Our Birth Plan

       BIRTH PLAN

         [names of parents and children]


LABOR:

Enema:  None

Prep:  None

Presence of family:  Coach (Dad) present at all times.  Children and their adult friends present at parents' discretion.

Position for labor:  Whatever works at the time.

Onset of labor:  Spontaneous.  If late or other complications, will discuss other options at the time.

Hydration/fluids:  Drinking water and juice until no longer tolerated, then ice chips.

Food:  Anything reasonable until no longer tolerated.

Monitoring fetal heart:  Stethoscope or Doptone.

Pain relief:  Relaxation, breathing, comfort measures.

Speed up labor:  If necessary, walking, nipple stimulation, pelvic rocking.  If complications, will discuss other options at the time.

To empty bladder:  Walk to the bathroom.


BIRTH:

Position:  Squatting, or if that doesn't work, hands and knees.  If neither of those two work, try whatever.

Expulsion techniques:  Bearing down with contractions.

Speed up birth:  Gravity-enhanced positions.  If complications, will discuss other options at the time.

Bed for birth:  Mother's choice of floor, bed, or whatever else is available.

Cleanliness of perineum:  Undraped, mother touches baby during birth.

Care of perineum:  Try for intact perineum with massage, support, and hot compresses.

Presence of family:  Coach (Dad) present at all times.  Children and their adult friends present at parents' discretion.

Handling of baby:  Mother gets to hold baby immediately, with father helping so baby doesn't accidently get dropped.  Suctioning or whatever done
   while baby is in mother's arms.  (Of course, if complications, will  discuss other options at the time.)


AFTER BIRTH:

Delivery of placenta:  Spontaneous or encouraged with breast stimulation and nursing the baby.

Cord cutting:  Clamp and cut after it stops pulsating.  Father cuts cord.

Presence of family:  Father and other children present at all times.

Discharge of mother and baby:  As soon as possible.  If medically feasible,  within 24 hours of admission to enhance insurance coverage.


BABY CARE:

Airway:  Baby coughs and expels own mucus.  Suctioned only if necessary.

Warmth:  Baby skin-to-skin with mother, with blanket covering both.

Immediate care:  Baby held by parents and nursed by mother.  Observed in  parents' arms.  If parents need a break, baby is kept nearby in  bassinet.

Eye care:  Nonirritating agent, such as erythromycin or tetracycline, as late as possible, so baby has a chance to look at her family.

First feedings:  Breastfeeding on demand.

Contact with baby:  24-hour rooming in.

                           BIRTH PLAN (PROBLEMS)


C-SECTION:

Rationale:  Unless emergency prohibits, confirm fetal heartbeat indicators with fetal scalp blood oxygen readings.

Partner's presence:  Father present.

Anesthesia:  As little as possible depending on circumstances.  No general  unless absolutely necessary.

Participation:  Screen lowered at time of delivery.  Events explained as they occur.

Contact with baby:  Held by father immediately after birth, where mother can  touch and see.  Breastfeeding as soon as possible.

Discharge of mother and baby:  As soon as possible.

SICK INFANT:

Contact with baby:  Parents visit and care for baby as much as possible.  If  baby must be transferred to another hospital, mother goes, too; if that's
   not possible, father goes with baby.

Feeding:  Mother nurses baby.  If that's not possible, parents feed mother's expressed milk to baby.  If neither is possible, will discuss other
   options at the time.

Contact with support group:  Yes.