My Birth Plan

I am looking forward to sharing my birth experience with you. I have created this birth plan in order to outline some of my preferences for birth. I would appreciate you reviewing this plan, and would be happy to do so with you. I understand that there may be situations in which my choices may not be possible, but I hope that you will help us to move toward my goals as much as possible and to make this labor and birth a great experience. I do not want to replace the medical personnel, but instead want to be informed of any procedures in advance, and to be allowed the chance to give informed consent. Please feel free to ask if you have any questions or comments. Thank you!


  • I expect that doctors and hospital staff will discuss all procedures with me before they are performed.
  • I would like to be free to walk, change positions and use the bathroom as needed or desired.
  • I will remain hydrated by drinking moderate amounts of fluids (water, juice, ice chips).
  • Please do not administer an IV or heparin lock unless there is a clear medical indication that such is necessary.
  • I would like a quiet, soothing environment during labor, with dim lights and minimal interruptions.
  • I would like to play my own music.
  • Please limit the number of vaginal exams.
  • As long as Gavin is doing well, I prefer that fetal heart tones be monitored intermittently with an external monitor or Doppler, even if the membranes have ruptured.
  • Please allow me to vocalize as desired during labor and birth without comment or criticism.
  • I do not mind observation by students, interns or staff.

Labor Augmentation/Induction:

  • I would like to avoid induction unless it is medically necessary.
  • As long as Gavin and I are healthy, I do not want to discuss induction prior to 40 weeks.
  • I would like to try alternative means of labor augmentation, like walking or nipple stimulation, before pitocin or artificial rupture of membranes is attempted.
  • If induction is attempted, but fails, I would like to come back at another time rather than pursue further intervention (assuming my membranes are intact and that waiting presents no danger to Gavin or myself).

Anesthesia/Pain Medication:

  • Please do not offer anesthesia/analgesia unless I ask for it.
  • If I ask for pain relief, please feel free to offer non-medical choices for coping and/or remind me how close I am to the birth.
  • If pain relief is considered, I would like to try a narcotic before an epidural.

Cesarean Section Delivery:

  • I feel very strongly that I would like to avoid a cesarean delivery.
  • If a cesarean is necessary, I expect to be fully informed of all procedures and actively participate in decision-making.
  • I would like Matt to be present during the surgery.
  • If possible, please do not strap my arms to the table during the procedure.
  • If conditions permit, I would like to be the first to hold Gavin after the delivery.

Perineal Care:

  • If I show signs that I may tear I would like to have an episiotomy than risk a tear.


  • Even if I am fully dilated, and assuming Gavin is not in distress, I would like to wait until I feel the urge to push before beginning the pushing phase.
  • I prefer to push or not push according to my instincts and would prefer not to have guidance or coaching in this effort.
  • I would appreciate help from Matt and staff supporting my legs as I push.
  • I would like to have a mirror available and adjusted so I can see Gavin’s head crowning.
  • I would like a soothing environment during the actual birth, with dim lights and quiet voices.
  • I would like Matt to help catch Gavin.
  • I would like to have the birth recorded with photographs, video tape and/or tape recording.

Immediately after the birth:

  • Please place Gavin on my stomach/chest immediately after delivery.
  • Either I or Matt will cut the cord.

Newborn Care:

  • I would like to hold Gavin skin-to-skin during the first hours to help regulate baby’s body temperature.
  • Please evaluate and bathe Gavin at my bedside.
  • If Gavin must go to the nursery for evaluation or medical treatment, Matt, or someone I designate, will accompany Gavin at all times.
  • I want to know the benefits and risks to all medications that may be needed for Gavin, including shots, antibiotics and vitamins, and be given a chance to make the decision I feel is best.

Postpartum Care:

  • I would like to have Gavin room-in with me at all times.
  • I would like Matt to room-in with me.
  • Assuming I feel up to it and we are medically healthy, I would like to be released from the hospital as soon as possible following the birth.
  • I would like permission for access to my chart and Gavin’s chart.


  • I plan to breastfeed and want to nurse immediately following the birth.
  • Please do not give Gavin supplements (including formula, glucose, or plain water) without my consent, unless there is an urgent medical necessity.
  • Unless I am unable to give my consent, please do not give Gavin any supplements without first informing me of the reason(s) and seeking my consent.
  • Please do not give Gavin a pacifier, I will provide one if I desire to use it.

Additional notes:

  • I would like to take still photographs during labor and the birth.
  • I would like to make a video recording of labor and/or the birth.
  • I am planning for Gavin to be circumcised before we check out of the hospital.

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )


Connecting to %s