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Click ‘Get Form’ to open it in the editor.
Begin by entering your name and birth date at the top of the form. This personal information is essential for your healthcare team.
Fill in your physician's name and your baby's due date, ensuring that all details are accurate for effective communication.
In the 'My labor support team' section, list the individuals you wish to have present during labor, including their relationships to you.
Check off any comfort measures you plan to utilize during labor, such as walking or using a birth ball, to communicate your preferences clearly.
Indicate your preferences for monitoring contractions and your baby's heart rate by selecting from the options provided.
Specify your choices regarding intravenous access and pain management methods that align with your birthing philosophy.
Complete sections on pushing preferences, umbilical cord cutting, and immediate care of your baby after birth by checking desired options.
Finally, review all entries for accuracy before signing and dating the document at the bottom. Bring this completed plan to a prenatal visit for discussion with your physician.
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