Sample Birth Plan/Preferences

Kawan share her birth preferences that she used when delivered her 1st baby at DEMC. So nak share kat sini birth plan/preferences tu. Mana-mana yg di word cross tu makna nya, sy taknak masukkan dalam birth plan sy. Overall ok for me...takde lah banyak sangat request nya..;)

So this is the sample:-

OUR BIRTH PLAN

Name:                                                                     Date:

IC No:                                                                      Doctor:

We have chosen the HypnoBirthing method of quiet, relaxed and natural birth. Below is our Birth Plan. We understand that these choices presume a normal pregnancy and birth. Should there be a medical emergency, we will give our full cooperation after we have had an opportunity for an explanation of the medical need. We wish to have clear and adequate explanations of all procedures, of the progress of labor as it is accessed, and of any possible complications if they occur. We would appreciate it if…..

During 1st Stage Labor
ENVIRONMENT ·          Quiet & private room, dimmed lights ·          Drawn drapes/closed door at all times ·          Min. staff (1 or 2) are present at any one time ·          Staff knock before entering ·          Play own music tapes ·          Allow to take photos of birth MOBILITY ·          Change positions for comfort & progress in labor ·          Freedom to walk & move ·          Fluids & light food, nutritional snacking if labor is prolonged FETAL MONITORING ·        No continuous EFM unless medically necessary. If it needs to be done – prefer to use a Fetal Doppler	PAIN RELIEF OPTIONS ·         No suggestion of anesthetic/analgesics unless requested INDUCTION / AUGMENTATION ·         Natural oxytocin stimulation – nipple/clitoral stimulation – and to be accorded the uninterrupted privacy to do so ·         No Pitocin/amniotomy without discussion ·         To be fully apprised & consulted before introduction of any medical procedure Vaginal examination (VE) ·        Not to have any vaginal examinations unless absolutely necessary – with permission – to avoid premature release of membranes
During 2nd Stage Labor	During 3rd Stage Labor
PUSHING TECHNIQUES ·         Gentle encouragement during final pushing stage without loud “pushing” prompts – prefer to follow my instincts and just be reminded to pant to let the perineum stretch while the baby is crowning Perineum ·         Not to have an episiotomy. Pressure episiotomy only if necessary with permission ·         Local anesthesia for repair of tears/episiotomy Birth ·         Allow to birth in ANY position I feel comfortable that will least likely require an episiotomy ·         Use of suction device rather than forceps if medically necessary ·         Cord clamping – wait until cord stops pulsating. Father will cut the cord. ·        Immediate skin-to-skin contact with baby on mother’s stomach/chest. No wrapping of baby. ·        Privacy for my husband, baby and I immediately after the birth for at least an hour	PLACENTA DELIVERY ·         Spontaneous or encouraged with breast stimulation and nursing baby (breast feeding) ·         No cord traction, Pitocin or manual removal of placenta unless there is evidence of excessive postpartum bleeding For baby (PAEDS) ·         Bright lights temporarily removed during birth & until baby is moved to mother’s chest ·         Air-con temporarily turn down/switch off ·         Allow vernix to be absorbed into baby’s skin; delay cleaning/rubbing ·         Baby to remain with mother & father for the 1st hour after birth (rubbed down, bathed, etc can be done after this) ·         For male baby, we request no circumcision. Delay circumcision for female baby until requested ·         Breastfeeding only. No bottle, formula, pacifier ·        The father will follow wherever the baby goes to after birth

We thank you in advance for your support & kind attention to our choices. We know you join us in looking forward to a beautiful birth.

_______________________ Dr.

________________________ Parents