
Birth Plan Checklist
Use this checklist to make sure you have covered everything you feel is important in your birth plan. You do not need to have something written for all these areas, this is only a list of areas you may have strong preferences about.
- Introduce Yourselves
- Names of parents
- Others who will be with you
- Important Issues
- Concerns
- Health Issues
- Fears
- Pain Management Preferences
- First Stage
- Second Stage
- Postpartum
- Medical Interventions you wish to use or avoid
- For inducing or speeding up labor
- For pain management
- For monitoring
- After baby is born
- Pushing
- Positions you are willing/wishing to try
- Style of pushing
- Who will be with mom
- Preferences in case of unexpected events
- Who contributes to decision making team
- How soon to begin medical interventions
- Preferences in case of cesarean
- Who should remain with mother/baby
- How soon to hold/feed baby
- How soon to receive visitors
- Postpartum care of baby
- Cord cutting
- When to perform routine assessments
- Breast or bottle feeding
- Rooming in or nursery
- First Bath
- Circumcision or Intact
- Other Important Items
- Photos and videos
- Privacy needs
- Environmental issues (lighting, music)
- When to discharge
- Educational needs (anything you want to be sure to learn about baby care before you leave)
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