Intro General Info Birth Philosophy Health Notes During Labor Pain Management 2nd Stage of Labor Delivery Cesarean Section Immediately After Delivery Postpartum Additional Notes Save/Print Saturday, July 27, 2024 My Birth Plan At EIRMC, we want you to feel comfortable, safe, and heard. That's why we encourage you to complete and print this birth plan and discuss in advance with your physician. We will do our very best to honor your wishes, while maintaining our obligation to keep you and your baby safe and healthy. General Information First Name Last Name OB-GYN Coach/Doula/Labor Assistant Birth Philosophy Birth Philosophy Health Notes Please note the following I am allergic to My blood type is I have Group B Strep I have gestational diabetes My delivery is planned as Vaginal C-section VBAC During Labor Upon arrival at the hospital, I prefer to: Have my partner with me at all times. Always keep my door closed while I am in labor. To wear hospital clothing. To wear my own clothes. To listen to music during labor and after I deliver. Have the lights dimmed. Have the room as quiet as possible. Have as few interruptions as possible. Be able to walk around, as mobility is important to me. Have my partner film and/or take pictures. Pain Management For pain relief, I’d like: No medication IV pain medication Epidural To chant, grunt or moan during labor as I choose. I would like the following equipment available to me: Birthing bed Birthing ball Squatting bar 2nd Stage of Labor While I'm pushing I would like: A squat or birth bar to aid in pushing. Foot pedals to allow me to sit up while pushing. Stirrups to allow me to lay back during pushing. My coach or doula to support my legs when pushing. To try to deliver in whatever way feels right at the time. To be able to move and change positions throughout my labor. Other Delivery I would like a mirror available so I can see the baby's head when it crowns. I would like the chance to touch the baby's head when it crowns. For spiritual or religious reasons, I would like the room to be totally silent as the baby is born. As long as my baby is healthy, I would like my baby placed immediately skin-to-skin on my abdomen with a warm blanket over it. Other Cesarean Section Delivery If I undergo a c-section, I'd like: To stay conscious, unless my physician advised otherwise, due to medical condition. The surgery explained as it happens. My partner to remain with me the entire time. My partner to hold the baby as soon as possible. To breastfeed my baby as soon as possible. Other Immediately After Delivery I would like: To cut the cord myself. My partner to cut the cord. The umbilical cord to be cut only after it stops pulsating. To keep the placenta. To see the placenta before it is discarded. To hold the baby while I deliver the placenta and any tissue repairs are made. Other I would like to hold the baby Immediately after delivery. After weighing. After being wiped clean and swaddled. Postpartum I’d like baby’s medical exam and procedures: Given in my presence. Given in my partner’s presence. Given only after we’ve bonded. Other Whenever possible post-delivery, I would like To not be separated from my baby. My partner to accompany the baby if the baby must be taken from me to receive medical treatment. Baby's first bath and assessment done in my presence. Other I would like to feed my baby: Only with breastmilk. Only with formula. With breastmilk and formula. On demand. With the help of a lactation specialist. Other Additional Notes Additional Notes Save My Birth Plan Save By selecting the Save button, your information will remain available for two days. If this is a public computer, we don't recommend saving this form. Print Preview You may also print out your birth plan to have on hand during your pregnancy. Reset By selecting the Reset button, your information will be cleared from all the above fields. Next Steps Once you complete your birth plan, we recommend the following next steps: Call (208) 227-2400 to schedule a tour. Sign up for a childbirth preparation class. Print and discuss the birth plan with your doctor Bring a printed copy of the birth plan with you when you come to deliver at the hospital General Internet communication is inherently not secure. DO NOT send data considered confidential or private in nature on this form. (e.g., Social Security Numbers, Diagnosis Information, Credit Card Numbers, etc.)
Saturday, July 27, 2024 My Birth Plan At EIRMC, we want you to feel comfortable, safe, and heard. That's why we encourage you to complete and print this birth plan and discuss in advance with your physician. We will do our very best to honor your wishes, while maintaining our obligation to keep you and your baby safe and healthy. General Information First Name Last Name OB-GYN Coach/Doula/Labor Assistant Birth Philosophy Birth Philosophy Health Notes Please note the following I am allergic to My blood type is I have Group B Strep I have gestational diabetes My delivery is planned as Vaginal C-section VBAC During Labor Upon arrival at the hospital, I prefer to: Have my partner with me at all times. Always keep my door closed while I am in labor. To wear hospital clothing. To wear my own clothes. To listen to music during labor and after I deliver. Have the lights dimmed. Have the room as quiet as possible. Have as few interruptions as possible. Be able to walk around, as mobility is important to me. Have my partner film and/or take pictures. Pain Management For pain relief, I’d like: No medication IV pain medication Epidural To chant, grunt or moan during labor as I choose. I would like the following equipment available to me: Birthing bed Birthing ball Squatting bar 2nd Stage of Labor While I'm pushing I would like: A squat or birth bar to aid in pushing. Foot pedals to allow me to sit up while pushing. Stirrups to allow me to lay back during pushing. My coach or doula to support my legs when pushing. To try to deliver in whatever way feels right at the time. To be able to move and change positions throughout my labor. Other Delivery I would like a mirror available so I can see the baby's head when it crowns. I would like the chance to touch the baby's head when it crowns. For spiritual or religious reasons, I would like the room to be totally silent as the baby is born. As long as my baby is healthy, I would like my baby placed immediately skin-to-skin on my abdomen with a warm blanket over it. Other Cesarean Section Delivery If I undergo a c-section, I'd like: To stay conscious, unless my physician advised otherwise, due to medical condition. The surgery explained as it happens. My partner to remain with me the entire time. My partner to hold the baby as soon as possible. To breastfeed my baby as soon as possible. Other Immediately After Delivery I would like: To cut the cord myself. My partner to cut the cord. The umbilical cord to be cut only after it stops pulsating. To keep the placenta. To see the placenta before it is discarded. To hold the baby while I deliver the placenta and any tissue repairs are made. Other I would like to hold the baby Immediately after delivery. After weighing. After being wiped clean and swaddled. Postpartum I’d like baby’s medical exam and procedures: Given in my presence. Given in my partner’s presence. Given only after we’ve bonded. Other Whenever possible post-delivery, I would like To not be separated from my baby. My partner to accompany the baby if the baby must be taken from me to receive medical treatment. Baby's first bath and assessment done in my presence. Other I would like to feed my baby: Only with breastmilk. Only with formula. With breastmilk and formula. On demand. With the help of a lactation specialist. Other Additional Notes Additional Notes Save My Birth Plan Save By selecting the Save button, your information will remain available for two days. If this is a public computer, we don't recommend saving this form. Print Preview You may also print out your birth plan to have on hand during your pregnancy. Reset By selecting the Reset button, your information will be cleared from all the above fields. Next Steps Once you complete your birth plan, we recommend the following next steps: Call (208) 227-2400 to schedule a tour. Sign up for a childbirth preparation class. Print and discuss the birth plan with your doctor Bring a printed copy of the birth plan with you when you come to deliver at the hospital General Internet communication is inherently not secure. DO NOT send data considered confidential or private in nature on this form. (e.g., Social Security Numbers, Diagnosis Information, Credit Card Numbers, etc.)