Here it is so far...
This is what we'll be giving to the nurses and midwives. At this point it sounds like the request for vitamin K drops might be out, depending on the pediatrician/availability. I have made a few minor changes to this document since my son was born, and of course, this is always a living document and work-in-progress. Feel free to comment.
Birth Requests Thank you, Samaritan Hospital Team, for helping us make this a special experience!
During Labor and Delivery Please knock before entering the room
Jacuzzi Tub I prefer to labor in the water for as long as possible.
Vaginal Exams Please ask each time before examining me, I am easily startled!
Pitocin, Analgesics and Anesthetics Please DO NOT offer these. We will discuss the need for these with our doula and midwife. We would like a natural childbirth modified only by conditions that directly threaten the health or safety of the mother or child.
IV We would like to avoid the use of an IV, if possible, and prefer to hydrate with electrolyte drinks. If the IV becomes necessary, please allow alternation between glucose and saline.
Monitoring We would like to avoid as much monitoring as possible. Please allow intermittent monitoring so that I may maintain mobility and change positions often. Please allow us to turn the machines and lights down to create a less stressful environment. We may ask to use the Doppler in addition to the fetal monitoring system to gain a more accurate picture of the baby's heart rate.
Natural Progression We would like to allow our labor to progress naturally, without pressure to speed it up for any time constraints, unless there are circumstances that truly threaten the mother or child. I may decide to change positions often and hope the nurses and midwives will facilitate any birthing positions I feel I would like to try.
Episiotomy We would like to avoid an episiotomy with the help of perineal massage, warm compresses, and taking the time to push slowly during key moments.
In Case of Cesarean Epidural. Please suture the layers one at a time. Give Toradol post-op.
Immediately After Delivery We request that the baby's cord be clamped and clipped only after it has stopped pulsating, or at least 2 minutes after delivery. Please place the baby on my chest and allow 45 minutes for nursing and bonding before bathing the baby etc. The father would like to clip the cord.
Routine Tests We ask that our baby not receive Vitamin K shot or eye ointment, please. We would like to request Vitamin K drops as an alternative. Please delay routine testing procedures for 45 minutes, and check with us before they are done.
Circumcision In the event that our baby is a boy and choose to have a circumcision performed during our stay: we would like a non-Gomco clamp circumcision and a local anesthesia applied.
Vaccinations/Medications We would like to waive the erythromyacin ointment.
No Bottles or Pacifiers, please!
I tried to keep this pretty simple, only mentioning the things that were really important to us. The nice thing is that several of the items on here were also questions on the hospital's pre-admission paperwork. Of course we can't know exactly how things will happen. I've removed my midwives', husband's and doula's names for their privacy. It all fits nicely on one page :) I've also written a document with requests for my doula and husband during the labor...but I think I'll wait to post those.