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Transcript of MOTHERLY’S BIRTH CLASS PRINTABLE WORKBOOK · MOTHERLY’S BIRTH CLASS PRINTABLE WORKBOOK You ......
INTRODUCTION
Hi there, and welcome to Mother ly 's Bi r th Class!
We are so thr i l led that you are jo in ing us, and honored to be here wi th you on th is incredible adventure. This workbook contains your c lass homework, that wi l l help you take what you've learned in the modules and t ranslate i t in to a plan that works for YOU. Feel f ree to inv i te your partner to work on i t wi th you, and have fun!
Remember to take some deep breaths, and t rust your inner awesomeness.
You've got th is !
MY WATER BROKE LOG
Date:
Time:
Amount :
Color :
Odor :
Baby moving (yes/no, same as usual , more than usual , less than usual ) :
•Cal l your doctor or midwife to not i fy them and discuss the plan.
T ime cal led doctor/midwife:
P lan:
Notes:
CONTRACTION LOG COPING SKILLS REMINDER SHEET
•Dance/sway•Lunge•Squat•Hip press•Lower back diamond press •Bir th bal l•Sway s ide to s ide•Hip c i rc les•Lean forward on partner•Hip press•Lower back diamond press •Rebozo/Woven Cloth -Support lower back Water -Bathtub -Shower -Washcloth •Music•Relaxat ion mp3s•Vocal izat ion•Breathing•Pleasant smel ls•Mantras
MANTRA SHEET 1
Cut out and br ing the mantra(s ) the resonates most wi th you to your bi r th , or make your own!
MANTRA SHEET 2
Cut out and br ing the mantra(s ) the resonates most wi th you to your bi r th , or make your own!
BIRTH PREFERENCES WORKSHEET
THE BIRTH
Where would you l ike to give bi r th (c i rc le )— hospi ta l /b i r th center/home
Who wi l l take care of you in labor— obstetr ic ian/midwife/doctor of osteopathy/ fami ly physic ian (c i rc le ) YOUR TEAM
I f you have a partner, wi l l they at tend your bi r th? Yes/no/unsureWi l l you hi re a doula? Yes/no/unsureOther fami ly members or f r iends that wi l l a t tend your bi r th
How wi l l you handle v is i tors in the f i rs t 24 hours of your baby’s l i fe?
First week?
First month?
CIRCLE YOUR FAVORITE COPING SKILLS
Dancing LungingSquatt ingHip press/ lower back diamondBir th bal lRebozo/woven c lothBathtubShowerWashclothMusicRelaxat ion MP3sBreathingPleasant smel lsMantras
PAIN MEDS
Do you want pain medicat ions to be of fered to you dur ing your bi r th? Yes/no/undecided
I f so, how? (example: only when I ask for them, or of fer as soon as possible) PLACENTA
Are you planning to bank your cord blood?I f so, have you arranged a serv ice?Do you want delayed cord c lamping? Yes/no/unsureDo you want to see you placenta af ter i t is born? Yes/no/unsureDo you want to have your placenta encapsulated? Yes/no/unsureI f so, have you contacted a specia l is t?Would you l ike to take your placenta home for other use? Yes/no/unsure CULTURAL CONSIDERATIONS Do you have any cul tura l , t radi t ional or re l ig ious considerat ions that you would l ike to share? BABY CARE Immediate skin- to-skin wi th your baby? Yes/no/unsureVi tamin K? Yes/no/unsureEye ointment? Yes/no/unsureI f you are having a boy, do you plan to c i rcumcise? Yes/no/unsureAre you planning to breast feed? Yes/no/unsureDo you want to room-in wi th your baby? Yes/no/unsure WHAT ELSE? Is there anything else you’d l ike us to know, to help us take the best care of you and your fami ly dur ing and af ter your bi r th?
HOPES + FEARS
LABOR/BIRTH When you th ink about you bi r th , what fears come up?
For each fear, can you ident i fy why you are afra id of i t?
What st rategies can you use to overcome each fear?
PARENTHOOD When you th ink about becoming a parent , what fears come up?
For each fear, can you ident i fy why you are afra id of i t?
What st rategies can you use to overcome each fear?
MY WATER BROKE LOG
Date:
Time:
Amount :
Color :
Odor :
Baby moving (yes/no, same as usual , more than usual , less than usual ) :
•Cal l your doctor or midwife to not i fy them and discuss the plan.
