Here’s one example of a plan for a natural childbirth. On the advice of our doula, we included some details that probably wouldn’t be in a non-twin, non-natural birth plan, along with a separate plan for baby care in case they are taken away from us for NICU or regular nursery care.
It’s actually three separate documents:
- a detailed plan (pasted below; 2 full pages on 1 double-sided sheet)
- a “highlights” tear-away plan (only the main points with no explanation; 2/3 of a page)
- a plan to go with the babies if they’re separated from us (“Infant Care” below in more detail; 1 full page)
“In-Training” Family Detailed Birth Preferences
New Mom: Mommy-in-Training
New Dad: Daddy-in-Training
OB/GYN: Doctor Doctor, MD
Doula: Doula Doula
Supporters: Friend 1, Friend 2, Friend 3
Our goal is a natural birth free of routine medical interventions. We wish to have the opportunity to accept or decline any medication or procedure. In the event of a medical emergency, we will remain flexible on all of these points for the safety of Mom and babies. To help us achieve our goals, we would appreciate the following support. Thank you!
THROUGHOUT LABOR, PLEASE:
§ Offer encouragement, not drugs. We will ask for pain medication if we want it.
§ Provide a hep-lock rather than an IV. Mom prefers to receive fluids orally.
§ Keep Mom and Dad together at all times. Dad is a trained labor coach and Mom’s primary source of support.
§ Explain all procedures and recommendations before performing or administering. We wish to take an active part in all decisions related to care of Mom and babies.
§ Support complete freedom of movement. Mom wishes to labor in whatever position is most comfortable, including standing, walking, side lying, squatting, shower, tub, ball, etc.
§ Follow ACOG’s recommendations for intermittent monitoring instead of continuous fetal monitoring. Please use only external monitoring techniques.
§ Limit vaginal exams, pain assessment, and other routine procedures to shift changes only. Mom and Dad need maximum concentration and minimum distraction.
§ Give Mom unrestricted access to clear liquids as well as light snacks in the event of a prolonged labor so she can keep her strength up.
§ Allow labor to proceed at its own pace. In the event that augmentation is necessary, we wish to use natural means first before moving to medication.
DURING THE PUSHING STAGE, PLEASE:
§ Limit vaginal examinations to Dr. Fitzhugh only.
§ Allow mom to push at her own pace (spontaneous pushing).
§ Keep us in an L&D room. As supported by Dr. Fitzhugh, we prefer not to move to an OR unless a C-section is imminent.
§ Allow mom to tear naturally rather than performing a routine episiotomy. Please administer local anesthesia before repairing any tearing after the birth.
AFTER DELIVERY, PLEASE:
§ Place each baby immediately on mom’s chest for skin-to-skin contact, bonding, and breastfeeding. Perform all routine examinations with baby in this position. Dad will hold Baby A while Baby B is being born.
§ Delay cord clamping or cutting until the cord stops pulsating naturally. Dad would like to cut both babies’ cords.
§ Allow the placentas to come on their own time; do not pull on the cords to accelerate delivery.
§ Administer a shot of Pitocin as soon as Baby B is born to limit mom’s risk of hemorrhage.
§ Place us in a larger post-partum room with a larger bed if possible to accommodate two isolettes and tandem nursing of twins in the recovery bed.
§ Turn away all unnecessary staff and visitors until we have had time to bond with our babies. We will let you know when we are ready for guests.
IN THE EVENT OF A C-SECTION, PLEASE:
§ Allow both Dad and doula into the operating room.
§ Lower the screen so Mom can watch the birth.
§ Leave Mom’s hands free so she can touch and hold the babies immediately.
§ Follow all preferences outlined above to the extent possible (e.g., immediate skin-to-skin contact and breastfeeding, delayed cord clamping, etc.)
INFANT CARE
§ We decline routine eye ointment/drops, hepatitis B vaccination, and the vitamin K shot. Vitamin K may be administered orally in the event of extreme bruising or bleeding. We will follow up with our pediatrician after delivery as necessary.
§ Please perform any routine procedures or exams in the presence of both parents, preferably with baby on Mom’s chest or in Mom’s or Dad’s arms. Dad would like to give the first baths if we decide baths are necessary.
§ We choose not to circumcise our sons. Please do not allow anyone to retract either boy’s foreskin for any reason.
§ Babies should be accompanied by a parent or our designee at all times if they must be removed from the birthing/recovery room for any reason.
§ We wish to exclusively breastfeed. Please do not give the babies formula or glucose for any reason without mom and dad’s permission. If a prolonged nursery or NICU stay is required, we will work with nursing staff to provide expressed colostrum and milk.
Medical Alert: Mom is allergic to Phenergan (promethazine) and Tegaderm. Mom is a Jehovah’s Witness and declines any treatment using blood or blood products. There is an advance medical directive on file with the hospital.
We the undersigned have reviewed and approved this document.
New Mom _________________________________________ Date _______________
New Dad _________________________________________ Date _______________
Doula _________________________________________ Date _______________
OB/GYN _________________________________________ Date _______________