We are looking forward to the birth of our first child. We understand that things may go wrong, but if everything goes smoothly and there are no emergencies, these are our wishes and we kindly ask they be respected.
The room is closed to all guests except, my husband, my mother, and my sister.
Please keep the lights dim and the door closed for our privacy.
I'd like to have as natural a birth as possible. Please don't offer any pain medication or do any interventions unless absolutely necessary. I do not want to be induced unless an emergency calls for it.
If when I arrive at the hospital my water isn't broken, I do not want it to be medically broken unless the baby's life or my life is in danger. If we must go home and come back when labor has progressed more, we will.
I would like to push at my own pace. Please no counting.
After the birth, I wish to nurse immediately. I ask that any evaluations be done while I am holding her. I also ask that the cord not be clamped or cut until it stops pulsating.
Please do not give our daughter any formula or pacifiers. We also ask that she not be given any shots. (Hep. B or Vit. K)
We prefer that our daughter be kept in the room with us at all times. If for any reason she must go anywhere outside our room, we ask that either I or her father go with her.
If Cesarean becomes necessary, I would like to be conscious, the father would like to be present at all times, and we still prefer for our daughter to be nursed immediately.
We prefer that our hospital stay be as short as possible and that we are able to go home as soon as possible.
Thank you for taking the time to help us achieve as natural of a birth as possible for our daughter.