Navigate    Midwifery    Services    Location    The Staff    History    Links    Contact Us    Webboard    Home    Registration    Printable Forms    Online Form    Resources    The Newsletter    Questions (General)    Questions (Daddy's)    References    Child Ed. Classes    Create a Birth plan    Breatfeeding Drug List    Healthy Living Tips	Create A Birth Plan A birth plan is a list of wants you hope to obtain throughout your labor and birth. Due to being in a more vulnerable position during labor, having a written birth plan helps your team fulfill your dream. Birth plans are a written means of communication and should be added to as needed for you to feel like your wishes are known. Birth Plan Form Birth Plan for & Labor & Birth Things I will bring or have to assist in labor: Music Arometherapy       List:                      Hypnatherapy tape Accupuncture Herbals/Homeopathy       List:                      Movement Hydrotherapy Low Lights Accupuncture Minimal vaginal exams Other        I do not want to have the following interventions unless medically necessary and only after I have been informed of need and participated in the decision making process. IV therapy Continuous external fetal monitoring Internal monitoring Rupture of membranes Narcotic pain relief such as Nubain, Demerol, Stadol, Etc. Epidural anesthetic Induction of labor by Prostaglaudins and Oxytocins Augmentation of labor with Oxytocins unless more natural methods such as nipple stimulation,       herbals and homeopathics have failed. Episiotomy Agressive perineal massage Neonatal hepatitis B vaccine the first 24 hours after birth. Pacifiers and/or nipples if supplements are medically necessary. I have done the following to prepare for the birthing process: Childbirth classes/reading Daily activity such as walking, yoga, belly dancing Kegels and/or squatting Perineal massage Postpartum in home help Participated in Le Leche League groups or other breastfeeding support. I would like the following interventions and procedures: To deliver in hands/knees, squat, or side-lying position. To push only with the urge to push. To watch the birth with use of a mirror To touch my babies head as it crowns/births. Support during crowning To have my baby placed on my abdomen. Delayed cord clamping Episiotomy only if necessary for the well being of the baby. Local anesthetic for repair of a tear or episiotomy Cord cut by signifant other Baby intervention and assessment in my presence and/or on my abdomen. Eye prophylaxsis held for first 2 hours to facilitate bonding. Umbilical cord banking Placenta donated to Missouri Search and Rescue If a cesarean birth was necessary for the health of my baby or myself, I prefer if possible: General anesthetic Epidual anesthetic Support people present FOB/SO present with the baby after delivery FOB/SO accompany baby to nursery if nessary Support person in recovery area with me Breastfeeding initiated in recovery or asap unless medical reasons cause delay. Other: I wish to take pictures/videos of the birth I do not want the baby circumcised I do want to be present during the circumcision I want a significant other present for the circumcision My Birth Team Name Relationship Job/Age (If younger than 20) 1: 2: 3: 4: 5: 6: *** Important Note *** Please print off one copy of the birth plan that you have completed and bring it with you on your next visit to The Woman's Hour.
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