T ime cal led doctor/midwife:
P lan:
Notes:
CONTRACTION LOG COPING SKILLS REMINDER SHEET
•Dance/sway•Lunge•Squat•Hip press•Lower back diamond press •Bir th bal l•Sway s ide to s ide•Hip c i rc les•Lean forward on partner•Hip press•Lower back diamond press •Rebozo/Woven Cloth -Support lower back Water -Bathtub -Shower -Washcloth •Music•Relaxat ion mp3s•Vocal izat ion•Breathing•Pleasant smel ls•Mantras
MANTRA SHEET 1
Cut out and br ing the mantra(s ) the resonates most wi th you to your bi r th , or make your own!
MANTRA SHEET 2
Cut out and br ing the mantra(s ) the resonates most wi th you to your bi r th , or make your own!
BIRTH PREFERENCES WORKSHEET
THE BIRTH
Where would you l ike to give bi r th (c i rc le )— hospi ta l /b i r th center/home
Who wi l l take care of you in labor— obstetr ic ian/midwife/doctor of osteopathy/ fami ly physic ian (c i rc le ) YOUR TEAM
I f you have a partner, wi l l they at tend your bi r th? Yes/no/unsureWi l l you hi re a doula? Yes/no/unsureOther fami ly members or f r iends that wi l l a t tend your bi r th
How wi l l you handle v is i tors in the f i rs t 24 hours of your baby’s l i fe?
First week?
First month?
CIRCLE YOUR FAVORITE COPING SKILLS
Dancing LungingSquatt ingHip press/ lower back diamondBir th bal lRebozo/woven c lothBathtubShowerWashclothMusicRelaxat ion MP3sBreathingPleasant smel lsMantras
PAIN MEDS
Do you want pain medicat ions to be of fered to you dur ing your bi r th? Yes/no/undecided
I f so, how? (example: only when I ask for them, or of fer as soon as possible) PLACENTA
Are you planning to bank your cord blood?I f so, have you arranged a serv ice?Do you want delayed cord c lamping? Yes/no/unsureDo you want to see you placenta af ter i t is born? Yes/no/unsureDo you want to have your placenta encapsulated? Yes/no/unsureI f so, have you contacted a specia l is t?Would you l ike to take your placenta home for other use? Yes/no/unsure CULTURAL CONSIDERATIONS Do you have any cul tura l , t radi t ional or re l ig ious considerat ions that you would l ike to share? BABY CARE Immediate skin- to-skin wi th your baby? Yes/no/unsureVi tamin K? Yes/no/unsureEye ointment? Yes/no/unsureI f you are having a boy, do you plan to c i rcumcise? Yes/no/unsureAre you planning to breast feed? Yes/no/unsureDo you want to room-in wi th your baby? Yes/no/unsure WHAT ELSE? Is there anything else you’d l ike us to know, to help us take the best care of you and your fami ly dur ing and af ter your bi r th?
HOPES + FEARS
LABOR/BIRTH When you th ink about you bi r th , what fears come up?
For each fear, can you ident i fy why you are afra id of i t?
What st rategies can you use to overcome each fear?
PARENTHOOD When you th ink about becoming a parent , what fears come up?
For each fear, can you ident i fy why you are afra id of i t?
What st rategies can you use to overcome each fear?
MY WATER BROKE LOG
Date:
Time:
Amount :
Color :
Odor :
Baby moving (yes/no, same as usual , more than usual , less than usual ) :
•Cal l your doctor or midwife to not i fy them and discuss the plan.
T ime cal led doctor/midwife:
Plan:
Notes:
CONTRACTION LOG COPING SKILLS REMINDER SHEET
•Dance/sway•Lunge•Squat•Hip press•Lower back diamond press •Bir th bal l•Sway s ide to s ide•Hip c i rc les•Lean forward on partner•Hip press•Lower back diamond press •Rebozo/Woven Cloth -Support lower back Water -Bathtub -Shower -Washcloth •Music•Relaxat ion mp3s•Vocal izat ion•Breathing•Pleasant smel ls•Mantras
MANTRA SHEET 1
Cut out and br ing the mantra(s ) the resonates most wi th you to your bi r th , or make your own!
MANTRA SHEET 2
Cut out and br ing the mantra(s ) the resonates most wi th you to your bi r th , or make your own!
