I used our childbirth flashcards to write up a one page birth preference list. If I learned one thing during my childbirth preparation, it’s to expect the unexpected. This one page bulleted list was a guideline so that Mr. S, my doula, my midwife and I were all on the same page. We discussed it beforehand (my midwife asked me to bring one to my 38w appointment before I’d even put the list on paper!), and whittled it down to the basics before printing off several copies and sticking them in my hospital bag, purse, and car.

When we arrived at the hospital, my nurse asked if I had a birth preference list. Juli, my doula, handed the folded piece of paper to her. She read through it, noted the penicillin allergy and that I wanted a med-free birth, stuck it in my chart and went on with her business.

While it was a total non-issue for my care providers, creating a birth preference list was a valuable exercise for me. In creating one, I put thought into my options, the possibles, and the parade of horribles. While I definitely had my preferences, I felt well-educated and comfortable with my knowledge of how decisions I made during labor might impact other events as it progressed.

Below is my exact birth preference list. The starred bullets are those preferences that we veered from, with an explanation in italics.

Mrs. Stroller  –  Birth Preference List
Husband: Mr. Stroller & Doula: Juli

I HAVE A PENICILLIN ALLERGY
PLEASE ALLOW MY HUSBAND TO ANNOUNCE THE SEX OF THE BABY

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Labor

  • *I’d like to have as natural an experience as possible – labor progress on its own, ability to move freely, intermittent monitoring, liquids and food orally, a saline lock instead of an ongoing IV – Everything progressed on its own until I got the epidural a few hours before baby S was born. When you get an epidural you need one bag of fluids first, so that was hooked up to my IV before I got the epidural. I also had a bit of Pitocin for a couple hours after I was given the epidural. I continued to drink and eat throughout my entire labor, however.
  • *Please place saline lock on the outside of my arm for ease of movement and administer only IV antibiotics unless absolutely necessary. Please consult with me before adding anything including fluids – My saline lock went on my hand instead of my arm; it was not a big deal.
  • *Please do not offer pain medications, I will ask for them when I’m ready – My midwife had to strongly encourage an epidural after 27 hours so that I could rest. Her fear was that after two nights of labor and little sleep, I wouldn’t have the energy to push baby S out.

Birth

  • *I would like to be free to move into different positions (hands & knees, squatting, etc.) for pushing  and to deliver on my side, if possible – My epidural hadn’t totally worn off so I delivered on my back instead of my side. It was a non-issue since I labored down and baby S was out in no time at all!
  • Please direct my pushing, apply warm compresses and massage my perineum to help minimize tearing
  • I prefer not to have an episiotomy nor  to have an instrument assisted birth.
  • *Please allow my husband to announce the sex of the baby (make sure he can see clearly or is quietly told what to announce!) – Poor Mr. S couldn’t see the “parts” and was terrified to announce the wrong sex – I heard Juli whisper what to say to him.
  • *After the birth I would like the baby immediately placed on my chest with skin-to-skin contact until breastfeeding is established – please do all initial evaluation and cleaning while on my chest – Baby S passed meconium in the last few hours of labor so he had to be evaluated by the NICU team. He was on my chest and doing the breast crawl within a minute or two though.
  • *Please allow the baby’s blood to flow freely through the cord for 2-5 minutes before clamping – we couldn’t do this because of the meconium.
  • I have an extra lobe of placenta that needs to be delivered (see my chart)
  • If possible, I’d like to avoid Pitocin after birth, unless necessary
  • *Please bag the first blankets/towels used to clean the baby for us to take home to introduce its scent to our dog – Mr. S did this surreptitiously. We brought a trash bag from home to use. Our dog, Feeney, didn’t care at all and my mom washed the blankets after letting him sniff them a few times during the day baby S was born

Cesarean (only if absolutely medically necessary)

  • I would love to create the same type of baby-friendly environment as a vaginal birth as much as possible. This includes having the baby skin-to-skin during repair and recovery, delayed clamping if possible, and encouraging breastfeeding during the recovery period
  • If the baby cannot be immediately placed on my chest, then I would like it placed skin-to-skin on my husband’s chest, if health permits
  • I would like my husband or doula to stay with me at all times during the repair and recovery

Baby Care

  • Please delay eye ointment, vitamin K injection and vaccinations for an hour
  • I have a penicillin allergy; please give baby a penicillin alternative, if appropriate
  • Please delay baby’s first bath for a few hours until after breastfeeding is established – He didn’t have a bath until the day we went home!
  • I would like a lactation consultant to visit as soon as possible to help with an inverted nipple

Did you create a birth preference list? Did it help you feel better prepared when things didn’t go as you had hoped?