Mercy Birth Plan


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Do you need an effective Mercy Birth Plan? Download this professional Mercy Birth Plan template now! 

This easy customizable Mercy Birth Plan can be used for any kind of personal matter. We support you by providing this Mercy Birth Plan template, which will save you time, cost and efforts and help you to reach a higher level of success in your life!

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My Mercy Birth Plan Expectant Mother’s Name Birthdate Expectant Mother’s Physician Baby’s Physician Baby’s Due Date My Labor Support Team • I plan to have the following people with me during my labor and birth: PartnerRelationship Doula Other visitorRelationship Other visitorRelationship Other visitorRelationship Comfort Measures • I plan to try these additional comfort measures (check all that are desired): Walking, squatting and using a birth ball Labor in water using a shower or tub Listening to music (please bring your own) Massage Aromatherapy (scented oils, fresh flowersplease bring your own) ¨ Wear my own clothes during labor (hospital gowns are also available) ¨ ¨ ¨ ¨ ¨ Monitoring My Contractions and Baby’s Heart Rate • I would prefer (check all that apply): ¨ Checking on the well-being of my baby using intermittent monitoring ¨ Continuous electronic monitoring placed with elastic belts around my abdomen ¨ Using a telemetry unit (when available) so I can be monitored while up and about in my room or hallways ¨ Placement of internal monitors using a fetal scalp electrode and/or intrauterine pressure catheter if medically necessary ¨ Whatever is recommended by my physician for the safety of myself and baby Intravenous Access (IV) • I prefer to have IV access using this method: ¨ Saline Lock – access into a vein with short tubing and no fluid attached ¨ Continuous IV – access into a vein with tubing and fluids attached Pain Management • I plan to: ¨ Labor and give birth with little or no intervention so please do


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