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My Mercy Birth PlanYour life is our life’s work.Completing Your Birth PlanPlease take some time to complete your Mercy Birth Plan and be sure to share it with your private physician several weeks or months prior toyour baby’s birth.Attending a labor and birth preparation program will provide the knowledge you need to create a meaningful birth plan. A list of classesavailable at the Mercy hospital near you is available on mercy.net.Expectant motherNameBirth date PhysicianBabyDue date PhysicianMy labor support teamI plan to have the following people with me during my labor and birth:Partner RelationshipDoulaOther visitor RelationshipOther visitor RelationshipOther visitor RelationshipComfort measuresIntravenous access (IV)I plan to try these additional comfort measures (check all thatare desired):o Walking, squatting and using a birth ballo Labor in water using a shower or tub*o Listening to music (please bring your own)o Massage*o Aromatherapy (scented oils, fresh flowers – please bringyour own)*o Wear my own clothes during labor (hospital gowns arealso available)I prefer to have IV access using this method:o Saline lock: A short tube attached to your IV, that may besafely disconnected from the IV bag and pole, when not in useo Continuous IV: access into a vein with tubing and fluidsattachedMonitoring my contractions and baby’s heart rateI would prefer (check all that apply):o Checking on the well-being of my baby using intermittentmonitoringo Continuous electronic monitoringo To be up and about in my room and in the hallways usingwireless monitoringo Placement of internal monitors using a fetal scalp electrodeand/or intrauterine pressure catheter if medically necessaryo Whatever is recommended by my physician for the safety ofme and my baby*Not available at all Mercy locations.6 Mercy Plan for ChildbirthPain managementI plan to:o Labor and give birth with little or no intervention so pleasedon’t offer pain medication. I will let you know if I change mymind.o Narcotic pain medication given through my IV, if safe for meand my babyo Epidural anesthesiao Nitrous oxide*o To make these decisions as I progress through labor,keeping all options availableBag of water breakingI would prefer to:o Allow my bag of water to break on its owno Have my bag of water artificially broken if medically necessary

Pushing preferences and birthCircumcisionI would like to try (check all that are desired):o Lying on my side to pusho Squatting in bed using the squat baro Sitting upright in bedo On all foursI plan to (check all that are desired):o Have my baby boy circumcisedo Not have my baby boy circumcisedo Arrange for a Bris at the hospital eight days after my babyboy’s birthEpisiotomyMother-baby UnitI would prefer:o To not have an episiotomyo Do whatever my provider recommends for the safety of meand my babyI plan to (check all that are desired):o Keep my baby with meo Have my formula-fed baby cared for in the newbornnursery at nighto Keep my breastfed baby with me at all times, includingovernight, to learn feeding cueso Have my partner spend the night during my hospital stayCutting the umbilical cordI plan to:o Have my labor partner cut the umbilical cordo I would prefer that my provider cut the umbilical cordo OtherImmediate care of my baby following birthI plan to (check all that are desired):o Have my baby placed skin-to-skin with me on my chestimmediately following the birtho Have the nurse clean my baby first, then place them in myarms for bondingo Keep my healthy baby with me at all timesOther things that are important to me:Feeding my babyI plan to (check all that are desired):o Initiate breastfeeding shortly after the birtho Exclusively breastfeed my baby on demando Pump and give my baby breast milk from a bottleo Bottle feed my baby with infant formula. Formulapreference: (Formula availability may differ by location)o Similac o Enfamil o GoodStart PacifiersI would prefer to:o Not allow the use of pacifiers or bottles duringthe hospital stayo Allow pacifiers for my bottle-fed babyAdministration of baby’s antibiotic eye dropsI would prefer:o Administration of antibiotic eye drops per hospital routineo Delay the administration of antibiotic eye drops for up toone hour after the birthThis birth plan serves as a communication tool between you, yourprovider and your nursing staff. It helps us know what is mostimportant to you during your baby’s birth and hospital stay. Thebirth process is unique to each woman and can be unpredictable.Expect that you may need to alter your birth plan if healthbecomes a concern. You can trust our team to honor your wisheswhile protecting you and your baby. Bring your completed birthplan to one of your prenatal visits. Your physician will review yourplan and answer questions that you may have about what toexpect during the labor and birth of your baby.Signatures*Expectant motherDateProviderDateEST 36643 (5/15/19)7 Mercy Plan for Childbirth* Signatures serve to acknowledge the expectant mother’s birthpreferences and that her physician is aware of her wishes.

