Birth Plan Template Page 3

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Birth Plan
I’d like to try the following positions for pushing (and birth):
Semi-reclining.
Side-lying position.
Squatting.
Hands and knees.
Whatever feels right at the time.
As long as my baby and I are doing fine, I’d like the pushing stage to
be allowed to progress free of stringent time limits.
I’d like to try the following pain-management techniques:
Bath/shower.
Breathing techniques/distraction.
Acupressure.
Massage.
Self-hypnosis.
Medication.
Please don‘t o er me pain medication. I'll request it if I need it.
Please do o er pain medication.
If I decide I want medicinal pain relief, I’d prefer:
Regional analgesia (an epidural and/or spinal block).
Systemic medication (eg. pethidine).
Nitrous oxide gas.
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