THE RESPONSES:

• Here are some links on creating a birth plan:
  http://www.mjbovo.com/brthform.htm
  http://www.mjbovo.com/BirthPlan.htm
  http://www.parentsplace.com/pregnancy/birthplan/
  http://www.childbirth.org/interactive/ibirthplan.html

• You can modify mine if you want:
  

  On or about October 24, 1998 we expect to give birth at home to our first child. In the event that we must be at the hospital for any part of the birth or afterwards because of complications, we ask that the hospital staff try, to the best of their ability, to respect our wishes – no medical procedure, including any testing, be preformed on either A or our child without the full consent of either A or J. If the situation arises in which A is unable to make decisions for herself or our child, J has full authority to make these decisions.

  A has a family history of malignant hyperthermia. Because of the risk of her and/or the baby having an allergic reaction, she should not, under any circumstance, be given general anesthesia.

  Our requests are as follows:
  

  · All medications and procedures will be explained to us. If they are not medically necessary for the health of the A or the baby, we will choose whether or not to receive the treatment.
  

  · If, for any reason, A is unable to coherently participate in such decision-making, J will do so with the help of the midwife in attendance. The midwife in attendance, M van Roojen, LM, is aware of our wishes. Hospital staff should consult her for guidance when necessary.
  

  · We consent to an initial monitoring on the external fetal heart monitor for twenty to thirty minutes, but do not want A connected to a monitor, external or internal while in labor. A fetascope may be used, selectively and intermittently.
  

  · The amniotic sac will not be artificially ruptured unless prior consent is given.
  

  · No routine IV drip.
  

  · J, M, M’s assistant K, E, and S will remain throughout labor and birth regardless of circumstances, and especially if a problem should arise.
  

  · We do not give permission for medical students, hospital house staff, or other nonessential personnel to be in the room during labor and birth.
  

  · A will walk during labor, and during birth will be assisted by staff in assuming whatever position is most comfortable.
  

  · During early labor, A will eat light food and later during labor will drink fruit juice and eat clear soups.
  

  · The labor and birth will be photographed by a support person.

  · We do not want the use of forceps or vacuum extractor to expedite our baby’s birth.

  · There will be no episiotomy without medical reason and without prior consent from A. Labor support or nursing staff will apply warm, wet cloths or oil to the area around vagina prior to delivery. The perineum will be supported during labor and A will be encouraged to birth slowly to minimize tearing.
  

  · The room will be warm and the lights dimmed for birth. Excessive noise will be avoided.

  · We will be the first to touch to baby’s head. J will catch the baby and either hold or place the baby on the bed in front of A until she is ready to pick up the baby. The baby will be gently massaged and caressed after being delivered. A blanket will cover baby, and the baby may be nursed within minutes after birth.

  · The first voice that the baby hears will be either A or J’s.

  · The baby is not to be washed or wiped immediately. Blood will be gently wiped off by A and J and the vernix massaged into the baby’s skin.

  · The baby will not be routinely suctioned.

  · The cord will not be clamped or cut until it has stopped pulsing, unless medically necessary. We want J to cut the cord.

  · The delivery of the placenta will not be hurried, but is to proceed at its own pace. Manual removal of the placenta and the use of oxytocic drugs are to be reserved for true medical emergencies.

  · The placenta is to be given to A and J to take home.

  · The baby is not to be placed in an artificial warming device. A will hold the baby skin to skin to keep her/him warm.

  · All examination and testing will be preformed while the baby is in bed with A. We want the weighing of the baby, etc. delayed until after an extended bonding period.

  · Our baby is for no reason to receive a bottle of water, sugar water, or formula.

  · Our baby will not be circumcised.

  · Our baby will not be given eye drops or Vitamin K injection.

  Cesarean Birth

  · A has a family history of malignant hyperthermia. Because of the risk of her and/or the baby having an allergic reaction, she should not, under any circumstance, be given general anesthesia.

  · We wish for hospital staff to honor all requests listed above whenever possible.

  · J and M will be present through the entire procedure.

  · Allow A’s arms to be free, and place the baby on A’s chest immediately after birth.

  · A will breastfeed as soon as possible after the operation is complete.

  · Do not give A medications that will affect her breastmilk.

  · We wish to have the baby in the recovery room with us.

  · If the baby must be separated from A, J will go with the baby.

  Thank you for your cooperation.

  Sincerely,