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Birth Plan and Contract

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I require a contract be signed by myself and the mother and father/birth partner in it is written about the stuff that a doula (myself) will do and not do and what I expect and what you can expect. For a copy of my contract please contact me and I will get a you a copy so you know what to expect.!

A birth plan helps you to discuss with your partner and health care provider how you would like your labor and delivery to go. Ideally speaking that is what you expect to happen. Of course having to understand that things happen all the time with Labor and Delivery things that we have no control over, but with in reason items in your birth plan could be followed providing that the baby's life would not be harmed in any way or the laboring mother.



Environment:
 Home
 Private birthing room
 Dim lights
 Soft music
 Peace and quiet
 Wear my own clothes
 Hospital gown
 Videotape labor and birth
 Take pictures during labor and birth
 Private phone
 Other amenities: VCR, stereo, flowers
Support People Present at Birth:
 Partner
 Relatives
 Friends
 Siblings
 Labor assistant/Doula
 No excess hospital staff
 Support people present at mother's discretion and according to hospital protocol
Preparation Procedures and Labor:
 Free to walk and move around
 Eat and drink during labor
 Clear fluids and ice chips available at all times
 Prefer to avoid an enema or shaving
 No IV unless necessary
 If so, then heparin or saline lock IV
 No unnecessary examinations and very minimal vaginal examinations
Monitoring:
 Fetoscope
 Doppler
 Intermittent external fetal monitoring
 Intermittent internal fetal monitoring
Pain Relief:
 Massage
 Hot/cold packs
 Hypnosis
 Relaxation
 Shower or bath tub
 Breathing techniques
 Movement (walking, swaying, rocking)
 Acupressure
 Acupuncture
 Meditation
 Epidural or spinal anesthesia
 Narcotics
 Sedatives and tranquilizers
 None at all
Induction:
Medically Induced:
 Pitocin
 Prostaglandin gel
 Amiotomy
 Stripping of membranes
 Cytotec
 Cervadil
Self Induced:
 Acupuncture
 Walk
 Castor oil
 Nipple stimulation/thumb sucking
 Sexual intercourse (if bag of waters aren't broken)
 Herbs
Episiotomy:
 Yes
 No
Delivery Positions for Labor:
 Semi-sitting with footrests or stirrups
 Side-lying
 Lying prone
 Squatting
 Hands and knees, pelvic rock
 Standing upright
 Walk
 Lunge
Birthing Equipment:
 Birthing bed
 Birthing stool
 Birthing chair
 Birthing pool/tub
 Beanbag chair
 Squatting bar
 Other
 I would like a mirror available so I can see the baby's head crown
 I would like to touch my baby's head as it crowns
 I would like to have the baby placed on my stomach/chest immediately after birth
 Room as quiet as possible
Pushing:
 Spontaneous
 Directed
Extraction Devices:
 None unless baby's health at risk
 Vacuum extraction
 Forceps
Cesarean:
 Partner present at all times during the operation
 I'd like to be conscious
 Screen lowered so I can see the baby coming out
 One hand free to touch the baby
 Immediate contact with the baby
Placenta:
 Cord Blood collection
 Injection of Pitocin to aid with delivery
 Spontaneous
 Encourage with breast stimulation, baby suckling
 Manual extraction
 I'd like to see it
 Use of placental tissue by the hospital
Cord-cutting:
 Partner cuts cord
 I would like to cut the cord
 Neither
 Other family member
Newborn Procedures:
 Done in my presence
 Done in my partner's presence
 Expanded Newborn Screening (arranged prior to delivery)
Feeding baby:
 Breast
 Bottle
 Both
Separation:
 No separation
 Partial rooming
 Nursery
Circumcision:
 Yes
 No
Hospital Stay:
 Short as possible
 Long as possible
 






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Bobbi Fargo

Miracles of Birth Doula Services.

Tubal Reversal Club group owner

Lisas Tubal Reversal Stats site

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