MY BIRTH WISHES
Name: _______ _______ _______ Medical Record #: ________ Estimated Due Date: __/__/____
IMPORTANT NOTES: NO Hepatitis B, NO Eye Ointment, NO Vitamin K
We have prepared for an UNMEDICATED VAGINAL BIRTH and truly appreciate your support in this goal as we welcome our daughter into the world.
LABOR WISHES
Yes, please…
• Only Aaron Botham in the room, please ask my consent before allowing anyone else into our room
• I prefer to remain IV free, if necessary I will consent to a saline lock
• I want to eat, drink, and move freely during labor
No, thank you…
• No offering pain medication
• No continuous fetal monitoring
• No artificial rupture of membranes
• No interventions or forceps unless medically necessary for safety of myself and baby
BIRTH WISHES
Yes, please…
• I want to try different positions during pushing
• If possible, please help prevent perineum tearing
• Place baby on my chest immediately after birth
• Leave all vernix on baby from birth until first bath
• Allow cord to stop pulsating before cutting
• Aaron Botham will cut the cord when the time comes
No, thank you…
• No coaching during pushing, please allow me to follow my body’s cues on this
• Lying on back during pushing, I want to remain as upright as possible
• No episiotomy
• Do not wipe baby off, please allow for uninterrupted skin to skin
• Do not pull the placenta out, please allow it to be delivered naturally
POSTPARTUM WISHES
Yes, please…
• I want breastfeeding to be initiated by baby, please don’t interfere unless I request help
• We will delay newborn bath for at least 24 hours after birth
No, thank you…
• No Vitamin K shot
• No Hepatitis B
• No eye ointment
• Baby will not leave the room unless permission is given by Aaron Botham or myself
• No bottles, pacifiers or glucose water without our expressed permission
IN CASE OF EMERGENCY
• If our baby needs to leave the room at any point during our hospital stay, Aaron Botham will accompany her at all times
• Aaron Botham has permission to make ALL decisions for myself and our baby if I am unable to clearly advocate
• In case of emergency C-Section, I want to be fully awake and alert during her birth, I want my arms to be free, and I want our baby to be placed on my chest immediately upon her birth (unless baby is in distress)
• If baby has great potential to die, Aaron Botham is to IMMEDIATELY perform emergency baptism
“I can do all things through Christ who strengthens me.” Philippians 4:13
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