Post Birth Plan
Post Birth Plan
The creator of this birth plan is [YOUR NAME]. This person's contact email is: [YOUR EMAIL].
I. General Information
Birth Details
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Parent's Full Name: [PARENT'S FULL NAME]
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Partner's Full Name (if applicable): [PARTNER'S FULL NAME]
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Due Date: [DUE DATE]
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Healthcare Provider's Name: [HEALTHCARE PROVIDER'S NAME]
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Preferred Birth Location: [PREFERRED BIRTH LOCATION]
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Contact Number: [CONTACT NUMBER]
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Alternate Contact Number: [ALTERNATE CONTACT NUMBER]
Support Team
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Partner's Name: [PARTNER'S NAME]
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Doula's Name (if applicable): [DOULA'S NAME]
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Other Support Persons: [OTHER SUPPORT PERSONS]
II. Immediate Post-Birth Preferences
Skin-to-Skin Contact
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Preferred duration: [PREFERRED DURATION]
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First skin-to-skin with: [NAME OF PARENT]
Initial Breastfeeding
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Preferred: [YES/NO]
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Assistance Required: [YES/NO]
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Alternate feeding method if necessary: [BOTTLE-FEEDING/FORMULATED MILK]
III. Baby’s Medical Care
Cord Care
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Delayed Cord Clamping: [YES/NO]
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Cord Blood Banking: [YES/NO]
Vitamin K Injection
Administer: [YES/NO]
Eye Ointment
Administer: [YES/NO]
IV. Mother’s Post-Birth Care
Pain Relief
Preferred Methods:
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Oral medication: [ORAL MEDICATION PREFERENCE]
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medication: [IV MEDICATION PREFERENCE]
Breastfeeding Support
Consultation with Lactation Specialist: [YES/NO]
Rest and Recovery
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Preferred Quiet Time: [PREFERRED QUIET TIME]
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Visitation Preferences: [VISITATION PREFERENCES]
V. Additional Notes
Any other specific instructions or preferences: [ANY OTHER SPECIFIC INSTRUCTIONS OR PREFERENCES]
VI. Emergency Situations
C-Section Birth: [PREFERRED PROCEDURES/CONTACTS]
Emergency Contacts:
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Contact 1: [CONTACT 1 NAME AND NUMBER]
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Contact 2: [CONTACT 2 NAME AND NUMBER]
Thank you for respecting our wishes and supporting us during this significant and exciting time!