AboutC-sectionsDelivery options.Vaginal deliveryPrior to delivery, your birthing team will discuss your childbirthpreferences and make every effort to accommodate them. Vaginaldelivery is the most common type of childbirth. Your baby is deliveredthrough the birth canal with the support of your provider or midwife.You may want to consider epidural anesthesia to help control pain, oryou may want to explore natural childbirth. Talk with your care providerabout your options.Most vaginal deliveries go smoothly, but some may require additionalcare, such as medication or emergency procedures. In some cases,a Cesarean section may be necessary. Your Mercy care teamwill monitor your delivery to ensure your safety and comfort andcoordinate any care you need.Inducing laborThe last few weeks of pregnancy can be physically and emotionallydraining for some pregnant women. However, unless medicallynecessary for the health of mom or baby, it is not recommendedthat labor be induced until you have completed at least 39 weeks ofpregnancy. This will help insure that your baby is mature enough to beborn. If it becomes medically necessary to induce your labor, pleasehave a discussion with your provider about methods of induction.After delivery, your Mercy team will help you recover by providingattentive, personalized care for you and your baby. Most moms gohome one to two days after natural childbirth, but the length of yourstay will depend on your provider’s recommendations. We want toensure you are both ready to start a healthy, joyful life together.8 Mercy Plan for ChildbirthA C-section may be planned orunplanned. In most cases, providersdo cesarean sections becauseof problems that arise duringlabor. Reasons you might need anunplanned C-section include: Labor is slow and hard orstops completely. The baby shows signs ofdistress, such as a very fast orslow heart rate. A problem with the placenta orumbilical cord puts the baby at risk. The baby is too big to bedelivered vaginally.When providers know about aproblem ahead of time, they mayschedule a C-section. Reasons youmight have a planned C-sectioninclude: The baby is not in a head-downposition close to your due date. You have a problem such asheart disease that could be madeworse by the stress of labor. You have an infection that youcould pass to the baby during avaginal birth. You are carrying more thanone baby. You had a C-section before,and your provider thinks laborpresents risks.Most women who deliver by C-sectiongo home after two to four days, andrecovery can take several weeks. Insome cases, a woman who had aC-section in the past may be able todeliver her next baby through the birthcanal. Ask your provider if vaginal birthafter cesarean (VBAC) might be anoption for you.

Preparing for your hospital stay.Listed below are suggestions for what to bring with you to the hospital for your baby’s birth.We recommend that you start packing several weeks before your baby’s due date. Yourcomfort is important to us at Mercy so we provide many things to help make your hospitalstay relaxing and enjoyable.Labor and Birth RoomsBring For Expectant Mom:n Photo ID and medical insurance card(required)n Birth plan (if you have completed one)n Baby book for footprints (optional)Clothing and personal itemsn E yeglasses, contact lens case andsolutions (if you need them)n Loose, comfortable clothesn Toothbrush, toothpaste andmouthwashn Bathroben Socks & slippersn Shower shoesn Hair bands, ties, or barrettesn Your favorite pillows or a blanketfrom homeLabor support bagn P ortable audio and video players(i.e. iPod) and headphonesn Your favorite music CDsn Lip balm or moisturizern Rolling pin or tennis ball for backachen Massage toolsn Vibrating massagern Lotion for massage by partnern Aromatherapy scentsn Focal point, such as an ultrasoundpicture of your baby or a vacationphotoFor distraction:n Books, magazines, or cardsfor early labor*Not available at all Mercy locations.9 Mercy Plan for ChildbirthOur Labor andBirth Rooms provide:n Hospital gownsn Birth ball/peanut balln Baby footprint sheetn TV with DVD player* and auxiliaryjack* for MP3 playersn Newborn Channel for momand baby care education (alsoavailable on the Mother-Baby Unit)n Ice packs for cold therapyn Clear liquids including ice chips,juice, jello, broth and popsiclesMother-Baby UnitBring For Expectant Mom:n Nightgowns or other comfortable,loose clothingn Nursing bran Hair care products, hairbrushand make-upn Comfortable, loose going-homeoutfit and shoesn Flip flopsBring for Baby:n Car safety seat properly installedin your carn Going-home outfit (a one-piecesleeper is easiest)n Receiving blanketsn Pair of socks or bootiesn Knitted capOur Mother-Baby Unitwill provide:n Personal hygiene supplies includingunderpants, sanitary pads, peri-bottleand ice packsn Breast pump and breast care supplieswhen medically necessaryn Newborn feeding supplies includinginfant formulan Diapers, diaper wipes, skin careproducts, blankets, sleepsacks*,and t-shirts for babyn Bulb syringe for suctioningbaby’s mucousSuggestions for your Partner: aving your own bag of things will helpHto make you comfortable during laborand an overnight stay.n Electronic devices for taking picturesand videosn Cell phone, Laptop (Wi-Fi available)and chargersn Non-perishable snacks and energydrinksn Cash for vending machines andguest traysn Mints or chewing gum for fresh breathn Change of clothesn Basic toiletries including toothbrush,toothpaste, mouthwash, shampoo,and soapn Bathing suit and shower shoes ifassisting mom with labor support inthe shower or tub*n Comforter and pillows from homeif partner plans to spend the nightn Medications you might need,including prescriptions orover-the-counter

