INSTANCE ADDRESSED TO THE NATIONAL HEALTH SYSTEM-INSALUD
Doña .................................. .................................................. ...., of ......... age, ..................................., neighboring province ...... ....................., domiciled in ......................... ..................., number ..............., floor ..........., ............................., phone with National Identity Document number ............. ...................... and affiliated to the Social Security number ......................................... before the National Health System-INSALUD appear and make an appropriate in law, I SAY: That
currently being pregnant and I feel my due date for the next ........... of ..................... ..........., is my intention to give birth at the Centre do my part, dependent on this body that I headed.
having knowledge of the manner in which coverage is currently being developed and birthing care in the centers belonging to that body, and this being different from that advocated by other sanitary means according to my opinion, I want to place on record of the following conditions under which they wish to develop my birth, if not present in pathological circumstances make it impossible for the exceptional performance of any of these conditions:
NOT want you to consider me a patient. Labor is a physiological process, natural, involuntary and non-pathological.
I want to respect the free and spontaneous expression of nature in me, without interfering - unnecessarily or routine or protocol set-in women's physiology or the necessary privacy for good reason.
I want you to NOT practice without my consent:
a) IUC
b) Shaving of pubic
c) Analgesia some
d) Anesthesia some
e) any
Episiotomy
want to facilitate my active participation as protagonist of my birth, by:
a) Respect to walking and the positions you choose to give birth throughout the delivery process: antepartum, expansion, breaks, expulsion and postpartum.
b) Respect for the time you need to be delivered, including all breaks spontaneously, without my practice, unnecessary or routine or established protocol, any act tending to accelerate or delay delivery, such as the drip of oxytocin rupture of membranes, the introduction of instruments or hands in my vagina, pull the cord during delivery with the placenta still attached.
I want to be a proper environment conducive for delivery by:
a) The use of a room quiet, with few people, cozy, dimly lit, avoiding stridency sensory and techniques, with adequate furniture and medical equipment saved except when used.
b) A birthing friendly, intimate and serene.
c) A NONINVASIVE external-control-during delivery, the state and the heart of my son. I want you
dulcifique the birth of my son, by:
a) To be in my arms immediately after birth.
b) The failure to cut his umbilical cord until it has completely stopped beating and the residual blood has gone to the extreme fetal cord.
c) is NOT unnecessary handling practice aimed at stimulating the onset of breathing, such as aspiration of mucus and others.
I want to be accompanied by people you want, particularly by the father of the baby during labor, delivery and post to it.
During the duration of my stay with my newborn at the Center, I want to:
a) Be able to breastfeed the baby from the first time without timetables or restrictions.
b) the baby can stay in constant contact with my body without timetables or restrictions.
c) Do not leave the baby on my side for any handling, cleaning, washing, test, test, etc. No my express consent.
d) will not give your baby any kind of vaccine.
e) Do not give your baby any ophthalmic eyedrops or other preventive or curative medicine without showing signs of illness and the baby without my consent.
f) Do not stand in the infant's mouth any pacifier.
g) baby not practice any invasive procedures, diagnostic or therapeutic, without my consent.
h) Do not give your baby any food or bottle without my consent.
i) There in the center and its internal environment adequate conditions of hygiene and asepsis.
j) Do not expose us, as non-ill persons we are, proximity or contact with infectious disease vectors, especially those known hospital.
k) That time of my stay as short as possible.
In the event that multiple birth was, I want to:
a) Respect the total time of delivery including spontaneous intervals between the outputs of each twin, without making unnecessary or repeated internal examinations and without taking any action that may alter the length of these intervals or the entire labor.
b) Be able to breastfeed infants only immediately after, not before, the birth of them all.
c) comply with all the above conditions arise if associated pathology that would make it impossible to fulfill any of them. Such a breach will never be out of habit or protocol established or unnecessarily.
If the baby was premature, I want to:
a) The baby remains with me, if not lodged a comorbidity that would make this impossible. Mode will remain by my side skin contact with mine all the time, day and night, protected by a cap baby, clothes and a bag attached to me that allows this contact, being both in a room and sobrecaldeada Baby can breastfeed freely according to their needs.
b) If the baby requires an incubator and not were in an emergency clinic, an incubator at room sobrecaldeada myself to switch the incubator with the bag described above, to leave the incubator and slowly progressive.
c) comply with all the above conditions arise if an associated condition that would make it impossible to fulfill any of them. Such a breach will never be out of habit or protocol established or unnecessarily.
In the event that there were no other possible alternative and the need arose practicárseme urgent cesarean section, never routine or established protocol or unnecessary, I want to:
a) I do not practice anesthesia affecting alertness or infant behavior and at the same time allows me to live a conscious birth.
b) The baby's father to accompany me in the operating room to inform us and enjoy both the baby from the moment of birth, uninterrupted.
c) The baby is placed over my chest from the first moment of birth to enable it, while caesarean section is completed, adjust to the outside world and then caught the nipple, thus initiating breastfeeding.
d) Do not leave the baby with me at any time and join me in returning to my room.
e) meet all the above conditions arise if associated pathology that would make it impossible to fulfill any of them. Such a breach will never be out of habit or protocol established or unnecessarily.
