I saw this birth plan form at baby center and was very giddy to make my own after reading it. Though some mothers said that they actually didn't follow their birth plan during the delivery itself. But its a nice to have and useful to discuss the details with your OB so she knows what you want on the event of your most life-changing experience.
| ATTENDANTS AND AMENITIES | |
| I'd like the following people to be present during labor and/or birth: | |
| Partner: Adrian | |
| Relative/s: My Mom | |
I'd also like: | |
| To take pictures and/or film during labor and delivery | |
| LABOR | |
Once I'm admitted, I'd like: | |
| My partner to be allowed to stay with me at all times | |
| Only my practitioner, nurse, and guests present (i.e., no residents, medical students, or other hospital personnel) | |
| To wear my contact lenses, as long as I don't need a c-section | |
| To stay hydrated by drinking clear fluids instead of having an IV | |
| To walk and move around as I choose | |
As long as the baby and I are doing fine, I'd like: | |
| To have intermittent rather than continuous electronic fetal monitoring. | |
When it's time to push, I'd like to: | |
| Be coached on when to push and for how long | |
I'd like to try the following positions for pushing (and birth): | |
| Whatever feels right at the time | |
| PAIN RELIEF |
If I decide I want medicinal pain relief, I'd prefer: |
| Regional analgesia (an epidural and/or spinal block) |
| VAGINAL BIRTH | |
| I'd like: | |
| The room to be as quiet as possible | |
After birth, I'd like: | |
| To hold my baby right away, putting off any procedures that aren't urgent | |
| To breastfeed as soon as possible | |
| My partner to cut the umbilical cord | |
| Not to get routine oxytocin (Pitocin) after I deliver the placenta | |
| C-SECTION | |
| If I have a c-section, I'd like: | |
| My partner present at all times during the operation | |
| The baby given to my partner as soon as he's dried (as long as he's in good health) | |
| To breastfeed my baby in the recovery room | |
| POSTPARTUM | |
| After delivery, I'd like: | |
| My partner to stay with the baby at all times if I can't be there | |
| To stay in a private room | |
I plan to: | |
| Breastfeed exclusively | |
I'd like my baby fed: | |
| On demand | |
I'd like: | |
| My baby to room-in with me only when I'm awake | |
If my baby's a boy: | |
| I'll have him circumcised later. | |
| I'm interested in checking out of the hospital early. | |
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