In case I am GBS + (test should be preformed as close as possible to due date), I would prefer in that case intrapartum vaginal flushings with chlorhexidine instead of in vein antiobiotics.
5. In case Induction becomes necessary for circumstances different than 42 week pregnancy or 24 hours after SROM/AROM, I and my husband would like to be actively involved in the discussion about the need of Induction, and given the possibility to understand the grounds and check medical record.
6. Should my labor slow down or stall, I would like to wait as much as possible for it to start or speed up again spontaneously, by changing position, moving if I will feel like it, having a shower, acupressure, nipple stimulation, relaxing to release tension (others?). I would like to feel no urge from my caregivers.
– Only in case my baby is in danger because of the stall/slow down of labor or under my request because I am too tired to go on spontaneously, I would prefer proceeding with AROM and Synthetic Oxitocyn as above (points 3 D and E).
Routine Procedures
8. I want to wear my own clothes during my stay in the hospital.
9. I don”t want pubic shaving and I would prefer to avoid enema unless I require it to help kick-start labor.
10. I want my husband and child (needed for nipple stimulation, as I can breastfeed her in case of stall/slowdown of labor! J ) and my doula to be with me during labor.
11. I don”t want other people to be around apart the necessary staff (midwives and Obsgyn when necessary), I would like to choose the intensity of lights, to listen to music, use aromatherapy (should learn something about it), not hearing people talking loud apart my family, to be checked as less as possible, not to be forced or urged to do things unless following gentle discussion and suggestions, to have all the time for my labor without timelines (unless emergency rise).
12. I want intermittent Electronic Fetal Monitoring preferably wireless or Doppler and I would like that it”s performed leaving to me the choice of the most comfortable position (about the Doppler, I have to get information, no idea on how it works).
13. I would like water labor and birth, and even when I”m not in the tub I would like to have always access to the bathroom for shower, bath or a pee.
14. As pain relief, I would like to use massage and acupressure, relaxation, hypnobirth, changing position. I don”t want to be offered drugs unless I ask for them.
15. I”m not planning an epidural.
Birth – 2nd Stage of Labor
16. I don”t want episiotomy, I prefer to tear. To help prevent tearing, I”m doing yoga exercises to help perineum to stretch and soften and back exercises for the pelvic floor (other ideas?). During delivery I want to avoid the lithotomic position and stay in a position in which gravity can help delivery, like squatting. I would also like to use a warm pack to place on the perineum (other ideas?). In case of tearing, I prefer not to be stitched at all, unless the tear it”s too big to heal spontaneously.
17. I”m oriented to water labor and birth, in any case I want to be able to choose the position I”m giving birth in. Any suggestion from my caregiver is welcome but I should feel free to follow or not the suggested positions.
18. When it comes time to push, I want to follow my body”s urge to push. Any suggestion on it (like not pushing too strong) will be welcome but I would prefer it to be given in the form of positive suggestion (like “Rock your baby!” instead of “Don”t” push!”, in order to have an active alternative) and I want to feel free to follow the suggestion or not.
19. If pushing stage becomes prolonged, I wouldn”t like to consider ventouse or forceps and continue on this stage unless an emergency rise or I am too tired. In case of need of any intervention, I would like I and/or my husband and my doula to be actively involved in the discussion and give previously consent.
20. I would like to catch the baby, or my husband (if present) to catch him/her. However this is not an issue.
21. I want to hold my baby immediately after birth, skin to skin, and let him/her breast crawling. I would like to have all the emergency equipment close to me or easily movable (oxygen, …) in order to have any minor emergency intervention performed while the baby is with me, in order to allow physical connection until the placenta is spontaneously born.
22. I want to have lotus birth in any case. For minor emergencies rising while placenta is not born yet, see point 21 above. In case of need of major intervention I would like to follow my baby and remain close to him/her.
23. Only in the unforeseeable cases (that should clearly be explained to me and/or husband and doula and indicated in medical record) I couldn”t remain close to my baby and placenta is not born yet, I would prefer the cut to be delayed as much as possible, to let it stop pulsing. In this case, I would prefer me or one of my family to cut the cord but this is not an issue.
Birth of Placenta – 3rd Stage of Labor
24. Lotus birth, as above.
25. I want a natural third stage, and I am willing to wait all the necessary time (I read that after a certain lapse of time it”s dangerous, why? How much time? I read of women with a safe 3 hours third stage…)
Baby”s care in the hospital
26. I don”t” want the baby to be routinely suctioned, having the possibility to breastfeed immediately when the baby wants it will be possible to check soon if he/she can breathe well.
27. I don”t want my baby to be administered vaccinations, due to adverse effects occurred to my first child after vaccination.
I prefer him/her not to be administered Vitamin K either.
28. I would like rooming-in for all of my stay in the hospital. The baby should be never taken away from me, even in case of emergency I or my husband would like to be present.
29. For baby care –washing and cleaning, wrapping, etc. I would prefer waiting some hours after birth. I would like to perform it personally or at least to be present (or my husband to perform).
30. I would leave the hospital as soon as possible after birth, may it be one day.
31. Since I intend to breastfeed, nothing as pacifiers, glucose, water and anything else should be given to my baby without my express permission. I do not want to be urged about the growth of my baby or possible lack of lactation onset in order to give formula, as I am aware that for successful breastfeeding some days after birth may pass.
32. My family should be able to stay with me at the hospital.
33. If my baby has jaundice (what are the parameters?) and treatment is considered necessary, I would prefer this to be done in my room rather than in the nursery.
In the event of a Cesarean
34. If a Cesarean becomes necessary, this should be after spontaneous beginning of labor or with Induction (is it possible?), in order to prepare the baby and to let him/her go as much as possible through the birth canal.
36. I would prefer an epidural.
37. I want to hold my baby immediately after birth and follow as much as possible my plan for natural birth as from point 20 onwards, including lotus birth, contact skin to skin and breastfeeding. In this case it will be even more important to postpone any non urgent care like washing to the time I will be able to move.