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  Birth Preferences Knowing that we are not in charge of this experience, we would like to influence the areas where it is reasonable and doesn’t interfere with our main goal. This goal being to take home our healthy baby, and secondly for his/her gentlest possible entry in our world. Name: Partner's Name: Due Date: Medication Allergies: Blood Type and Rh: Group B Strep status: Our Obstetricians: Dennis McGrooary, MD & Susan Malley, MD Our Pediatrician: Environment - I would like the following people to be present during labor:
- I would like the following people to be present during birth:
- I would like to bring music.
- I would prefer dim lighting
- I would like to wear my own clothes.
- I would prefer to stay in one room during labor, birth, if possible.
- I would like to be able to have photos taken during baby's birth.
- I would prefer no students to be present.
- I would like to be able to walk around, mobility is important to me.
- I would prefer a warm bath over walking, if I do not feel up to walking.
Labor induction/augmentation If I go past my due date and there are no health risks for me or my baby, I would prefer not to be induced, but monitored closely. My physicians have explained to me the risks and benefits of induction past my due date. - I would prefer trying the following methods to induce labor:
- Stripping or breaking membranes
- Breast Stimulation
- Other recommendations from my doula, such as:
- Walking
- Sexual intercourse
- Prostaglandin gel
- Mechanical dilation with a foley bulb
- Pitocin
Equipment My physicians explained that there is a rocking chair and shower in my room and a Jacuzzi/hot tub on labor and delivery. In addition, NWH offers an integrative medicine team, who offer aromatherapy, massage and acupuncture. I may bring the following with me: - Birthing ball
- Birthing stool
- Beanbag
Preparation - I would like to wear contact lenses if possible.
- I would prefer to be able to eat and drink during labor. (I will likely pack a small bag of comforting foods, knowing ginger ale, chicken broth, graham crackers are available at the hospital.)
- I would prefer no IV unless indicated for the well-being of myself or baby.
Monitoring - I would prefer external fetal monitoring (as opposed to internal monitoring.)
- I would prefer to be monitored for the minimal acceptable amount of time spent considered good medical care, so that I may be free to ambulate, if able.
- My physicians have explained to me this means: 20 min per hour in active labor, if all is well (no signs of maternal or fetal distress.)
- If I have an epidural, I understand this will mean continuous external fetal monitoring.
Anesthesia - Pain medication - I would prefer to try laboring without pain medication. Please do not ask me. My partner will be watching out for me, and will help me decide if I want pain relief.
- I would like to try narcotics in early labor before considering an epidural.
- I would like an epidural unless labor is anticipated to be imminent.
First Stage of Labor - I do not want to be separated from my partner during labor or birth.
- I would like the option of returning home if my labor is not progressing.
- I would like no time limits on laboring
- I prefer labor not to be augmented unless medically necessary.
- I would prefer vaginal exams kept to a minimum.
- I would like encouragement throughout labor.
Episiotomy/Perineal Massage - I'd prefer not to have an episiotomy, unless there is a medical necessity.
- My physicians explained that they routinely use warm olive oil and massage to try to prepare the perineum during pushing and crowning to try to minimize vaginal tearing, and do not perform routine episiotomy.
Second Stage of Labor (pushing) - I'd like a mirror present to view birth.
- I'd like to be able to touch baby's head when it crowns.
- I'd like my partner/labor coach/or nurse to help me support my legs when I push.
- I'd like to be able to try any position comfortable during pushing.
- I would like to wait to push until I feel the urge even if I am fully dilated.
- I would like no time limits on pushing, if there are no signs of distress to my baby.
- I would like counting/cheering to help me push.
- I would not like counting/cheering to help me push.
Our Delivery and Post-Partum - I'd like my partner to be as involved as he/she is comfortable with.
- I'd like to have baby placed on my chest immediately after birth.
- I'd like to wait on cutting the umbilical cord until it stops pulsating.
- I'd like to have my partner cut the cord.
- My partner does not wish to cut the cord. Please do not ask.
- I'd like to have my partner present for our baby's first bath.
- I would like to see my placenta after birth.
- I plan to bank baby's umbilical cord blood. I will bring the collection kit to the hospital. (It's packed with my hospital bag.)
- I would like baby to room in with me.
- I would like baby to stay in nursery at night so I can rest.
- I would like my partner to stay in the room with me.
- I'd like to be discharged as soon as possible.
- I'd like to stay as long as possible.
Cesarean Section - If c-section is necessary, I'd like my partner present.
- I would like to touch baby soon after birth.
- I would like partner to hold baby as soon as possible after birth.
- I would like screen lowered so I can view the baby being born.
- I would like my partner to photograph parts of the c-section.
- I would like to breastfeed baby as soon as possible after birth.
Breastfeeding - I plan to breastfeed. My physicians have strongly encouraged this as the optimal feeding method for my baby, as it has proven health benefits to myself and my baby.
- I would prefer to bottlefeed.
- I would like to breastfeed and bottlefeed.
- I do not want my baby given any formula or water, unless medically necessary, and I am part of the decision process.
- I would like to see a lactation consultant.
- I would like to attend the hospital’s postpartum breast feeding classes.
Pacifier - I do not want my baby to have a pacifier.
- I would like my baby to have a pacifier. My physicians have explained to me that the most recent medical evidence indicates that pacifier use has been shown to decrease the incidence of SIDS.
Circumcision - If I have a son, I do not want to have my baby circumcised
- I would like my son circumcised before I leave the hospital. My physicians have explained to me that this is a topic of controversy in the medical community, and may be more of a cultural/personal decision, than one based on all the medical facts.
- Currently, the benefits of circumcision include: reduction in the rates of urinary tract infection, penile cancer, some STDs, and penile inflammation (meatitis, balanitis, phimosis), as well as easier hygiene. Future female partners of my son also benefit by reduction in cervical cancer and some STDs. These benefits are weighed against potential risks of the procedure (2-5/1,000, usually minor), and in context of the low incidence of UTIs and penile cancer in men.
- I understand that swaddling, local anesthesia (lidocaine injection), and oral Tylenol, as well as soothing talk will be used during circumcision.
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