Sample Birth Plan# NextGeneration - 我爱宝宝
s*e
1 楼
Due Date: 03/19/2009
Patient of Dr. McDermott
Scheduled to deliver at Seattle Grace
03/17/2009
Dear Dr. McDermott
I'm having a baby and these are my wishes for before, during and post
delivery. Please direct any questions to Claire or Ginger. Thank you.
Sincerely,
Mary Doe
Labor
* I wish to be able to move around and change position at will
throughout labor.
* I would like to be able to have fluids by mouth throughout the first
stage of labor.
* I would prefer to keep the number of vaginal exams to a minimum.
Monitoring
* I do not wish to have continuous fetal monitoring unless it is
required by the condition of my daughter.
Labor Augmentation/Induction
* I do not wish to have the amniotic membrane ruptured artificially
unless signs of fetal distress require internal monitoring.
* I would prefer to be allowed to try changing position and nipple
stimulation before Pitocin is administered.
Anesthesia
* I do not want any kind of anesthesia offered to me during labor,
though I would like it available if I specifically request it.
* Custom note regarding use of an epidural.
Cesarean
* If my primary care provider determines that a Cesarean delivery is
indicated, I would like to obtain a second opinion from another physician if
time allows.
* I would like my husband present at all times if my daughter requires a
Cesarean delivery.
* I wish to have an epidural for anesthesia.
* If my daughter is not in distress, my daughter should be given to (
blank) immediately after birth.
Episiotomy
* I would prefer not to have an episiotomy unless absolutely required
for the baby's safety.
Delivery
* I would like my husband and/or nurses to support me and my legs as
necessary during the pushing stage.
* I would like a mirror available so I can see my daughter's head when
it crowns.
* Even if I am fully dilated, and assuming my daughter is not in
distress, I would like to try to wait until I feel the urge to push before
beginning the pushing phase.
* I would like to have my daughter placed on my stomach/chest
immediately after delivery.
After Delivery
* I would like to cut the cord myself.
* I would like to have my daughter examined and bathed in my presence.
* If my daughter must be taken from me to receive medical treatment, my
husband or some other person I designate will accompany my daughter at all
times.
* I would like a private room if available.
* After the birth, I would prefer to be given a few moments of privacy
to urinate on my own before being catheterized.
* I would like to donate the umbilical cord blood.
Breastfeeding
* Unless medically necessary, I do not wish to have any bottles given to
my daughter (including glucose water or plain water).
I do not want my daughter to be given a pacifier.
Photos
* I would like to make a videorecording of labor and/or the birth.
Other
* My support people are my doula and (blank) I would like them to be
present during labor and/or delivery.
这个网页很不错
http://www.earthmamaangelbaby.com/free-birth-plan
Patient of Dr. McDermott
Scheduled to deliver at Seattle Grace
03/17/2009
Dear Dr. McDermott
I'm having a baby and these are my wishes for before, during and post
delivery. Please direct any questions to Claire or Ginger. Thank you.
Sincerely,
Mary Doe
Labor
* I wish to be able to move around and change position at will
throughout labor.
* I would like to be able to have fluids by mouth throughout the first
stage of labor.
* I would prefer to keep the number of vaginal exams to a minimum.
Monitoring
* I do not wish to have continuous fetal monitoring unless it is
required by the condition of my daughter.
Labor Augmentation/Induction
* I do not wish to have the amniotic membrane ruptured artificially
unless signs of fetal distress require internal monitoring.
* I would prefer to be allowed to try changing position and nipple
stimulation before Pitocin is administered.
Anesthesia
* I do not want any kind of anesthesia offered to me during labor,
though I would like it available if I specifically request it.
* Custom note regarding use of an epidural.
Cesarean
* If my primary care provider determines that a Cesarean delivery is
indicated, I would like to obtain a second opinion from another physician if
time allows.
* I would like my husband present at all times if my daughter requires a
Cesarean delivery.
* I wish to have an epidural for anesthesia.
* If my daughter is not in distress, my daughter should be given to (
blank) immediately after birth.
Episiotomy
* I would prefer not to have an episiotomy unless absolutely required
for the baby's safety.
Delivery
* I would like my husband and/or nurses to support me and my legs as
necessary during the pushing stage.
* I would like a mirror available so I can see my daughter's head when
it crowns.
* Even if I am fully dilated, and assuming my daughter is not in
distress, I would like to try to wait until I feel the urge to push before
beginning the pushing phase.
* I would like to have my daughter placed on my stomach/chest
immediately after delivery.
After Delivery
* I would like to cut the cord myself.
* I would like to have my daughter examined and bathed in my presence.
* If my daughter must be taken from me to receive medical treatment, my
husband or some other person I designate will accompany my daughter at all
times.
* I would like a private room if available.
* After the birth, I would prefer to be given a few moments of privacy
to urinate on my own before being catheterized.
* I would like to donate the umbilical cord blood.
Breastfeeding
* Unless medically necessary, I do not wish to have any bottles given to
my daughter (including glucose water or plain water).
I do not want my daughter to be given a pacifier.
Photos
* I would like to make a videorecording of labor and/or the birth.
Other
* My support people are my doula and (blank) I would like them to be
present during labor and/or delivery.
这个网页很不错
http://www.earthmamaangelbaby.com/free-birth-plan