Given the spirit of easy, non-intervention and non-interference of the above conditions, it is completely obvious, as in other well-endowed centers dependent on this body which I head, which at the Centre on the date Today is for me to give birth, can and should develop my birth in the above conditions. Therefore:
a) I want to give birth at the Centre which to date to me.
b) Under the responsibility that I could match, DO NOT accept, under any circumstances, giving birth in another separate center.
The experience of the above conditions not only stems from my own convictions about how it should develop my delivery, but also a large and successful European experience. These conditions are contained in the legislation of countries similar to ours. In France, the Ministerial Decree number 83-24 of August 1, 1983 (maternity), in Italy, in Lazio Council Act of 14 March 1984 (Rights of Pregnant Women and Newborn) . Globally these conditions have been approved and published by the World Health Organization International Conference in Fortaleza (Brazil) from 22 to 26 April 1985 in the form of twenty-one recommendations. As they are based on the principle that every woman has the fundamental right to benefit from adequate prenatal care, women must play its essential role in everything that concerns this assistance through its active participation in the planning, implementation and evaluation of such assistance.
Furthermore, here in Spain, the conditions required by me are supported by:
a) The Law 14/1986 of April, General Health.
b) The recommendations of the Ministry of Health issued on July 6, 1989.
c) Decree 175/1989, dated 18 July, the Basque Country, Bill of Rights and obligations of patients and users.
d) The Law 6 / 1995 of March 28 in Madrid, on Guarantees of the Rights of Children and Adolescents.
e) Decree 101/1995, of April 18, of Andalusia, the rights of parents and children in the health sector during the birth process.
f) The Convention for the Protection of Human Rights and Dignity of the Human Being with regard to the Application of Biology and Medicine, the Council of Europe, in force in Spain since January 1, 2000.
the foregoing, based on the legal elements above and pursuant to the provisions of Article 68 and related provisions of the existing Law on Regime Legal Framework of Public Administrations and Common Administrative Procedure, ASK
National Health System-Health Institute, which have of this application will serve to admit and, under account the content of it, order the adoption of measures appropriate for my delivery and postpartum are carried out under the conditions herein.
In Justice.
In ................................., to ....... of .................... of .........
Doña .................................. .................................................. ...., of ......... age, ..................................., neighboring province ...... ....................., domiciled in ......................... ..................., number ..............., floor ..........., ............................., phone with National Identity Document number ............. ...................... and affiliated to the Social Security number ......................................... before the National Health System-INSALUD appear and make an appropriate in law, I SAY: That
currently being pregnant and I feel my due date for the next ........... of ..................... ..........., is my intention to give birth at the Centre do my part, dependent on this body that I headed.
having knowledge of the manner in which coverage is currently being developed and birthing care in the centers belonging to that body, and this being different from that advocated by other sanitary means according to my opinion, I want to place on record of the following conditions under which they wish to develop my birth, if not present in pathological circumstances make it impossible for the exceptional performance of any of these conditions:
NOT want you to consider me a patient. Labor is a physiological process, natural, involuntary and non-pathological.
I want to respect the free and spontaneous expression of nature in me, without interfering - unnecessarily or routine or protocol set-in women's physiology or the necessary privacy for good reason.
I want you to NOT practice without my consent:
a) IUC
b) Shaving of pubic
c) Analgesia some
d) Anesthesia some
e) any
Episiotomy
want to facilitate my active participation as protagonist of my birth, by:
a) Respect to walking and the positions you choose to give birth throughout the delivery process: antepartum, expansion, breaks, expulsion and postpartum.
b) Respect for the time you need to be delivered, including all breaks spontaneously, without my practice, unnecessary or routine or established protocol, any act tending to accelerate or delay delivery, such as the drip of oxytocin rupture of membranes, the introduction of instruments or hands in my vagina, pull the cord during delivery with the placenta still attached.
I want to be a proper environment conducive for delivery by:
a) The use of a room quiet, with few people, cozy, dimly lit, avoiding stridency sensory and techniques, with adequate furniture and medical equipment saved except when used.
b) A birthing friendly, intimate and serene.
c) A NONINVASIVE external-control-during delivery, the state and the heart of my son. I want you
dulcifique the birth of my son, by:
a) To be in my arms immediately after birth.
b) The failure to cut his umbilical cord until it has completely stopped beating and the residual blood has gone to the extreme fetal cord.
c) is NOT unnecessary handling practice aimed at stimulating the onset of breathing, such as aspiration of mucus and others.
I want to be accompanied by people you want, particularly by the father of the baby during labor, delivery and post to it.
