:
VBAC Birth Preferences
Of Cailin
Dear Staff
Our desire is to give birth vaginally with little medical intervention as possible. We have chosen the HypnoBirthing Method of quiet, relaxed, natural birth. Please see attatched form for more information.
We plan to have the following people constantly present: Marc (Father) and Kelly Zantey (Birth Attendant) and also to be present should a medical emergency arise and a caesarean is performed.
Others who may be present depending on the type of birth, or stages of birth: *Insert Name* (Paternal Grandmother), Paris (Sibling – in care of MIL), *Insert Name* (Paternal Aunt), *Insert Name* (Friend - if where Paternal Grandmother or Aunt cannot be present).
We ask that the following preferences be adhered to where possible, and where not possible we are to be informed beforehand with a detailed explanation as to why.
• Subdued Lighting
• Please honour our wishes for minimal disruption.
• Please refrain from reference to pain or hurt.
• No suggestions of analgesics or anaesthetics unless required in a medical emergency or specifically requested.
• To be advised of all medical procedures before they are undertaken.
• If a decision needs to be made in regards to any medical procedures, we would like to be informed and allowed privacy to discuss these options before making any decision. Please do not ask the mother to make any decisions immediately, especially during a contraction.
• No references to present time, time taken or progression are to be made directly to the mother. This information should be passed onto the father and Birth Attendant only.
• In the case of an emergency caesarean please see attached “Caesarean Birth Preferencesâ€.
• To birth in an atmosphere of gentle encouragement during the final pushing stage.
• To maintain membranes intact unless there is a medical necessity to rupture.
• Immediate skin-to-skin contact with baby placed on the mothers stomach with no wrapping of baby.
• Umbilical cord to be left to pulsate rather than to be clamped and cut straight away.
• Father to cut umbilical cord.
• To allow (if possible) 30-40 minutes for natural placenta delivery. NO cord traction, manual removal, massage or injection for removal of placenta unless necessary.
• We would like to keep the placenta. So please be sure to make the appropriate arrangements with us.
• Please use a soft cloth between baby and the weight scales.
• APGAR and all exams are to be performed with one or both parents present.
• To encourage breastfeeding, we would prefer not to use bottles, formula, pacifiers or artificial nipples unless required after discussion with us.
• No medical procedure to be performed on the baby, including vaccination, without our consent.
• Vitamin K to be given orally.
• Baby to be bathed by both parents.
Whilst this plan outlines our preferences for birth we understand that not all births go to plan and in certain medical emergencies not all preferences can be undertaken. However in these situations we as the parents would still like to be informed.
These preferences have been viewed and accepted by our Obstetrician Dr. Lionel H. Steinberg.
Signed:
____________________ ____________________ ____________________
*Insert Parents Names & Dr*
Edited to add Cesarean Birth Preferences
:
Emergency Caesarean Birth Preferences
Of Cailin
Dear Staff
In the case of an emergency caesarean we have outlined the following preferences.
We plan to have the following people constantly present: Marc (Father) and Kelly Zantey (Birth Attendant).
We ask that the following preferences be adhered to where possible, and where not possible we are to be informed beforehand with a detailed explanation as to why.
• We would prefer that a spinal epidural is given and that the mother remain conscious during the operation
• If under an emergency situation and a general anaesthetic is needed, then we wish for the baby to be given to Marc (Father) straight after the birth and held by him until Cailin (Mother) is conscious. In that time the father will have skin-to-skin contact at all times.
• If possible both parents would like to view the birth by having the screen lowered or a mirror positioned for optimum viewing.
• We would like to be informed by a verbal description of the birth as it is happening. We would like the parents to remain a part of the birth and to not be treated as though they are not present.
• Although we understand that the cord cannot continue to pulsate for as long as it is possible with a vaginal birth, we would still appreciate it if the cord can be left to pulsate as long as possible.
• We would like the baby to be placed on the mother as soon as possible, unclothed in their naked newborn state and if either require it, a blanket placed over both baby and mother.
• Cailin (Mother) would like to try to feed her baby whilst she is being sutured, and where possible for the baby to be kept with her during the surgery and also during recovery.
• We would like to keep the placenta. So please be sure to make the appropriate arrangements with us.
• APGAR and all exams are to be performed with one or both parents present.
• To encourage breastfeeding, we would prefer not to use bottles, formula, pacifiers or artificial nipples unless required after discussion with us.
• No medical procedure to be performed on the baby, including vaccination, without our consent.
• Vitamin K to be given orally.
• Baby to be bathed by both parents.
Whilst this plan outlines our preferences for birth we understand that not all births go to plan and in certain medical emergencies not all preferences can be undertaken. However in these situations we as the parents would still like to be informed.
These preferences have been viewed and accepted by our Obstetrician Dr. Lionel H. Steinberg.
Signed:
____________________ ____________________ ____________________
*Insert Parents Names & Dr*
*hugs*