Birth Wish List for [your name]
[hospital name] Hospital. Our due date is [edd].
Desire: Have a safe, gentle, natural (no drug) and joyful birth using Active Birth Method
Labor- I want to stay home and labor as long as possible.
- Request nurses that support natural child birth.
- Intermittent fetal monitoring.
- I want to drink fluids (clear liquid), fruit juices, throughout the first stage of labor.
- I do not want I.V. fluids. If necessary, please use Heplock.
- I want to labor in any position I feel comfortable.
- I want my husband and my doula to stay with me at all times and not be excluded.
- I want to use alternative methods such as different positions before pitocin is used.
- I want to be able to walk around even after my water has broken.
- I would like minimum number of vaginal exams.
- I want the use the shower, Jacuzzi and have my husband and my doula with me.
- I want my amniotic membranes intact and to not be ruptured artificially only if medically necessary.
Pain medication
- No pain medication and analgesics administered unless I request them.
- Not intending to have epidural.
Caesarean
- No Caesarean unless my Doctor, my husband and myself determine it medically necessary. I would like my husband and doula to remain with me.
- My husband to accompany our baby after birth unless in distress.
Episiotomy
- Do not want episiotomy. Please assist with counter pressure and warm compresses.
During delivery
- I would like to follow my body instincts and be coached on how and when to push.
- I would like our son to be placed on my chest immediately after delivery.
After delivery
- My husband would like to cut the cord.
- Prefer having at least1 hour bonding time with our son after birth. Please delay newborn procedures.
- Please do newborn screening tests in the room while I nurse.
- For normal delivery, time for placenta to expel on its own.
- I would like only the Vitamin K shot for our baby. No HEP B and no antibiotics in his eyes.
- No circumcision for baby.
- Please give us a copy of discharge summary for our pediatrician.
Breastfeeding
- I would like to breastfeed. My doula and will help baby latch on.
- No bottle or pacifier given to baby unless medically necessary.
- I would like to get assistance from the lactation specialist during my stay at the hospital.
Photos/Video
- My doula will take still pictures or video at birth.