plan is intended to express the preferences and desires concerning the labor and birth of my daughter/son/child. It is not intended to be a script. I understand the need to remain flexible and will be prepared for any necessary last minute changes in care. However, I need to be informed (medical reason, risks, benefits and alternatives) of each procedure and given time for discussion before it is done, so that I have the opportunity to be involved in my daughter's birth and how it is managed.

I plan for my husband/mom/sister/doula/midwife (and include their names) to be my birthing coach. As soon as possible after birth I would like for my other children to be able to come and meet his brother/sister. My mother/father (include their names) will accompany him.

I would prefer that no students, interns, residents or non-essential personnel be present during my labor or the birth.

I would like to take still photographs and make a video recording during labor and the birth.

Labor
I would like to be free to walk around during labor.

I wish to be able to move around and change position at will throughout labor.

I would like to be able to have fluids by mouth throughout the first stage of labor.
I do not want an IV unless I become dehydrated.

Monitoring
I do not wish to have continuous fetal monitoring unless it is required by the condition of my baby.
I do not want an internal monitor unless my daughter has shown some sign of distress.

Labor Augmentation/Induction
I do not wish to have the amniotic membrane ruptured artificially unless signs of fetal distress require internal monitoring.

I would prefer to be allowed to try changing position and other natural methods (walking, nipple stimulation) before pitocin is administered.

Anesthesia/Pain Medication
I realize that many pain medications exist — I'll ask for them if I need them.

Cesarean
Unless absolutely necessary, I would like to avoid a Cesarean.
If a Cesarean delivery is indicated, I would like to be fully informed and to participate in the decision-making process.

I would like my husband/support person present at all times if my baby requires a Cesarean delivery.

I wish to have an epidural for anesthesia

If my daughter is not in distress; she should be given to my husband immediately after birth.

Episiotomy
I would prefer not to have an episiotomy unless absolutely required for the baby's safety.

I would appreciate guidance in when to push and when to stop pushing so the perineum can stretch. I would also like to be given the chance to wait for my body to need to push, not just push because I'm at 10cm.

I would like a local anesthetic to repair any tear or an episiotomy.

Delivery
I would like to be allowed to choose the position in which I give birth.

I would like my husband/support person and/or nurses to support me and my legs as necessary during the pushing stage.

I would like a mirror available so I can see my baby's head when it crowns.

I would like the chance to touch my daughter's head when it crowns.

I would appreciate having the room as quiet as possible when my baby is born.

I would like to have my daughter placed on my stomach/chest immediately after delivery.

Immediately After Delivery
I would prefer that the umbilical cord stop pulsating before it is cut.

I would like to have my husband/so/support person/myself cut the cord.

I would like to hold my baby while I deliver the placenta and any tissue repairs are made.

I would like to hold my baby for at least fifteen minutes before she is examined.

I would like to have my baby evaluated and bathed in my presence.

I plan to keep my baby near me following birth and would appreciate if the evaluation of her/her can be done with him/her on my abdomen, with both of us covered by a warm blanket, unless there is an unusual situation.

If my baby must be taken from me to receive medical treatment, my husband or some other person I designate will accompany her at all times.

I would prefer to hold my baby rather than have him/her placed under heat lamps.

I do not want a routine injection of pitocin after the delivery to aid in expelling the placenta.

I would like to delay the eye medication for my baby until a couple hours after birth. (You may choose to put that you want this avoided all toghether. Be prepared with proper waiver forms if required.)

Postpartum
Unless required for health reasons, I do not wish to be separated from my baby.

I would like to have my baby 'room in' and be with me at all times.

Breastfeeding
I plan to exclusively breastfeed my baby and would like to begin nursing very shortly after birth.

Unless medically necessary, I do not wish to have any bottles given to my baby (including glucose water or plain water). (You may want to also add that this needs to first be approved by you before they say it is medically necessary and give it to the baby).

I do not want my baby to be given a pacifier.

Thank You for your Support & Encouragement in my making my birth the best it can be.

NAME _____________________________


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