How To Quickly And Easily Create A Birth Plan With A Template ... - Free Printable

- Fill in your name and expected due date.
- List the names and relationships of people you want present during labor/birth.
- Select preferences for labor atmosphere (e.g., quiet, dim lighting, limited staff).
- Choose pain relief methods (e.g., breathing, massage, epidural) or indicate if you prefer no medication.
- Specify delivery position(s) (e.g., standing, squatting, side-lying).
- Indicate preferred props for labor (e.g., birth ball, squat bar).
- Choose fetal monitoring type (intermittent or continuous).
- Decide on episiotomy preference (yes, only if medically necessary).
- State who should accompany your baby if separation is needed for medical care.
- Choose cord clamping timing (delayed for ___ minutes or immediate).
- Specify who will announce the baby’s sex.
- Select newborn care preferences (skin-to-skin contact, bathing/measuring timing).
- Choose placenta delivery method (naturally or with injection).
- Select cord blood handling (collected by staff/specialist or not collected).
- Check desired medications for baby (eye ointment, vaccines, vitamin K).
- Indicate feeding plan (breast, pumped milk, formula).
- For a boy, choose circumcision preference.
- Record Group B Strep, gestational diabetes, and Rh factor test results.
- List any other pregnancy conditions, allergies, disabilities/impairments, religious considerations, or additional notes.
- Provide doctor/midwife and pediatrician contact information.