BIRTH PLAN
This is the birth plan for , whose baby is due on .
Location
I would like to give birth .
Support and Birth Partner
Delivery Method
I plan on having a .
Equipment
I plan on using birthing equipment during labour discussed with my doctor or midwife.
Labour and Monitoring
During the first stage of labour, I would like to try:
In so far as possible, during labour, I would like to:
I have discussed how I want my baby’s heartbeat to be monitored, if everything is straightforward, with my doctor or midwife.
Pain Management and Relief
For pain management during labour and delivery, I wish to try:
Tears and Episiotomy
I have spoken to my midwife or doctor about why and when an episiotomy may be necessary.
I hope to avoid having an episiotomy and wish to minimise any potential tears. As a result, I will appreciate guidance on and support to adopt positions to minimise tears.
If tears occur, I would .
Delivery
During my baby’s birth, I would like to be:
Placenta
I would like to be given an injection to help with the delivery of the placenta.
I would like the placenta to be .
After Delivery
If possible, after birth, I would like my baby to be
Unless I request otherwise, where possible, I would like my baby in the room with me .
Baby
I would like to .
I have given my midwife or doctor consent to give my baby vitamin K.
Other Requirements and Requests