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It collects names, pronouns, support person information, healthcare provider, and due date, then guides choices on attended prenatal education, pain management strategy, comfort measures, and post-delivery wishes such as skin-to-skin, umbilical cord cutting, and cord blood collection. 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exercises.",{"name":116,"@type":107,"acceptedAnswer":117},"What does the form ask about newborn care and feeding?",{"text":118,"@type":110},"It requests newborn feeding intentions (exclusive breastfeeding, pumped milk bottle feeding, formula, and extra help if needed), plus post-birth preferences like skin-to-skin timing, umbilical cord cutting, and collecting cord 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not intended to replace any documentation provided by your Healthcare Provider and/or delivering hospital.  \nName of Expectant Person:    \nI identify by the pronoun:    \nMy support person’s name:    \nMy support person  \nidentifies by the pronoun:  \nName of my Healthcare Provider who cared for me during pregnancy:  \nBaby’s Due Date:  \n... / ... / ...  \nI  \nam pregnant with:  \n One baby  \n Multiples (twins)  \nHere are some things I would like you to know about me/us (Previous experiences, fears, concerns):  \n\n|  |\n| --- |\n|  |\n\nI / we have attended:  \n Prenatal Classes  Breast Feeding Classes  \n Newborn Care Classes  Emergency First Aid Classes  \nMarkham Stouffville Services Buiding • Suite 403, 379 Church Street, Markham, ON, L6B 0T1 905-294-BABY(2229) [www. markhamprenatal. com](www. markhamprenatal. com)  \nPain management  \n I would like a medication free birth  \n I would like to see how things go and make a decision about pain relief dependent on my labour  \n I would like to have pain medication as soo n as it is available to me  \nComfort measures I would like to try:  \n Listening to music that I have brought with me  Dim Lights  \n Use a mirror to watch see the baby crowning  \n I am open to trying different positions to cope with labour such as Hands & Knees / Exercise Ball / Walking  \n Bath/shower  \n Breathing & relaxation or meditation exercises that I have practiced  \nAfter my baby is born  \n My support person would like to cut the umbilical cord (if possible )  \n I will do skin to skin with baby but if I am unable then   will do skin to skin  \n I would like to collect the baby ’ s cord blood/ tissue and have brought the kit and completed the paperwork  \n I would prefer to delay the baby ’ s first bath and do it myself at home  \n Name of the Doctor who will care for my baby:    \nNotes:    \nMarkham Stouffville Services Buiding • Suite 403, 379 Church Street, Markham, ON, L6B 0T1 905-294-BABY(2229) [www. markhamprenatal. com](www. markhamprenatal. com)  \nNewborn feeding plan  \n I plan to exclusively breastfeed and will only give supplement if medically necessary  \n I am planning on pumping my breast milk and feeding the baby with a bottle  \n I am planning to feed the baby formula  \n I had difficulty breast feeding my first baby and would appreciate extra help this time  \nDetails:    \nFollowing Discharge From Hospital  \n I am aware of community resources once discharged  I am aware that I need a car seat for the baby  \nMarkham Stouffville Services Buiding • Suite 403, 379 Church Street, Markham, ON, L6B 0T1 905-294-BABY(2229) [www. markhamprenatal. com](www. markhamprenatal. com)","cbCaia8Ag8dozJKH","https://ap.wps.com/l/cbCaia8Ag8dozJKH","pdf",150858,"English","# Name and basic details\n## Support, provider, and due date\n# Prenatal education and personal notes\n# Pain management and comfort measures\n# After birth preferences\n# Newborn feeding plan\n# Following discharge from hospital","[{\"question\":\"What personal information does the Birth Plan form collect?\",\"answer\":\"It prompts for the expectant person’s name, pronoun, support person’s name and pronoun, the healthcare provider’s name, and the baby’s due date.\"},{\"question\":\"How does the form help record labor and pain management preferences?\",\"answer\":\"It includes options for medication-free birth versus making pain relief decisions during labor, plus comfort measures such as music, dim lights, mirror use, positions, bath/shower, and breathing/relaxation exercises.\"},{\"question\":\"What does the form ask about newborn care and feeding?\",\"answer\":\"It requests newborn feeding intentions (exclusive breastfeeding, pumped milk bottle feeding, formula, and extra help if needed), plus post-birth preferences like skin-to-skin timing, umbilical cord cutting, and collecting cord blood/tissue.\"}]","Sample Birth Plan - Form | PDF",1790093687]