During the duration of my stay with my newborn at the Center, I want to:
a) Be able to breastfeed the baby from the first time without timetables or restrictions.
b) the baby can stay in constant contact with my body without timetables or restrictions.
c) Do not leave the baby on my side for any handling, cleaning, washing, test, test, etc. No my express consent.
d) will not give your baby any kind of vaccine.
e) Do not give your baby any ophthalmic eyedrops or other preventive or curative medicine without showing signs of illness and the baby without my consent.
f) Do not stand in the infant's mouth any pacifier.
g) baby not practice any invasive procedures, diagnostic or therapeutic, without my consent.
h) Do not give your baby any food or bottle without my consent.
i) There in the center and its internal environment adequate conditions of hygiene and asepsis.
j) Do not expose us, as non-ill persons we are, proximity or contact with infectious disease vectors, especially those known hospital.
k) That time of my stay as short as possible.
In the event that multiple birth was, I want to:
a) Respect the total time of delivery including spontaneous intervals between the outputs of each twin, without making unnecessary or repeated internal examinations and without taking any action that may alter the length of these intervals or the entire labor.
b) Be able to breastfeed infants only immediately after, not before, the birth of them all.
c) comply with all the above conditions arise if associated pathology that would make it impossible to fulfill any of them. Such a breach will never be out of habit or protocol established or unnecessarily.
If the baby was premature, I want to:
a) The baby remains with me, if not lodged a comorbidity that would make this impossible. Mode will remain by my side skin contact with mine all the time, day and night, protected by a cap baby, clothes and a bag attached to me that allows this contact, being both in a room and sobrecaldeada Baby can breastfeed freely according to their needs.
b) If the baby requires an incubator and not were in an emergency clinic, an incubator at room sobrecaldeada myself to switch the incubator with the bag described above, to leave the incubator and slowly progressive.
c) comply with all the above conditions arise if an associated condition that would make it impossible to fulfill any of them. Such a breach will never be out of habit or protocol established or unnecessarily.
In the event that there were no other possible alternative and the need arose practicárseme urgent cesarean section, never routine or established protocol or unnecessary, I want to:
a) I do not practice anesthesia affecting alertness or infant behavior and at the same time allows me to live a conscious birth.
b) The baby's father to accompany me in the operating room to inform us and enjoy both the baby from the moment of birth, uninterrupted.
c) The baby is placed over my chest from the first moment of birth to enable it, while caesarean section is completed, adjust to the outside world and then caught the nipple, thus initiating breastfeeding.
d) Do not leave the baby with me at any time and join me in returning to my room.
e) meet all the above conditions arise if associated pathology that would make it impossible to fulfill any of them. Such a breach will never be out of habit or protocol established or unnecessarily.
Given the spirit of easy, non-intervention and non-interference of the above conditions, it is completely obvious, as in other well-endowed centers dependent on this body which I head, which at the Centre on the date Today is for me to give birth, can and should develop my birth in the above conditions. Therefore:
a) I want to give birth at the Centre which to date to me.
b) Under the responsibility that I could match, DO NOT accept, under any circumstances, giving birth in another separate center.
The experience of the above conditions not only stems from my own convictions about how it should develop my delivery, but also a large and successful European experience. These conditions are contained in the legislation of countries similar to ours. In France, the Ministerial Decree number 83-24 of August 1, 1983 (maternity), in Italy, in Lazio Council Act of 14 March 1984 (Rights of Pregnant Women and Newborn) . Globally these conditions have been approved and published by the World Health Organization International Conference in Fortaleza (Brazil) from 22 to 26 April 1985 in the form of twenty-one recommendations. As they are based on the principle that every woman has the fundamental right to benefit from adequate prenatal care, women must play its essential role in everything that concerns this assistance through its active participation in the planning, implementation and evaluation of such assistance.
Furthermore, here in Spain, the conditions required by me are supported by:
a) The Law 14/1986 of April, General Health.
b) The recommendations of the Ministry of Health issued on July 6, 1989.
c) Decree 175/1989, dated 18 July, the Basque Country, Bill of Rights and obligations of patients and users.
d) The Law 6 / 1995 of March 28 in Madrid, on Guarantees of the Rights of Children and Adolescents.
e) Decree 101/1995, of April 18, of Andalusia, the rights of parents and children in the health sector during the birth process.
f) The Convention for the Protection of Human Rights and Dignity of the Human Being with regard to the Application of Biology and Medicine, the Council of Europe, in force in Spain since January 1, 2000.
the foregoing, based on the legal elements above and pursuant to the provisions of Article 68 and related provisions of the existing Law on Regime Legal Framework of Public Administrations and Common Administrative Procedure, ASK
National Health System-Health Institute, which have of this application will serve to admit and, under account the content of it, order the adoption of measures appropriate for my delivery and postpartum are carried out under the conditions herein.
In Justice.
In ................................., to ....... of .................... of .........
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