About Baby Birth Plan (Page 3 of 4) in pdf

About Baby Birth Plan Page 3

During labor I would like: (check all that apply)

[ ] To bring my own music to play

[ ] Dim lighting

[ ] The room as quiet as possible

[ ] As few interruptions as possible

[ ] To wear my own clothes

[ ] To stay hydrated with clear liquids and ice chips

[ ] To be offered an epidural as soon as possible

[ ] To be coached on when to push and for how long

[ ] To be mainly coached by my doula or partner (circle those that apply)

[ ] To view the birth using a mirror

[ ] To touch my baby’s head as it crowns

[ ] Additional:

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For pain relief I would like to try: (check all that apply)

[ ] Breathing techniques

[ ] Distraction (labor stool, birthing ball, etc.)

[ ] Massage

[ ] Nitrous oxide

[ ] IV medications

[ ] Epidural

[ ] Please don’t offer me pain medications unless I ask for them (including an epidural)

[ ] Additional:

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If I need a Cesarean section I would like: (check all that apply)

[ ] My partner to remain with me the entire time

[ ] The screen lowered so I can watch my baby come out

[ ] To hold my baby immediately after delivery

[ ] To breastfeed during recovery

[ ] Additional:

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About Baby Birth Plan Page 3