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    My Birth Day Preferences

    Below is a list of common situations that are encountered during the birth of a child. We want to share with you the customary practices at California Pacific so that you will have an idea of what to expect when you are admitted. We hope it provides a framework for discussion to help you and your partner identify your feelings and desires for this special day. Please begin to think about these issues and discuss them with your care provider. You may want to bring a copy of this preference list with you to the hospital.

    • Date


    • Name


    • Support Person(s)


    • Religious, cultural, or spiritual preferences that you would like to incorporate into your birth experience

    Labor & Birth

    1. Early labor is sometimes a lengthy process. During this time, it is very important for you to be able to move freely, change positions, and eat light snacks. In most circumstances, home is a much better place for early labor. Do not be discouraged if, on the first exam in OB reception, you are asked to walk for a period of time or even to return home. Occasionally, a medication can be provided to help you rest if you are sent home.


    2. All of our Labor & Birth Rooms are private and have showers. We encourage you to bring your favorite music with CD player; dim the lights to create a relaxing environment and change positions as you need for comfort. You may invite friends and family to be with you during labor.


    3. It is important to stay well hydrated during your labor and so we encourage you to drink clear liquids during this time. We provide ice chips, water, juice, broth, tea, and Jell-O™. You may also wish to bring hard candy for yourself and snacks for your partner.


    4. We do not routinely start an IV upon admission. You will be free to walk around, drink clear liquids, and try different positions for comfort and to help encourage the progression of labor. We do not routinely perform enemas or shaving for delivery at California Pacific.


    5. Every baby’s heart rate is monitored externally on admission to Labor and Birth for 20-30 minutes. If the baby’s heart rate is reassuring, then you will only be monitored intermittently (10-20 minutes per hour). Sometimes continuous monitoring becomes medically necessary.


    6. We support a range of non-medication options for pain management including walking, massage, rocking chairs, birthing balls, etc. What other options are you considering?


    7. Walking around and being upright are helpful for the progress of labor. If labor does not progress, you may need additional help such as breaking the bag of water or Pitocin. Pitocin is the same hormone that your body produces during labor. If this is necessary, we start Pitocin at the lowest dose and increase gradually while monitoring the baby. Your care provider will discuss with you which option(s) are the most appropriate.


    8. For pain medication, we offer two options that are both safe for the baby:
      1. a rapid acting short term narcotic (either IV or intramuscularly) and


      2. epidural anesthesia (pain medication in the lower back).
      Epidural medication is provided by on-site anesthesiologists and is available 24 hours a day. With an epidural, your blood pressure will be monitored continuously, you will not be able to walk around and may have diminished sensations of the need to urinate. If this happens, you may need to have a catheter to help empty your bladder. The baby’s heart rate will be monitored continuously. Even if you do not plan to have either of these options, it is good to know about them before you go into labor. Please review the pain medication handout in your prenatal information. (See “A Guide to Your Pregnancy & Newborn”, Medications in Labor, pg. B-38).


    9. Episiotomies are not routinely performed at California Pacific; however, there are some circumstances in which your care provider may recommend it. Please discuss with your care provider the reasons for an episiotomy.


    10. Forceps and vacuum births are not routinely performed at California Pacific; however, there are some circumstances when your care provider may recommend their use. (See “A Guide to Your Pregnancy & Newborn”, Assisted Delivery, pg. B-33).


    11. Should a cesarean birth become necessary, you will likely be awake and your support person can remain with you for the birth. You and your partner will be able to hold your baby immediately as long as he/she is in good health. On rare occasions, you may need general anesthesia. In this circumstance, you will be asleep and your support person will be asked to wait outside of the operating room.

    Recovery Period

    1. After a vaginal birth, we usually place the baby on your tummy and clamp the umbilical cord at that time. Newer studies indicate that very little blood flow occurs through the cord after birth. If your support person desires, he/she will be able to cut the umbilical cord.


    2. For security purposes, matching identification bands will be given to the baby, mother and designated support person. Our staff will discuss the Infant Security System with you.


    3. The recovery period is a time of transition. You will stay in the Labor and Birth room while we monitor the safe transition for you and the baby. During this time, the new parents and baby stay together as much as possible. We encourage you to participate in your baby’s transition, including bathing and dressing your baby. The baby will be receiving standard medications such as Vitamin K (to help blood clotting) and Erythromycin ointment to the eyes (to prevent infection).


    4. We support your decision to breast or bottle-feed your baby. While there are many studies demonstrating the health and social advantages of breastfeeding, each family has its unique needs. If you choose to breastfeed, we will help you initiate this within the first hour of life. Our staff is here to help you become successful in caring for your baby.

    Postpartum

    The postpartum period is not only a time to rest and recover, but also a time for you and your baby to learn about each other. Our staff is here to teach you about the changes you will be going through immediately after the birth and about your baby’s behavioral cues. We encourage you to take classes offered through Newborn Connections (415-600-BABY) before and after birth to help prepare for this exciting time.

    1. At California Pacific, we encourage the baby and new parents to stay together as much as possible. The baby will be transferred with you to the Mother-Baby unit where we support rooming in to promote bonding with your baby.


    2. Please let our staff and your pediatrician know your preferences regarding the use of pacifiers, or any other artificial nipple such as bottles, for your baby.


    3. Newborn circumcision is only done by parents’ request. The circumcision is scheduled after the pediatrician has examined the baby and after you have signed the informed consent. Please discuss the procedure with your Pediatrician and Obstetrician.


    4. Are there any other preferences or requests that you’d like to share with us?


    Our desire is to honor your preferences for your birth experience. In some situations, the health of you or your baby may necessitate flexibility and collaboration with the health care team.

    I have had the opportunity to review with my Health Care Provider.