Recognizing labor.Every woman experiences labor differently, but mosthave a handful of labor signs in common.“Lightening” is what happens when the baby drops down into yourpelvis. This can happen hours before labor, or up to a few weeksbefore. You may discover you can breathe a little easier as the baby’srepositioning eases the pressure on your lungs; the trade-off is often anincreased urge to urinate, thanks to added pressure on the bladder.Your bag of water breaks. Your baby grows inside you in a bag filledwith amniotic fluid that provides warmth and protection from theoutside world. For some women the bag of water breaks on its ownas a first signal that labor has begun. Your provider may recommendartificially breaking your bag of water to help labor progress. Take timein a prenatal visit to talk with your provider about when it’s appropriateto break your water.Contractions are a sign of labor but many women—especially newmoms—aren’t sure if the discomfort they feel is the real deal. BraxtonHicks contractions, or false labor, can start as early as 16 weeks. Thesepractice contractions are irregular and only last a few minutes butcan be uncomfortable. If the contractions become regular, painful orpersistent, contact your provider.You’ll lose the mucus plug in the minutes or hours before labor starts.The mucus plug is a thick mass of mucus that prevents bacteria fromentering the cervix. Your cervix will begin to thin out and relax beforelabor and your body will expel the mucus plug. Known as “bloodyshow,” the plug may be tinged pink or red with blood. It may even beclear and not noticeable at all.Braxton Hicks ContractionsTrue Labor ContractionsContractions are weak, start strong then taper off,or do not get stronger.Intensity gradually increases.The duration of contractions and time betweenthem are irregular.Contractions are evenly spaced and will grow closer together.Each will last about 30 – 70 seconds.A change in position or activity may stopcontractions.Walking, resting and moving around do not stop them.Pain is usually isolated in the front of your belly.Back-to-front pain in the belly and back is typical of true labor.There are no changes to the cervix.The cervix dilates to 3 cm in early labor, 7 cm in active labor, andreaches full dilation at 10 cm. Your provider will measure dilation.10 Mercy Plan for Childbirth

