Writing a birth plan template

It helps your family and health-care providers understand your ideal hospital experience and feeding goals. It will help you set your breastfeeding goals and it will help your health care team understand what you need during and after delivery. This plan can be completed with your doctor, your baby's doctor or the hospital staff. Exclusive Breastfeeding My goal is to exclusively breastfeed my baby.

Writing a birth plan template

Besides communicating your desires about your baby's birth to your health care provider, writing a birth plan helps you and your partner to mentally prepare for the birth. It also may help facilitate discussions with your health care providers about details that you may have overlooked.

Think through each and every choice you list on your birth plan. What are your environmental preferences lighting, noise level, music, etc.

Yes, I want to record the event with video No just cameras No recording devices of any kind What are your clothing preferences check one? A hospital gown What are your fetal monitoring preferences check one?


Internal fetal monitor What labor position do you plan to use? What other labor preferences do you have check all that apply? I prefer to keep my contact lenses in unless I undergo anesthesia.

Please keep pelvic exams to a minimum. I want to be able to walk around and change positions as desired. I want to be able to drink when I'm thirsty. I plan to use breathing, hypnosis, massage, or other pain management techniques. I want a room with a tub. I want an enema upon being admitted.

I want to use a birthing ball. What are your preferences for medications and anesthesia check one? I'm planning an epidural, sedatives, tranquilizers, or narcotics.

I want to be offered pain medications if I am obviously uncomfortable. I prefer to ask for them. What are your preferences for induction and labor augmentation check one?

writing a birth plan template

I prefer that Pitocin be used if necessary. I want to use natural methods, like nipple stimulation, exercise, sexual intercourse, or herbs. Consult your physician before using any method to augment labor. I want my membranes to rupture naturally.

I would like them ruptured artificially to speed up labor. Second Stage Birth Which birthing position do you plan to use? Which birthing accessories do you plan to use for comfort check all that apply?Birth Plan- template/sample?? (22 Posts) I vividly remember two occasions when the head was delivered while the midwife was sat down writing notes!

One home water birth and one birth in a midwifery led unit. One of these ladies had a second degree tear. This wasn't that long ago either, about eight years or so. Have you thought about writing a birth plan yet? If not, download your free birth plan template now - you can personalise the plan with your wishes for what you would like to happen during and after the birth.

Writing your birth plan 0 What a birth plan is, the benefit of having one, plus a downloadable birth plan for you to print and fill in. My birth plan Any other comments or preferences about my labour and birth: Please write in the box below. Skin-to-skin contact with your baby Immediately after the birth you can have your baby lifted straight onto you before the cord is cut so that you can be close to each other immediately.

Like the Natural birth plan, The bump birth plan, VBAC birth plan, cesarean, water delivery.

+ Plan Templates – Free Sample, Example, Format Download! | Free & Premium Templates

You can also choose the position that what position do you want to give birth like while standing, sitting on a stool, lying on the bed or any other pose you want.

I’m in the last few weeks of my pregnancy, so I decided to go ahead and write up a pregnancy birth plan. Now as a soon-to-be mom of 3, I know that sometimes the best plans sometimes fall through in the heat of the moment.

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