Preparing For Childbirth Birth Plan

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C
-S
B
T
C
S
. J
H
O
PONSORED BY
ELLINGHAM
ECHNICAL
OLLEGE AND
T
OSEPH
S
OSPITAL
P
C
REPARING FOR
HILDBIRTH
Birth Plan
Name(s) __________________________________________ Due Date __________________________
Primary Caregiver ___________________________________ Birth Setting ________________________
My support people will be _____________________________ _________________________________
(Name)
(Relationship/Role)
_____________________________ _________________________________
(Name)
(Relationship/Role)
We realize that our birth plan is neither a contract nor a guarantee of an uncomplicated labor. Our purpose
is to introduce ourselves and to help you understand our preferences.
Introducing ourselves:
Important wishes, issues, fears, or concerns regarding mother or baby:
Preferences for managing labor pain:
Preferences for Normal Labor and Birth
First stage of labor (positions, movement, comfort measures, and food and beverages):
Second stage (positioning and pushing efforts):
Third stage and first hours after birth (for mother and baby):

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