When to call yourproviderLabor and delivery:what to expect.Ideally, labor will begin on cue andbaby will arrive close to the expecteddue date. However, if that projecteddate has come and gone and you stillhaven’t begun labor, your provider mayrecommend inducing labor. Generally,labor is induced when it’s not safe foryou and your baby to wait for naturaldelivery. It’s a good idea to discuss thepossibility of inducing labor with yourprovider or midwife before your duedate, so that you understand what willhappen if it becomes necessary.Labor can be uncomfortable, but thereare a number of things you can do tohelp manage discomfort naturally.Include the ones you like in your birthplan, so we can make sure you havewhat you need when you get to thebirthing center.Monitoring your contractionsand baby’s heart rate.Our care team will monitor your baby’sheart rate, which is a good indicationof how well your baby is toleratingthe labor process. Mercy follows theAmerican College of Obstetriciansand Gynecologist (ACOG)recommendations, which include aminimum of 30 minutes when you firstarrive in labor and birth. Continuousmonitoring is appropriate if yourbaby’s heart rate is unstable, if youare receiving medications to stimulateyour labor, or if you have pregnancycomplications.11 Mercy Plan for ChildbirthHere’s more of what to expectduring labor and delivery.Intravenous access (IV)For the safety of you and your baby,most providers prefer IV access toprovide fluids, medications or if youplan to have epidural anesthesia. AnIV will not limit your ability to movearound.Pain managementHaving a baby is hard work. Thereare many ways to decrease yourpain during labor and birth, includingan epidural or a combination spinaland epidural known as a CSE*. Somewomen prefer to go without or delayreceiving pain medicine by tryingnatural comfort measures first.EpisiotomyEpisiotomy refers to an incision that’smade between the mother’s vaginalopening and rectum to allow moreroom for the baby’s birth. Although thepractice of routine episiotomy is nolonger common, it may be medicallynecessary in some cases. It’s a goodidea to talk with your provider aboutepisiotomy before you go into labor.Cutting the umbilical cordMany labor partners enjoy beinginvolved by cutting the baby’s umbilicalcord immediately following the birth.Your provider will provide guidancewhen the cord is cut.Especially if this is your first child,you may be anxious about yourlabor signs. That’s normal, and ithelps to know that most women dojust fine during labor. However, if youdo have any unusual symptoms suchas vaginal bleeding, pelvic pain orleaking fluid, especially during earlylabor, call your provider right away orgo to the hospital. If bleeding or painis severe, call 911. Mercy’s expertsare specially trained in caring foremergencies during labor, and we’llprovide the best possible care tokeep you and your baby safe.Cord blood collection and donationNew parents have the option of havingtheir baby’s cord blood collectedimmediately following the birth. Cordblood can be used to treat manylife threatening illnesses includingleukemia, metabolic disorders, geneticdisorders or immune deficiencies.Some parents choose to pay a fee toa private company to have the cordblood stored for their own use. Manyother parents donate their baby’s cordblood for public use. It is important toarrange for a private or public donationprior to your baby’s birth.*Not available in all Mercy locations. Check withyour provider.

Baby’s first hours.We want to keep healthy moms and babies together asmuch as possible. To encourage bonding, consider havingyour baby placed skin-to-skin on your chest immediatelyfollowing birth. Your baby will stay warm, and the instinctto find the breast and initiate nursing will often occurnaturally. If you prefer, your baby can be cleaned, swaddledand then placed in your arms for bonding. Your nurse willstay nearby to monitor your baby’s breathing, heart rate,color and temperature.ColostrumColostrum, the first milk your body makes, is important to your baby’s health. Ithelps prevent infection and prepares the baby’s stomach for future feedings.Expressing colostrum within the first six hours will give your body the best start toproducing a full milk supply. Our registered nurses are prepared to help you giveyour baby the colostrum when baby is ready, and will contact one of our lactationconsultants if you need additional help during your hospital stay.CircumcisionCircumcision is a common surgical procedure performed on baby boys prior todischarge from the hospital. This involves surgical removal of the foreskin thatcovers the tip of the penis. Your provider can help prepare you for what to expectand answer your questions about circumcision. All baby boys receive anesthesiaprior to the procedure.12 Mercy Plan for Childbirth

Postpartum recovery.Here is some of what you can expect during your postpartum recovery.SymptomWhat to doWeight lossMost women lose about 10 pounds duringbirth. Weight loss slows considerably afterthat.Wait at least six weeks to attempt additionalweight loss—then take it slow. Focus on restand nutrition, and accept that it may taketime.Water retention.Postpartum edema may continue for about aweek after delivery.Drink plenty of water and take short walkswhen possible.Belly painPains in the lower abdomen, called“afterpains,” happen as the uterus heals andshrinks.Apply a hot water bottle or warm compressto your belly.Baby bluesSadness after childbirth is normal ashormones change.Contact your provider if sadness continuesor deepens over time. This could be moreserious postpartum depression.Breast sorenessIt is normal to have some soreness in thebreasts and nipples during the first few daysof breastfeeding.If soreness continues beyond the first days,experimenting with feeding positions. Itcould be that the baby isn’t latching on fully.Perineum sorenessThe perineum is the area between thevagina and anus. Even without tearing orepisiotomy, the perineum will be sore andpossibly swollen for several weeks aftervaginal birth.You can apply cold packs to the area torelieve pain and swelling.Vaginal bleeding anddischargeBleeding and discharge (lochia) is common,even after a C-section. This will be heavy inthe first week or so as your body expels theextra fluid and tissue that nourished yourbaby. Lighter bleeding or spotting can lastup to six weeks.Use only sanitary pads (no tampons) duringthis time. It is normal to pass small clots,bu

Completing your birth plan Attending a labor and birth preparation program will provide the knowledge you need to create a meaningful birth plan. Your plan will help you make decisions about pain management, episiotomy, cord blood and other options, so you can achieve the birth experience that's best for you and your baby. Please take some time