BIRTH PREFERENCES WORKSHEET
THE BIRTH
Where would you l ike to give bi r th (c i rc le )— hospi ta l /b i r th center/home
Who wi l l take care of you in labor— obstetr ic ian/midwife/doctor of osteopathy/ fami ly physic ian (c i rc le ) YOUR TEAM
I f you have a partner, wi l l they at tend your bi r th? Yes/no/unsureWi l l you hi re a doula? Yes/no/unsureOther fami ly members or f r iends that wi l l a t tend your bi r th
How wi l l you handle v is i tors in the f i rs t 24 hours of your baby’s l i fe?
First week?
First month?
CIRCLE YOUR FAVORITE COPING SKILLS
Dancing LungingSquatt ingHip press/ lower back diamondBir th bal lRebozo/woven c lothBathtubShowerWashclothMusicRelaxat ion MP3sBreathingPleasant smel lsMantras
PAIN MEDS
Do you want pain medicat ions to be of fered to you dur ing your bi r th? Yes/no/undecided
I f so, how? (example: only when I ask for them, or of fer as soon as possible) PLACENTA
Are you planning to bank your cord blood?I f so, have you arranged a serv ice?Do you want delayed cord c lamping? Yes/no/unsureDo you want to see you placenta af ter i t is born? Yes/no/unsureDo you want to have your placenta encapsulated? Yes/no/unsureI f so, have you contacted a specia l is t?Would you l ike to take your placenta home for other use? Yes/no/unsure CULTURAL CONSIDERATIONS Do you have any cul tura l , t radi t ional or re l ig ious considerat ions that you would l ike to share? BABY CARE Immediate skin- to-skin wi th your baby? Yes/no/unsureVi tamin K? Yes/no/unsureEye ointment? Yes/no/unsureI f you are having a boy, do you plan to c i rcumcise? Yes/no/unsureAre you planning to breast feed? Yes/no/unsureDo you want to room-in wi th your baby? Yes/no/unsure WHAT ELSE? Is there anything else you’d l ike us to know, to help us take the best care of you and your fami ly dur ing and af ter your bi r th?
HOPES + FEARS
LABOR/BIRTH When you th ink about you bi r th , what fears come up?
For each fear, can you ident i fy why you are afra id of i t?
What st rategies can you use to overcome each fear?
PARENTHOOD When you th ink about becoming a parent , what fears come up?
For each fear, can you ident i fy why you are afra id of i t?
What st rategies can you use to overcome each fear?
MY WATER BROKE LOG
Date:
Time:
Amount :
Color :
Odor :
Baby moving (yes/no, same as usual , more than usual , less than usual ) :
•Cal l your doctor or midwife to not i fy them and discuss the plan.
T ime cal led doctor/midwife:
Plan:
Notes:
CONTRACTION LOG COPING SKILLS REMINDER SHEET
•Dance/sway•Lunge•Squat•Hip press•Lower back diamond press •Bir th bal l•Sway s ide to s ide•Hip c i rc les•Lean forward on partner•Hip press•Lower back diamond press •Rebozo/Woven Cloth -Support lower back Water -Bathtub -Shower -Washcloth •Music•Relaxat ion mp3s•Vocal izat ion•Breathing•Pleasant smel ls•Mantras
MANTRA SHEET 1
Cut out and br ing the mantra(s ) the resonates most wi th you to your bi r th , or make your own!
MANTRA SHEET 2
Cut out and br ing the mantra(s ) the resonates most wi th you to your bi r th , or make your own!
I t r u s t my s e l f and
my b ody
My baby and I a r e
s af e
I am b i� h ing w � h
w om en a l l o v e r � e w or l d
B r e a� e i n ca lm ,
b r e a� e ou t t e n s i on
BIRTH PREFERENCES WORKSHEET
THE BIRTH
Where would you l ike to give bi r th (c i rc le )— hospi ta l /b i r th center/home
Who wi l l take care of you in labor— obstetr ic ian/midwife/doctor of osteopathy/ fami ly physic ian (c i rc le ) YOUR TEAM
I f you have a partner, wi l l they at tend your bi r th? Yes/no/unsureWi l l you hi re a doula? Yes/no/unsureOther fami ly members or f r iends that wi l l a t tend your bi r th
How wi l l you handle v is i tors in the f i rs t 24 hours of your baby’s l i fe?
First week?
First month?
