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the bed, say in the shower, I do not wish to be moved from this position. This includes the birth itself as well.

In the event that our baby is breech, we wish to attempt a vaginal delivery. We understand that this may mean transport to another hospital more prepared for a vaginal breech birth of there is no practitioner present who is comfortable with vaginally birthing a breech baby. If in active labor and we feel that a transfer can not be obtained in a time frame that we feel comfortable with, we still wish to attempt a vaginal delivery unless we feel immediate circumstances warrant a c-section. A c-section for a breech presentation will only be performed with our express written consent after we feel that the best of efforts have been made to accommodate our wish to try a vaginal delivery first.

The father will catch the baby. This is non-negotiable. If a situation such as shoulder dystocia or nuchal cord or hand etc. occurs, coaching and assistance is welcome but we still wish for the baby to be caught by the father unless the situation is absolutely life threatening.

There will be no episiotomy unless it is a life or death situation and express permission is obtained.

In the unlikely event, I prefer vacuum to forceps but these will only be employed after full discussion with the parents and consent from the mother and no episiotomy. I want to push my baby out while the vacuum applies constant pressure, but the vacuum is not used to pull the baby out.

If shoulder dystocia occurs we wish to try the gaskin maneuver, and if that fails we wish the Woods (corkscrew) maneuver to be used.

The cord will not be clamped or cut until the placenta has been birthed and the cord has stopped pulsating however long that takes. We will decide when it is an appropriate time to cut the cord unless legitimate emergency such as a non-pulsing nuchal cord dictates otherwise. The father will cut the cord in all non-emergency situations, and the cord will be left long. (Approximately 5 inches from abdomen.) This is due to our personal beliefs on nervous sensation in the cord and is non-negotiable.

The third stage of labor will be physiological, not managed unless I personally feel that the birthing of the placenta is taking too long. The use of oxytocic drugs and manual removal of the placenta is to be reserved for true medical emergencies with express permission. If maternal hemorrhage occurs, we wish to try all alternative treatments including cold compresses applied to the uterus

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