VBA2C Birth Plan


Mother: Katie Whiddon

Father: Cole Greene

Today’s date: July 4th, 2017

Due date: July 25th, 2017

Baby’s name: Jaxton Cole Alexander Greene

Doctors name:

Hospital name:



•Repeat cesarean ONLY if mother or baby’s life is at risk

•During labor I would like for my children, family and friends to enter the room as long as I am comfortable enough for visitors.

I would like the following people present during birth:

•Father/partner: Cole Greene

•Maternal Grandmother/support person: Toni Bender

During labor I would like:

•music played

•lights dimmed

•room quiet as possible

•as few interruptions as possible

•vaginal exams only as requested, unless medically necessary

•no residents, students, or interns present during labor or birth

•to wear my own clothes

•support person to film and/or take pictures

•my partner and support person to be present at all times

•to stay hydrated with clear liquids and/or ice chips

•to eat and drink as approved by my doctor

I would like to spend the first stages of labor in any position that I am comfortable and progressing in:


•laying down


•in shower

•in tub

I am not interested in:

•Urinary catheter

•an IV, unless I am dehydrated. Saline lock IS okay, but only in arm so mobility isn’t restricted.

Fetal monitoring:



Labor augmentation:

•performed only if baby is in distress

•first attempted by most natural methods

•performed with pitocin ONLY if most natural methods fail

•NEVER to include artificial rupture of the membrane, unless dilated to 6cm

Pain relief:


•breathing techniques





Birthing positions:



•lie on my side

•be on my hands and knees


•lean on my partner or support person

•use people for leg support

•use a birth bar for support

•use a birthing stool

As the baby is delivered, I would like to:

•allow body to push naturally

•push without time limits, as long as the baby and I are not at risk

•use a mirror to see baby crown

•touch the head as it crowns

•avoid forceps usage

•avoid vacuum extraction

•let partner catch the baby


•used only after perineal massage, warm compress, and different positioning have failed

•performed ONLY with my consent, after my doctor deems necessary

•performed with local anesthesia

After delivery:

•my partner is to cut the umbilical cord

•the umbilical cord cut only after it stops pulsating

•no pitocin, unless deemed medically necessary by my doctor.

If cesarean is necessary:

•make sure all other options have been exhausted

•I am to stay conscious, unless at immediate risk

•my partner is to remain with me the entire time, even if unconscious

•screen lowered so I can watch delivery of baby

•my hands left free so I can touch baby, unless limbs become uncontrollable

•surgery explained as it happens

•spinal block for anesthesia

•my partner to hold baby as soon as possible

•breastfeed in the recovery room

•I would like to hold and breastfeed baby immediately after delivery.

Baby’s medical exam and procedures:

•given in my presence

•given only after both parents have bonded

Please do not give baby:

•vitamin K, unless visible sign of bruising or surgery is needed

•sugar water



•any artificial nipple

Baby’s first bath given:

•given by me and my partner

I’d like to feed baby:

•only breastmilk

•on demand

Baby is to stay in my room at all times.

I’d like my partner:

•to stay in my room

•to have unlimited visiting

As needed post-delivery:

•stool softener


After birth I would like to stay at the hospital:

•as long as possible

If baby is not well:

•my partner and I are to accompany baby to NICU

•only give breastmilk from my breast, pumped milk or donor breast milk via syringe/spoon/cup/tube

•to hold him whenever possible


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