BIRTH PLAN

Discussing your birth plan with your care provider is one of the most important things you can do if you want to take control of your birthing. Leave space for flexibility since not all things can go as planned, so it’s important to make informed choices. 

Here is the birth plan that I discussed with my OB a week before my birth. I was supposed to ask for some changes during our next appointment but I gave birth four days before that. Things still went smoothly. With prayer and perseverance, we were able to achieve the gentle birth that we yearned for.

Birth Preferences

Name: Roxanne C. Gutierrez-Taylan
Estimated Due Date: November 17, 2015
Doctor/Midwife’s Name(s): Dr. Susan Pelea-Nagtalon
Others attending birth:  Ralph Waldo S. Taylan (husband), Irina Otmakhova (doula)

Privacy/Modesty

• I would like to limit the number of people entering the room to as few as possible
• I prefer to maintain a calm and happy environment having my husband, my doula, and doctor serve as the main providers of labor support
• I prefer to labor with lights dim and music on

Labor

• I prefer to labor and deliver without any medication or drugs unless medically indicated
• I prefer to move around freely during labor with lights dim and music on

• I want to manage my pain through Hypnobirthing techniques and massage if possible

• I will use a variety of positions, exercises and natural measures like meditation, massage, breathing, balance ball, homeopathic remedies and heat/cold to help cope
• I prefer to have no IV but will consent to a Hep lock if necessary

• Please refrain from injecting anything else through the IV without informing or consulting us and our doctor

• I would prefer to eat and drink as needed during labor
• I prefer external fetal monitoring to be done by Doppler machine at regular intervals (not continuous)
• I prefer to avoid catheterization
• I prefer to keep the number of vaginal exams to a minimum and prefer to only be examined by my doctor only.
• I prefer to push in whatever position feels most comfortable at the time

• Have an undefined, unhurried time to labor  – even if in a latent phase/dilation not increasing

Labor Augmentation/Induction

• I prefer to have no medication to augment labor. Please do not offer me any pain medication. I will request if I wish to have it.
• If labor augmentation becomes necessary, I would like to try natural methods first including:  nipple stimulation, walking, herbs, homeopathic remedies etc.
• I do not wish to have the amniotic membrane ruptured artificially unless reasons are discussed with me first and I have consented

Episiotomy

• I prefer no episiotomy unless absolutely required for baby’s safety and would like perineal support, massage or hot compresses to help avoid a tear if needed

• If I am successful in delivering the baby out naturally and unmedicated, local anesthesia for the episiotomy is definitely welcome.

 

Birth/Delivery

• I would like to push in whatever position feels comfortable
• I prefer that no vacuum or forceps are used
• I prefer to try all a natural options before considering a c-section and will only consent to c-section for imminent medical reason

Cesarean

• Unless totally and absolutely necessary or unsafe for mom and baby, I would like to avoid Cesarean.

• I would like my husband and my doula present at all times if my son requires a Cesarean delivery
• I would like my doula to perform vaginal swabbing for the transfer of microbiome to my child
• I wish to have an epidural for anesthesia
• I prefer to be conscious and that the father and doula remain present during the whole procedure, and that we are provided the opportunity to establish skin-to-skin contact and breastfeeding as soon as the baby is born.
• I would like to have a double layer of sutures.

After Delivery

• Please place baby immediately on my chest and leave baby there
• I prefer expectant management of the third stage (delivery of the placenta) with the cord staying attached to the baby.
• I would like my husband to cut the cord/burn the cord only after at least 4 hours after birth
• I would like to have skin to skin with baby while being stitched (if needed) and breastfeed as soon as possible
• I would like delay all newborn procedures for a moment until I have had a chance to bond and breastfeed my son
• If my son must be taken from me to receive medical treatment, my husband will accompany my son at all times.
• I would like my son’s tests done only after he has had skin-to-skin contact with both me and my husband

We have chosen to decline the ff.:	We will consent to the ff.:
·         Eye ointment*	·         Vitamin K shot ·         Hep B Vaccine ·         PKU test ·         Hearing test ·         Heart screen ·         Necessary emergency treatment

 

• Baby will be exclusively breastfed, please do not offer pacifier, sugar water or formula
• I would like to request for assistance from the hospital’s lactation nurses
• I wish for my baby to remain in my room 24/7 and will accompany baby to any testing
• I would prefer to leave the hospital as soon as possible after birth of my baby

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