How to write a Hospital Birth Plan? Download this Hospital Birth Plan template that will perfectly suit your needs.
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Epidural anesthesia Pain medication(s): Type____________________________________________ When Under what conditions _______________________________________ ________________________________________________________________ Immediate Postpartum Skin to skin contact as soon as possible after birth Support person to identify sex of baby Support person to cut cord Breastfeeding as soon as possible after birth Other requests____________________________________________________ Cesarean Birth Support person to be present ________________________________________ Drape lowered so you may observe birth Support person to hold baby when baby is ready Breastfeeding in recovery room ________________________________________________________________ Mother/Baby Care Support person staying with mother and baby____________________________________________________________ Breastfeeding Bottle feeding First bath done by mother/support person with nurse Rooming in No bottles unless medically indicated Visitor restrictions__________________________________________________ Circumcision______________________________________________________ Discharge planning notes____________________________________________________________________________________________________________________________ Other ideas_______________________________________________________ ________________________________________________________________ November, 2009.
This blank Hospital Birth Plan is intuitive, ready-to-use and structured in a smart way. Try it now and let this Hospital Birth Plan sample inspire you. We certainly encourage you to use this Hospital Birth Plan for your own benefit.
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