BIRTH PLAN

Prepared by: [Your Name]

Date: [Date Prepared]

This birth plan has been prepared to ensure the smooth progression of labor and delivery at [Hospital/Place of Birth]. Please keep this document with you and share it with your healthcare provider. This plan is intended to highlight your preferences during labor, delivery, and postpartum care. While every attempt will be made to honor these wishes, unforeseen circumstances may necessitate changes.

I. Before Labor

A. Contact Details

• Primary Contact: [Your Name]

• Support Person/Partner: [Partner's Name]

• Healthcare Provider: [Doctor/Midwife's Name & Contact Information]

• Hospital Address: [Hospital/Place of Birth Address]

B. Preparations

Preferred classes or courses: [Birthing Classes, Family Planning]

Personal items to bring: [List of Items]

II. During Labor

A. Environment

• Room Preferences: [Lighting, Music, Aromatherapy]

• Clothing: [Special Gown or Personal Clothing]

B. Medical Interventions

Intervention	Preference
Induction	[Yes/No/If Necessary]
Pain Relief	[Epidural/Meditation/Breathing Techniques]
Monitoring	[Intermittent/Continuous]

C. Support Persons

People allowed in the labor room: [Partner's Name, Family Member, Doula]

III. Delivery

A. Preferences

• Delivery Position: [Birthing Chair, Water Birth, etc.]

• Episiotomy: [Avoid/Only if Necessary]

• Cord Cutting: [Who performs/Delayed clamping]

IV. Postpartum Care

A. Immediate Post-Delivery Care

Aspect	Preference
Skin-to-Skin Contact	[Immediately/After Examination]
Breastfeeding	[As Soon as Possible/Within the First Hour]

B. Visitation

Visitation preferences after delivery: [Family Only/Open/Restricted]

V. Additional Notes

Please let the healthcare team know about any additional preferences or requirements, such as dietary restrictions, allergy information, or language assistance: [Details]

Contact for any updates or changes to this birth plan.