top of page
Writer's pictureHannah Botham

Birth Wishes Template


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

11 views0 comments

Recent Posts

See All

Tips For An Unmedicated Birth

Here are my tips for an unmedicated childbirth! This is not written to judge women who use epidurals or other medications, but rather to...

Birth Affirmations

Bible Affirmations “That pain that you’ve been feeling, can’t compare the joy that’s coming” Romans 8:18 “Be strong and courageous. Do...

Comments


bottom of page