Basic Birth Plan

BabyCenter Birth Plan worksheet – page 2
LABOR PROPS
If available, I'd like to try a:
birthing stool
birthing chair
squatting bar
birthing pool/tub
I'd like to bring the following equipment with me:
birthing stool
beanbag chair
birthing pool/tub
other: ____________________________________________________________
PAIN RELIEF
I'd like to try the following pain-management techniques:
acupressure
bath/shower
breathing techniques/distraction
hot/cold therapy
self-hypnosis
massage
medication
other: ____________________________________________________________
Please don't offer me pain medication. I'll request it if I need it.
If I decide I want medicinal pain relief, I'd prefer:
regional analgesia (an epidural and/or spinal block)
systemic medication
PUSHING
When it's time to push, I'd like to:
do so instinctively
be coached on when to push and for how long
be allowed to progress free of stringent time limits as long as my baby and
I are doing fine
I'd like to try the following positions for pushing (and birth):
semi-reclining
side-lying position
squatting
hands and knees
whatever feels right at the time
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Basic Birth Plan PDF

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