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Homebirth to Hospital Transport Birth Plan

by Anita

Dear Dr. Smith:

We would like to thank you for services during my pregnancy. I am planning a homebirth in June, as we expect to rely on the normal physiology of the labor and birthing processes to effect our baby's birth. However in the event your skills should become necessary and we transport to the hospital, by minimizing medical interventions, as well as by recognizing our concerns to have a truly family centered birthing experience, we hope that you will be able to help us achieve our goal of an optimal birth. The attached birth plan includes important facets of family-centered birthing; it is our sincere wish that all involved will work with us to achieve our goal on this very special occasion in our lives.

If there are any concerns regarding these items, please don't hesitate to call. Thank you.

Birth Plan

Anita and Russell

I expect that during my stay in the hospital, me, my body and my baby will be treated with Dignity and Respect. Because what I will take away from this experience will be more than my baby and a sore body...it will be the memories of how you behaved with me, towards me and my baby. You can make the difference. And since you can't be a mind reader...and you don't know me well...we'll share what we might consider respectful.

All of our requests presume that Anita has a normal birth. If there is a situation that constitutes a medical emergency for either Anita or our baby, we agree to consider all medical judgments only after informed consent. We would prefer to have the following set of requests honored:

  1. Please do not offer pain medication.
  2. Please use a stethoscope or fetoscope for monitoring.
  3. No IV.
  4. Freedom to eat and drink.
  5. No artificial rupture of membranes.
  6. No internal exams unless requested.
  7. No shave or enema.
  8. Nipple massage for stimulating contractions. If pitocin is required, start with the lowest dose.
  9. Please use perineal support and warm compresses. Mom prefers a tear over an episiotomy.
  10. Mom would like to labor and deliver in her own clothes.
  11. Mom would like to wear her contact lenses, even in the event of a cesarean.
  12. Please, no students at any time in the room.
  13. Dad and private labor coach remain with the mother from hospital admission forward.
  14. More than one support person if desired. Our children should be free to view birth.
  15. We would like to have our tape player and music during labor and delivery.
  16. We would like to videotape and photograph the birth, even if it is a cesarean.
  17. Lights dimmed, room quiet with minimal staff.
  18. Freedom to give birth in any position mom chooses. Mom prefers to squat.
  19. Mom would like to touch her baby's head as it crowns. She would also like a mirror to view the birth.
  20. Please allow Mom or Dad to cut cord after it stops pulsating.
  21. Baby on mom's tummy immediately after birth.
  22. Nursing immediately after birth. No introduction of anything artificial for the baby; breastfeeding only.
  23. Newborn exam should be done at mom's bedside.
  24. We waive the use of vitamin K and eye drops.
  25. No bath; vernix should be rubbed into the baby's skin.
  26. Cesarean: an epidural should be used. Russ will be allowed to accompany Anita to the operating and recovery room. Please use the former low transverse cesarean scar for the incision site. Please lower the drape so that Anita may see the birth. Anita would prefer not to have her hands tied down. Russ to hold the baby immediately after delivery. Baby should remain with Russ for remainder of surgery unless baby requires intensive care attention, in which case Russ should be allowed to stay with baby. No extra analgesia; Anita would like to breastfeed in recovery. Baby should not be removed to NICU without informed consent.
  27. Discharge as soon after birth as possible unless there are complications, in which case we would like to room-in.
Our goal is to give our baby and ourselves the most gentle, loving, safe, advantageous birth possible. We believe the above options will most likely accomplish this. We would very much appreciate your caring cooperation. Thank you.

Copyright by Anita
(This article was Formerly published on Cyndi Egbert's website before she took her website down.)


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