I know that some medical personnel frown upon birth plans, but I feel like having what I'd PREFER written down will help during our birthing process, as I am a FTM and delivering twins. I am very acutely aware that things can change very quickly and that procedures I'm hoping not to have may very well happen. I am a nurse myself and I am trying to be realistic - my twin pregnancy is considered "high risk" so my twin delivery may be as well.

I used a website to create my birth plan and it turned out a bit... long. I want it to cover everything, though, as a c-section is very possible and an epidural is a definite.

Please let me know what you would change/omit to make this as clear and concise of a birth plan as possible! I don't want to be seen as "high maintenance" or a pain in the butt. Thanks!

*Please note - I put in that I am a nurse because I have found in the past that some medical professionals are put off by being "surprised" by that fact.*

We have created this birth plan in order to outline some of our preferences for birth. We understand the need to be flexible as there may be situations in which our choices may not be possible. We do not want to replace the medical personnel, but instead want to be informed of any procedures in advance, and to be allowed the chance to give informed consent. Please feel free to ask if you have any questions or comments. Thank you!

Please Note
I am a nurse and would like all procedures to be discussed with my husband and myself prior to it occurring and to provide informed consent unless I am unable to speak for myself.

Labor
I would like to be free to walk, change positions and use the bathroom as needed or desired and wish to labor freely in the shower.
I will remain hydrated by drinking moderate amounts of fluids (water, juice, ice chips).
So I can stay as mobile as possible, I would prefer to have a heparin lock administered instead of an IV.
I would like a quiet, soothing environment during labor, with dim lights and minimal interruptions.
As long as the babies are doing well, I prefer that fetal monitoring be performed intermittently with an external monitor.
Please allow me to vocalize as desired during labor and birth without comment or criticism.
Please do not permit observers such as interns, students or unnecessary staff into the room without my permission.
To preserve my privacy and dignity, I would prefer that everyone knock before entering.
As I am a first-time mother, I would appreciate gentle guidance and reassurance through the labor and delivery process.

Labor Augmentation/Induction
I would like to avoid induction unless it is medically necessary and would like to try alternative means of labor augmentation, like walking or nipple stimulation, before pitocin or artificial rupture of membranes is attempted.
If pitocin is required, I would like to start and stay at the lowest effective dose.

Anesthesia/Pain Medication
If I ask for pain relief, please feel free to offer non-medical choices for coping.
I have fears regarding the epidural and would like my husband present during its insertion.
I would like to have the epidural catheter placed but refrain from using the medication for as long as possible, as I would like to walk and move during labor.
I would like the epidural to wear off slightly as I approach full dilation and the pushing stage.

Cesarean Section Delivery
I feel very strongly that I would like to avoid a cesarean delivery, but understand if it is medically necessary. Please let me know what is occurring to require a c-section (i.e. fetal distress, etc.)
I would like my husband Patrick to be present during the surgery from as early in the procedure as possible.
Please explain the surgery to me as it happens.
I would prefer epidural anesthesia, if possible, in order to remain conscious through the delivery and would accept general anesthesia in an emergency only.
If possible, please do not strap my arms to the table during the procedure.

Perineal Care
I prefer not to have an episiotomy and would rather tear unless an episiotomy is medically necessary.
To help my perineum stretch, please help guide my pushing efforts by letting me know when to push and when to stop.
Please administer local anesthesia when repairing any episiotomy or tear(s).

Delivery
I would like to have a mirror available and adjusted so I can see the babies' heads crowning and to have the opportunity to touch the babies' heads as they crown.
I would like the freedom to push and deliver in any position I like, if it is safe for the babies and myself.

Immediately after the birth
Please place the babies on my stomach/chest immediately after delivery.
My husband, Patrick would like the option to cut the cords.
Please show me the placenta after it is delivered.
Please remove my IV as soon as it is safe to do so after delivery.

Newborn Care
I would like to hold the babies skin-to-skin during the first hours to help regulate baby's body temperature, unless it is medically contraindicated.
I would like to hold the babies through delivery of the placenta and any repair procedures.
If the babies must go to the nursery or NICU for evaluation or medical treatment, my husband Patrick will accompany the babies at all times.
Please notify me of any procedures or medications to be administered to my sons prior to their administration.

Postpartum Care
I would prefer not to be catheterized until I've had some private time to attempt urination on my own.
I would like the babies in the nursery at night, but brought to me for breastfeeding on demand.
I would like to limit visitors for the first hour or so after birth, if possible, to allow for bonding and quiet time for my babies, myself, and my husband.

Breastfeeding
I plan to breastfeed and want to nurse immediately following the birth.
Please do not give the babies supplements (including formula, glucose, or plain water) without my consent, unless there is an urgent medical necessity.
I would like to know more about breastfeeding and meet with the lactation consultant.

Additional notes
I am planning to have the babies circumcised. Please discuss this with my husband and myself before the procedure is performed.

**Edited to reflect changes suggested! Thanks! **