[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-1-en-105":3,"doc-seo-353166-105":53,"doc-detail-353166-en":127},{"code":4,"msg":5,"data":6},0,"success",[7,14,19,24,29,34,39,44,49],{"id":8,"doc_module":9,"doc_module_name":10,"category_name":11,"show_sort_weight":12,"slug":13},11,1,"Template","Presentations",90,"presentations",{"id":15,"doc_module":9,"doc_module_name":10,"category_name":16,"show_sort_weight":17,"slug":18},12,"Resumes",80,"resumes",{"id":20,"doc_module":9,"doc_module_name":10,"category_name":21,"show_sort_weight":22,"slug":23},14,"Invoices",70,"invoices",{"id":25,"doc_module":9,"doc_module_name":10,"category_name":26,"show_sort_weight":27,"slug":28},15,"Posters",60,"posters",{"id":30,"doc_module":9,"doc_module_name":10,"category_name":31,"show_sort_weight":32,"slug":33},16,"Social Media",50,"social-media",{"id":35,"doc_module":9,"doc_module_name":10,"category_name":36,"show_sort_weight":37,"slug":38},17,"Forms",40,"forms",{"id":40,"doc_module":9,"doc_module_name":10,"category_name":41,"show_sort_weight":42,"slug":43},18,"Letters",30,"letters",{"id":45,"doc_module":9,"doc_module_name":10,"category_name":46,"show_sort_weight":47,"slug":48},21,"Paper Templates",5,"papers-templates",{"id":50,"doc_module":9,"doc_module_name":10,"category_name":51,"show_sort_weight":4,"slug":52},158,"General","general-158",{"code":4,"msg":54,"data":55},"ok",{"site_id":56,"language":57,"slug":58,"title":59,"keywords":60,"description":61,"schema_data":62,"social_meta":120,"head_meta":122,"extra_data":124,"updated_unix":126},105,"en","birth-plan-template-fill-in-your-preferences","Birth Plan Template - Fill in Your Preferences","","Birth Plan Template provides structured prompts to document preferences and medical information for labor and delivery. It guides users to list preferred names, pertinent health details, cultural or family traditions, preferred birth environment, and pain management choices including epidural, IV narcotics, or natural techniques. Sections also cover routine orders, IV access, fetal monitoring, approach to additional interventions, pushing and third-stage requests, post-birth preferences, and handling unexpected situations such as cesarean or NICU.",{"@graph":63,"@context":119},[64,80,102],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":36,"@type":70,"position":76},"https://docshare.wps.com/template/forms/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/birth-plan-template-fill-in-your-preferences/353166/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/birth-plan-template-fill-in-your-preferences/353166.png","ImageObject",442,249,{"name":88,"@type":89},"Rowan","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-10-16","2026-09-22",true,{"@type":98,"interactionType":99,"userInteractionCount":101},"InteractionCounter",{"@type":100},"ViewAction",8,{"@type":103,"mainEntity":104},"FAQPage",[105,111,115],{"name":106,"@type":107,"acceptedAnswer":108},"What information should be included in the “Preferred Names” section?","Question",{"text":109,"@type":110},"List the names or forms of address you want staff to use for you and your baby, including guidance for unusual or difficult names. Include who is welcome with you during birth.","Answer",{"name":112,"@type":107,"acceptedAnswer":113},"What does “Pertinent Health Information” cover?",{"text":114,"@type":110},"Provide the midwife/doctor and baby’s doctor, along with allergies and relevant medical history. Add any concerns or details for anyone joining your birth who may have special needs or anxiety related to blood or fainting.",{"name":116,"@type":107,"acceptedAnswer":117},"Which preferences are addressed after the baby is born and in unexpected situations?",{"text":118,"@type":110},"After birth, specify environment preferences and baby procedures, skin-to-skin contact, and feeding. For unexpected situations like cesarean birth or NICU admission, list preferences when mom and baby may need separation.","https://schema.org",{"og:url":78,"og:type":121,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":123,"canonical":78},"index,follow",{"doc_id":125,"site_id":56},353166,1791313698,{"code":4,"msg":5,"data":128},{"doc_id":125,"user_id":129,"nickname":88,"user_avatar":130,"doc_module":9,"category_id":35,"category_name":36,"doc_title":59,"doc_description":61,"doc_content":131,"file_id":132,"file_url":133,"file_type":134,"file_size":135,"view_count":101,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":79,"language":136,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":137,"faqs":138,"seo_title":139,"seo_description":61,"update_tm":140,"read_time":73},1099514067415,"https://ap-avatar.wpscdn.com/avatar/100002539d78ffe74a7?x-image-process=image/resize,m_fixed,w_180,h_180&k=1779092875211072502","Birth Plan Template  \nA useful template to create your own truly effective birth plan.  \n\n| \u003Cbr>Preferred Names |\n| --- |\n| Use this space to write the names or language you would like the staff to use when talking with you or about your baby. List punctuation for any unusual or difficult names. Provide a list of everyone who is welcome with you during your birth. |\n\n\n| \u003Cbr>Pertinent Health Information |\n| --- |\n| Midwife/Doctor:\u003Cbr>Baby’s Doctor:\u003Cbr>Allergies:\u003Cbr>History: This is where I would let them know about any specific medical concerns, past experiences, or health history that affect you or your feelings. If anyone who will be with you has special needs or is nervous about seeing blood or fainting you can include that information here or in the next section. |\n\n\n| \u003Cbr>Personal Background, Preferences & Cultural, Spiritual, or Family Traditions |\n| --- |\n| Use this space to let your birth team know about any special rules or rituals you plan to follow during your birth. Also include details about your feelings about birth if you feel that your perspective or your previous experiences impact the type of care that is best for you. |\n\n\n| \u003Cbr>Environment |\n| --- |\n| Explain what type of lights, sounds, voices, music, and smells you prefer. Be sure to comment on the overall tone of care you wish for, such as light-hearted and friendly, sacred and reverent, hushed voices, or casual and comfortable conversation. If you prefer to limit conversation or extra personnel (such as medical students) say so here. |\n\n\n| \u003Cbr>Pain Management: Preferences, Preparations, & Help You Would Like Today |\n| --- |\n| Share in this section your plans for an epidural, IV narcotics, or natural techniques. Make specific requests such as: help with breathing, relaxation, positions, cold wash clothes, and so on. Ask for aids that you would like present such as: a birth ball, extra pillows, and/or the use of a tub or shower. Paint a picture of the type of help you would like. |\n\nBirth Plan Template (06/13) by Deb Rhizal, CD, CCE  \n© 2013-Some Rights [Reserved-www. marasworld.com/license/](Reserved-www. marasworld.com/license/)[ ](Reserved-www. marasworld.com/license/)[http://www. marasworld.com/planning-guides/birth-plan-template.pdf](http://www. marasworld.com/planning-guides/birth-plan-template.pdf)  \n\n| \u003Cbr>Routine Orders, IV Access & Method of Fetal Monitoring |\n| --- |\n| This box pertains to standard routines at your place of birth. Learn what the routine practices are where you are giving birth for things like assessments and lab work when you arrive in triage, the use of IVs, policies about eating and drinking in labor, and the method of fetal monitoring. You may simply write “standard practice” if you are planning to follow the routine protocols at your place of birth. Some hospitals or care providers offer choicesand you may simply indicate your preference. Other times you may find that choices are not routinely offered, and that veering from the routine practice at your place of birth is unusual. If this is the case you need to discuss you preferences with your care provider ahead of time. Use this box to indicate that you and your care provider have agreed to the following, and then list the interventions that you are anticipating upon arrival and throughout your labor. |\n\n\n| \u003Cbr>Approach to Additional Interventions |\n| --- |\n| Let your birth team know if you are eager for any interventions they recommend, or if you prefer to avoid interventions. You do not need to list every intervention here! Simply state your general approach. If there are any particular interventions you feel strongly about, or that are an exception to your general approach add those details. You may also use this section to ask for the type of information you want if your care provider thinks an intervention may be useful or necessary. |\n\n\n| \u003Cbr>During the Pushing Phase |\n| --- |\n| Let them know what type of help and environment you prefer during the pushing stage. |\n\n\n|","cbCaicYxC46UzCaJ","https://ap.wps.com/l/cbCaicYxC46UzCaJ","pdf",178019,"English","# Birth Plan Template\n## Preferred Names\n## Pertinent Health Information\n## Personal Background, Preferences & Cultural, Spiritual, or Family Traditions\n## Environment\n## Pain Management: Preferences, Preparations, & Help You Would Like Today\n## Routine Orders, IV Access & Method of Fetal Monitoring\n## Approach to Additional Interventions\n## During the Pushing Phase\n## Third Stage\n## After the Baby’s Birth\n## Unexpected Situations","[{\"question\":\"What information should be included in the “Preferred Names” section?\",\"answer\":\"List the names or forms of address you want staff to use for you and your baby, including guidance for unusual or difficult names. Include who is welcome with you during birth.\"},{\"question\":\"What does “Pertinent Health Information” cover?\",\"answer\":\"Provide the midwife/doctor and baby’s doctor, along with allergies and relevant medical history. Add any concerns or details for anyone joining your birth who may have special needs or anxiety related to blood or fainting.\"},{\"question\":\"Which preferences are addressed after the baby is born and in unexpected situations?\",\"answer\":\"After birth, specify environment preferences and baby procedures, skin-to-skin contact, and feeding. For unexpected situations like cesarean birth or NICU admission, list preferences when mom and baby may need separation.\"}]","Birth Plan Template - Fill in Your Preferences | PDF",1790103388]