• We have educated ourselves on childbirth by taking Bradley Method classes and have made the following choices after much research and thought.
• It is our desire to have a natural, medication-free, and intervention-free childbirth. We chose X-Y-Z Hospital because of your reputation for supporting a woman's choice to birth naturally.
• We realize that a situation may arise that would cause us to deviate from the plan, but otherwise, we would appreciate your assistance in avoiding unnecessary medical procedures.

Environment - It is very important to us to have as much privacy as possible. We do not wish to have any visitors, including family, until after the delivery.

Informed Consent - We expect that Dr. A-B-C and/or the hospital staff will discuss all procedures with us before they are preformed including why it is necessary, risks, benefits, and possible alternatives.

Fetal Monitoring - We prefer that fetal heart tones be monitored intermittently with an external monitor.

Pain Management - Please do not offer pain medications. We would greatly appreciate your support to cope with the pain naturally using methods such as movement, showers, verbal encouragement, etc.

IV - Please do not administer an IV or heparin lock unless there is clear medical indication that such is necessary. We will stay hydrated by drinking fluids and using ice chips.

Internal Exams - We would prefer not to undergo internal exams unless fetal heart tones indicate distress or until feeling the urge to push.

Amniotomy - Please allow the bag of waters to break naturally. If the water breaks in early labor, we would like to wait the 6-12 hours before contemplating induction or augmentation.

Augmentation - We would like to try alternative means of labor augmentation such as walking or nipple stimulation and be free of time limits as long as fetal heart tones are fine.

Pushing - It is important that we be supported in pushing instinctively and not be told how or when to push. We would like to be free of time limits on pushing as long as fetal heart tones are fine. If an assisted birth becomes medically necessary, we would prefer vacuum extraction over the use of forceps.

Episiotomy - We would like to use olive oil, massage, and warm compresses to encourage elasticity of the perineum. We would rather risk a tear than have an episiotomy, but if one is needed, we would prefer it to be a pressure episiotomy.

Cord Cutting - It is extremely important to us that the umbilical cord stop pulsating before it is clamped.

Delivery of Placenta - We would like to deliver the placenta unassisted and not have routine Pitocin.

Breastfeeding - Please allow us to breastfeed immediately after birth and as baby demands.

Separation/Rooming In - We would prefer rooming-in and no separation of the baby from the parents.

Eye Drops - Please allow us to wait the state's 2-hour limit before administering eye drops.

Discharge - Please discharge us as soon as possible from the hospital.