Hypnobirthing Birth Plan

Amy Johnson – Due Date: 12 December

I have put together a simple birth plan. I would appreciate your effort to accommodate our wishes. However, we
do understand that emergencies happen, complications arise, and therefore all our request may not be possible.

Labor
 Please let us know when we can take photos and videos;
 We are a hypnobirthing family;
 Please do not offer pain medication, do not assess my pain levels, or ask about my pain. If I need pain
relief, I will ask for it;
 If possible, please keep the room warm and dimly lit;
 After a 20-minute NST strip, please allow intermittent monitoring and permission to walk in the room;
 Please allow me to labor down to crowning;
 If no antibiotic risk factors are present, I decline antibiotics from unknown GBS status—I want to follow
the CDC guidelines for intrapartum unknown GBS;

Delivery
 I do not wish to have students or extra people in the room;
 I wish to keep the lights dim if possible;
 I wish to keep the room as quiet as possible;
 I prefer no forced pushing or counting to 10 while pushing. Please allow me to do this my own way;
 Please allow for restitution, and do not pull my baby out. Allow me to push my baby out;
 Please offer warm perineal compresses;
 I do not wish to have an episiotomy, perineal massage or perineal ironing;
 If shoulder dystocia is suspected, please let me get on my hands and knees;
 Please allow me to birth in a position other than lithotomy, if that is working well;
 Please put my baby directly on my chest, skin to skin;
 Please delay cord clamping until the cord has stopped pulsating so that she gets all of her stem cells and
blood volume.
 My husband would like to cut the cord;
 I do not have gonorrhea or chlamydia, so please do not administer erythromycin eye ointment;
 Please allow my baby to stay skin to skin and in my arms, instead of the warmer;
 Please do not add chemicals to the placenta and do not send it to pathology—we would like to take it
home with us.

Postpartum Care
 Please put us in a room with a sofa or roll-away bed for my husband to sleep on;
 I will breastfeed exclusively;
 Please keep my baby in the room with me;
 We decline a septic workup on the baby for unknown GBS status;
 I would like to request an early discharge if both my baby and I are stable.

Thank you for sharing the birthing experience with us.