PROGRAMA PART PROGRAMME Birth Plan

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1 PART: Programa d Atenció i Respecte al part HospiTalari Servei de Medicina Maternofetal. Institut Clínic de Ginecologia, Obstetrícia i Neonatologia (ICGON) Servei d Anestesiologia, Reanimació i Terapèutica del Dolor Servei d Atenció a la Salut Sexual i Reproductiva (ASSIR) Esquerra. Institut Català de la Salut PROGRAMA PART PROGRAMME Birth Plan Introduction The basic principle of our center is to provide delivery care centered on the needs of the woman and her partner / companion. With this objective, we created the program PART (Program of low risk hospital birth). Following the line of respect of this program, we offer the possibility to decide the maximum number of aspects according to your emotional, affective and cultural needs. This document is a tool to express your preferences, within the alternatives we can offer. To find information to make this Birth Plan, consult the Information Sheet PART. Also, during pregnancy, the professionals who care for you will give you all the information necessary to make informed decisions. Remember that to be candidate for this program is necessary that the pregnancy and birth are considered low or medium risk at all times. Therefore, the appearance of a factor that increases the risk may involve modifications of any part of this Plan, depending on the situation. General Care during labour As far as possible, the process of labour and delivery will take place in the same space, where we maintain a relaxing atmosphere. During labour I want to be accompanied by (maximum two people): Companion / s:... Unaccompanied In case of needing a caesarean section or a forceps or vacuum delivery, whenever possible, I prefer to be: With an / a companion Unaccompanied

2 We offer different options in relation to physical space to make you feel more comfortable. Preferences related to the physical space: Listen to music Graduate light intensity Other:... The hospital also offers you all the support material during the birth process, although you can bring your own material. If available, I would like to try a: Birthing tub/bath Swiss ball Pillows Mirror Birthing chair Suspension rope Relaxing videos Other: We will try that you have the maximum freedom of movement within the possibilities of space, as well as you have the possibility to try different positions for pushing and birth. We will control your son/daughter welfare in the most appropriate way. I would like the control of the welfare of my son / daughter is done with: Only auscultation Intermittent fetal monitoring Continuous electronic fetal monitoring Hydration during delivery is important and you can drink clear liquids during labour (water, tea, coffee, teas, juices without pulp, sports drinks...). Hydration can be oral or intravenous. Regarding the hydration during labour: I will take my choice drinks I prefer not to drink during labour

3 Our protocol recommends putting an intravenous catheter to allow treatment if necessary. If the birthing process runs smoothly, the catheter will remain unconnected to any serum. I would like: In case it is necessary to administer any medication, I want to be told and I see my opinion. Other options: I would like to wear my own clothes during labour and delivery. I would like to use hospital clothing There are several methods for pain relief during labor. As for pain relief, I would like To try to have a birth without anesthesia To have anesthesia as soon as possible To try pharmacological methods if I need Nitrous oxide Walking epidural Epidural Other: To try the following pain-management techniques Cutaneous stimulation: Massage, hot/cold therapy... Transcutaneous electrical nerve stimulation (TENS), I will provide. Bath/ shower Sterile water injections Massage To try the following complementary therapies. I will provide: Homeopathy Bach Flowers Acupuncture Naturopathy Aromatherapy Other:

4 Attention during delivery We will try that you have the maximum freedom of movement during delivery and also, you can choose the position. We will control the welfare of your son / daughter with minimum intervention possible. Whenever possible, we will try to make an active protection of the perineum to prevent the realization of episiotomy. About pushing, in a normal delivery should only be done if you feel the need to do and only with full dilatation. Pushing at other times or continuously are not indicated, except in situations such as the use of epidural anesthesia. We can clamp and cut the umbilical cord shortly after leaving the baby or we can wait to stop beating. Both, you and your companion, can cut it if you want. About my preferences during delivery, I would like that: My companion / s can stay with me My companion / s can see the birth To view the birth using a mirror To stay in the position I feel better for pushing To give birth in the water To wait until the umbilical cord stops beating before it is clamped and cut I do not care the moment that the umbilical cord it is clamped and cut My partner can cut the umbilical cord Cord blood bank In case you want to donate the cord blood, it is necessary to cut the umbilical cord into 30 seconds maximum because otherwise the chances of obtain the necessary amount of blood is greatly reduced. I want to donate cord blood to a public bank I do not want to donate cord blood I will bring material to donate cord blood privately After baby is born, I would like to: Get in my arms right away. Wait for the first checks before receiving my son / daughter in my arms. My baby placed immediately skin-to-skin on my abdomen. My partner to be skin to skin with the baby. To make the routine newborn procedures over me. To breastfeed my baby as soon as possible. If I have a cesarean section, I would like my partner to be skin to skin with the baby. Do not separate me from my child unless it is absolutely necessary.

5 In relation to the delivery of the placenta: Active management of the third stage of labour is highly effective at preventing postpartum haemorrhage. This management includes the administration of intravenous oxytocin after birth. If you do not want that option, we can wait for the spontaneous delivery of the placenta. I prefer an active management of the delivery of the placenta I would like a spontaneous delivery of the placenta. Immediate postpartum A few minutes after birth it is recommended the administration of vitamin K to all newborns. This measure has demonstrated a high effectivity in the prevention of hemorrhagic complications in babies. The recommended via is intramuscularly (injection), but it but it can also be administered orally (less effective). I prefer the intramuscular administration of the vitamin K. I would like the oral administration of the vitamin K. It is also recommended the use of antibiotic ointment for ocular prophylaxis (avoiding eye infections). I understand and accept the use of the ointment I prefer to delay the use of the ointment (less visual interference between mother and child). After delivery, you will be one hour in the same room before moving to the maternity floor. Breastfeeding I plan to: Breastfeed exclusively Formula-feed exclusively Other: Do not offer my baby any food without consulting me. Do not offer my baby a pacifier without consulting me. Breastfeeding on demand

6 Hospital stay Our hospital offers the possibility of early discharge in women who have had low-risk pregnancies and labour. The Program "Parto en el hospital, comadrona en casa" offers the opportunity for those families who wish, to go home between 8-18 hours after birth and postpartum visit at home the next day with a midwife. I would like to be discharged with the program: Parto en el hospital, comadrona en casa. It is possible to stay in a private room, this being paid. If you want it, it is advisable to request it at the time of admission to the hospital I prefer a private room, if available. I prefer a shared room during my hospital stay. Other needs The expectations and requirements of all care received during labor also depend on the individual characteristics of each person and their cultural needs. If you have a specific requirement or need to discuss this with obstetrics team professionals (midwives and obstetricians), and will assist as much as possible. Is there any need that it is not covered and you would like to discuss with the obstetric team? In case of a language problem, the hospital has the opportunity to contact China, Morocco and Romanian translators, which are available in the morning. Check if you want to use this resource. Chinese Translator Morocco Translator Romanian Translator If you want to film / take pictures during the birth of your son / daughter you must have prior authorization.

7 I, with ID, know this document, I have received information about PART (Program of low risk hospital birth) and I chose the options that I found necessary. I have understood and accepted the conditions to receive care under this Protocol of low risk with my duty to maintain the respect due to the standards set in the center and the staff that works in it. In any case, I reserve the right to change all or part of the decisions expressed in this document at any time during the process. Birth Plan Creation Birth Plan Delivery Date/Signature Date/Signature

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