Natural Childbirth
"Except for being hanged by the feet, the supine position is the worst conceivable position for labor and delivery" ...Dr. Roberto Caldeyro-Barcia
Sample Birth Plan
This is the birth plan that we used for Joshua's birth.
Request For Our Child's Birth
- To: [Hospital - Maternity Unit]
- Parents: [Mother & Father's Names]
- Approximate Delivery Date: [Estimated Due Date]
- Obstetrician/Midwife: [Doctor or Midwife's Name]
- Labor Assistant/Doula: [Doula's Name]
Because it is difficult to hold discussions and make decisions during the involvement of labor and delivery, we have carefully discussed our concerns and expectations in advance, and would like your staff to be aware of our requests.
We are deeply committed to a philosophy of birth that wholly relies on the normal and natural physiological process of labor and delivery, and helps to insure the safest beginning for our child. Thus, we fully expect our child's birth to be normal and free of medical intervention; in the unlikely event that complications occur, we shall confer with our obstetrician, whose medical judgment we respect and trust.
By withholding routine interventions and respecting our hope for a natural family-centered birth, the medical professionals involved can enable us to achieve our optimal experience. Of great importance to us is that we maintain an aura of personal intimacy throughout labor and delivery, so we ask that interruptions to our privacy be restricted to an absolute minimum. The health and well being of our baby is of utmost importance, which is one of the reasons that we have taken the time to explore the safest options. The following listings are important to us, and we rely on the sensitivity of the hospital staff, as a joyous and personal birth experience is something we long for, and hope to achieve with this delivery.
Thank you,
[Parent's signatures]
Labor:
- Father and Doula to remain with Mother throughout Labor & Delivery
- Absolutely nothing done without our full knowledge & consent
- No routine prep, enema, fetal monitor, or artificial rupture of membranes
- Heparin Lock for I.V. (I.V. removed after appropriate dose of antibiotic is administered)
- No labor stimulants or medications
- Minimum of internal exams with Mother's consent only
- Mobility unrestricted (No routine confinement to bed or labor room)
- Water (or my own tea, honey) & light snacks as needed during labor
- We do NOT give permission for students, hospital house staff, or other non-essential personnel to be in the room during labor and birth
Delivery:
- Absolutely nothing done without our full knowledge & consent
- Choice of delivery positions (including squatting)
- No episiotomy
- Hot compresses for perineum
- Mother wishes to use gentle pushing and controlled exhalation techniques
- Father to help deliver or "catch" Baby if possible
- Cord allowed to finish pulsing - Father cuts umbilical cord
- Baby placed on Mother's abdomen immediately
- Immediate breastfeeding
- Placenta to deliver spontaneously (NO Pitocin, cord traction or manual extraction)
- Immediate and sustained contact between Baby and Parents
- Baby to hear our voices first (we wish to be the first to speak to our baby)
- Do not announce the Baby's gender - the Parents wish to discover that themselves
- Siblings present if desired or included as soon as possible
If complications arise at birth:
- Anything unexpected: full information
- Father not asked to leave at any time - Doula present at all times
- Any medication or anesthesia: administered only with our complete knowledge and consent
- Father present if anesthesia administered
- All previous request to be honored to the extent possible
Recovery/Postpartum:
- Please note that our Pediatrician is Dr. [name]
- Absolutely nothing done to our Child without our full knowledge & consent
- Erythromycin delayed for at least one hour after birth
- Parents, Siblings and Baby stay together as a family
- All Newborn care will be done at Mothers's bedside (or with at least one Parent present)
- Due to the nature of the PKU test we wish to delay it until the Baby is 7 days old (we will bring the baby back to the hospital for the test)
- Our Child is NOT to be immunized (waiver enclosed)
- NO BOTTLES - NO PACIFIERS
- Due to a family history of food allergies our Baby is to receive breastmilk only
- No routine separation of Mother and the Baby if maternal fever or neonatal jaundice
- If a boy, our Child is NOT to be circumcised
- Early discharge (approximately 4 - 12 hours after birth)
- If early discharge is not possible then 24 hour rooming in - Breastfeeding as Baby desires
CC:
- [Doctor/Midwife]
- [Covering Doctors/Midwives]
- [Labor Assistant/Doula]
- [Pediatrician]
- [Nursing Staff: Maternity Unit]
Variation of Sample Birth Plan
Modified from Silent Knife: Cesarean Prevention & Vaginal Birth After Cesarean: by Nancy Wainer Cohen & Lois J. Estner.
This is the birth plan that we used for Alex's birth.
On or about [due date] we expect to give birth at [name of hospital/birth center] to our [1st, 2nd, 3rd etc...] child. Unless a medical problem should arise, in which case we expect both the problem and any required procedural changes to be discussed with us, we request the following. If any of our plans cannot be carried out at your facility, we wish to be informed of this ahead of time. We have placed asterisks next to the requests that are most important to us. We reserve the right to change, or withdraw any of our requests at any time before or during labor.
- There will be no routine shaving of the pubic hair.
- No medications will be administered without prior consent of the mother. This request excludes none and specifically includes oxytocins, analgesics, barbiturates, and tranquilizers.
- The amniotic sac will not be artificially ruptured.
- There will be no routine IV. Intravenous fluids will only be used with good medical reason as determined by the parents and the physician in consultation.
- There will be no electronic fetal monitoring, either internal or external, without good medical reason. Frequent listening to the fetal heart is expected. A Doptone may be used if desired.
- The father and other support person will remain throughout labor and birth regardless of circumstances, especially if a problem should arise.
- The mother will walk during labor and will be assisted by staff in assuming whatever position is most comfortable during labor and birth. She will not be arbitrarily confined to bed during labor.
- There will be no episiotomy without good medical reason. The parents or nursing staff may apply warm, wet cloths or oil to the area around the vagina prior to delivery
- The perineum will be supported during delivery, and the mother's legs will not be held excessively wide apart.
- The room will be warm and the lights dimmed for the birth. Excessive noise will be avoided.
- The baby will be placed on the mother's abdomen after being delivered. The baby will be nursed within minutes of birth.
- The cord will not be clamped or cut for at least two minutes unless it must be cut to complete the birth of the baby.
- Erythromycin in the baby's eyes will be delayed for at least one hour after birth.
- The third stage of labor (delivery of the placenta) is not to be rushed but is to proceed at its own pace. The use of oxytocin drugs and manual removal of the placenta are to be reserved for true medical emergencies.
- All care of the baby is to take place at the mother's bedside. The baby is not to be taken to the nursery.
- The baby is not to be given a pacifier or bottles of water or sugar water.
- We do NOT give permission for students, hospital house staff, or other non-essential personnel to be in the room during labor and birth
Back | Home | Next
Natural Mothering: Birth Plan Page
First on-line: 6/28/1996