私が利用したMt Auburn Hospitalでは、事前に受けた出産講座でバースプランのフォーマットをもらうことができました。
- Dim lighting
- Quiet environment
- Play music
- Wear my own clothing
- Bring these things in from home like blankets or photos:
- I prefer to maintain all mobility, including walking and changing positions.
- I prefer to be able to move around in bed only and get up to use the bathroom.
- Mobility is not important to me, and I understand that if I get an epidural I may be confined to bed and need a urinary catheter to go to the bathroom.
Hydration and Nourishment (水分補給と栄養補給)
- I would like to eat light snacks and drink clear fluids whenever possible during labor.
- It would not bother me to have an IV for hydration if necessary.
- I prefer a saline lock if the placement of an IV is required by my hospital, but no fluids or medication are needed during my labor.
- I prefer my baby to be monitored as minimally as possible.
- I would like as much monitoring as possible.
- I prefer a method that allows me to remain mobile.
- Fetal monitoring in bed is fine with me.
Pain Relief (鎮痛)
- Relaxation techniques
- Changing positions/walking
- Fitness ball
- Breathing techniques
- Hot/cold packs
- Epidural anesthesia
- Nitrous oxide (if available)
- I prefer that pain medication only be offered to me at my request.
Methods to Speed Up Labor If my labor slows down, I would:
- First try nonmedical methods like walking and using upright labor positions
- Prefer that my practitioner breaks my bag of waters.
- Prefer that my bag of waters breaks on its own.
- Not mind having an IV of Pitocin and understand the benefits and risks involved.
- Prefer to receive an IV of Pitocin only after all other methods are tried, and only if medically necessary.
- I prefer to wait to push until I feel the urge or until my baby descends.
- I would like to use a variety of positions during pushing.
- I would like a mirror placed at the foot of the bed so I can watch my baby’s birth.
- I would like to push whenever I feel like it.
- I would like to be directed as to when to push.
- I prefer any natural tearing over an episiotomy.
- I would not mind having an episiotomy.
- I would like to avoid forceps and/or vacuum extraction unless absolutely necessary.
- I would like to touch my baby’s head as it crowns.
- I would like my healthcare provider to hand me the baby immediately if there aren’t any complications.
Birth and Baby Care (分娩後)
- I would like to hold my baby skin to skin immediately after birth and breastfeed as soon as possible.
- I would like to cut the umbilical the cord.
- I prefer to have the cord cut immediately.
- I would like to wait to have the cord cut until the baby receives all the blood from the placenta.
- I would like to donate the umbilical cord blood.
- I would prefer that routine hospital procedures be done while I hold my baby if possible.
- I would like all routine tests, shots, and procedures for my newborn.
- I prefer to choose the tests that are done and discuss it with my baby’s pediatrician ahead of time.
- I am breastfeeding exclusively and don’t want my baby to be given pacifiers, bottles, or formula.
- I plan to formula-feed only.
- I prefer a combination of breastfeeding and formula-feeding.
- I want to room in with my baby.
- If I have a boy, I prefer to have him circumcised.
- I do not want my baby boy to be circumcised.
- I would like my baby’s hearing to be tested.
In Case of a Cesarean (帝王切開の場合)
- I would like to accompany me during surgery.
- If possible, I would like two people to accompany me.
- If anesthesia is a choice for me, I would prefer an epidural.
- If anesthesia is a choice for me, I would prefer a spinal.
- If possible, I would like music played in the operating room.
- I would like the drape/screen lowered during surgery so I can see the birth.
- I would like the surgeon to describe the surgery as he or she goes along.
- I would like to have video or photos taken.
- I would like my support person to cut the cord.
- I would like to have at least one arm released so I can hold my baby right away.
- I would like to breastfeed as soon as possible in the recovery room.