CIRCLE YOUR FAVORITE COPING SKILLS
Dancing LungingSquatt ingHip press/ lower back diamondBir th bal lRebozo/woven c lothBathtubShowerWashclothMusicRelaxat ion MP3sBreathingPleasant smel lsMantras
PAIN MEDS
Do you want pain medicat ions to be of fered to you dur ing your bi r th? Yes/no/undecided
I f so, how? (example: only when I ask for them, or of fer as soon as possible) PLACENTA
Are you planning to bank your cord blood?I f so, have you arranged a serv ice?Do you want delayed cord c lamping? Yes/no/unsureDo you want to see you placenta af ter i t is born? Yes/no/unsureDo you want to have your placenta encapsulated? Yes/no/unsureI f so, have you contacted a specia l is t?Would you l ike to take your placenta home for other use? Yes/no/unsure CULTURAL CONSIDERATIONS Do you have any cul tura l , t radi t ional or re l ig ious considerat ions that you would l ike to share? BABY CARE Immediate skin- to-skin wi th your baby? Yes/no/unsureVi tamin K? Yes/no/unsureEye ointment? Yes/no/unsureI f you are having a boy, do you plan to c i rcumcise? Yes/no/unsureAre you planning to breast feed? Yes/no/unsureDo you want to room-in wi th your baby? Yes/no/unsure WHAT ELSE? Is there anything else you’d l ike us to know, to help us take the best care of you and your fami ly dur ing and af ter your bi r th?
HOPES + FEARS
LABOR/BIRTH When you th ink about you bi r th , what fears come up?
For each fear, can you ident i fy why you are afra id of i t?
What st rategies can you use to overcome each fear?
PARENTHOOD When you th ink about becoming a parent , what fears come up?
For each fear, can you ident i fy why you are afra id of i t?
What st rategies can you use to overcome each fear?
MY WATER BROKE LOG
Date:
Time:
Amount :
Color :
Odor :
Baby moving (yes/no, same as usual , more than usual , less than usual ) :
•Cal l your doctor or midwife to not i fy them and discuss the plan.
T ime cal led doctor/midwife:
Plan:
Notes:
CONTRACTION LOG COPING SKILLS REMINDER SHEET
•Dance/sway•Lunge•Squat•Hip press•Lower back diamond press •Bir th bal l•Sway s ide to s ide•Hip c i rc les•Lean forward on partner•Hip press•Lower back diamond press •Rebozo/Woven Cloth -Support lower back Water -Bathtub -Shower -Washcloth •Music•Relaxat ion mp3s•Vocal izat ion•Breathing•Pleasant smel ls•Mantras
MANTRA SHEET 1
Cut out and br ing the mantra(s ) the resonates most wi th you to your bi r th , or make your own!
MANTRA SHEET 2
Cut out and br ing the mantra(s ) the resonates most wi th you to your bi r th , or make your own!
B r e a� e I ’ v e g ot � i s
I am a bada�
BIRTH PREFERENCES WORKSHEET
THE BIRTH
Where would you l ike to give bi r th (c i rc le )— hospi ta l /b i r th center/home
Who wi l l take care of you in labor— obstetr ic ian/midwife/doctor of osteopathy/ fami ly physic ian (c i rc le ) YOUR TEAM
I f you have a partner, wi l l they at tend your bi r th? Yes/no/unsureWi l l you hi re a doula? Yes/no/unsureOther fami ly members or f r iends that wi l l a t tend your bi r th
How wi l l you handle v is i tors in the f i rs t 24 hours of your baby’s l i fe?
First week?
First month?
CIRCLE YOUR FAVORITE COPING SKILLS
Dancing LungingSquatt ingHip press/ lower back diamondBir th bal lRebozo/woven c lothBathtubShowerWashclothMusicRelaxat ion MP3sBreathingPleasant smel lsMantras
PAIN MEDS
Do you want pain medicat ions to be of fered to you dur ing your bi r th? Yes/no/undecided
I f so, how? (example: only when I ask for them, or of fer as soon as possible) PLACENTA
Are you planning to bank your cord blood?I f so, have you arranged a serv ice?Do you want delayed cord c lamping? Yes/no/unsureDo you want to see you placenta af ter i t is born? Yes/no/unsureDo you want to have your placenta encapsulated? Yes/no/unsureI f so, have you contacted a specia l is t?Would you l ike to take your placenta home for other use? Yes/no/unsure CULTURAL CONSIDERATIONS Do you have any cul tura l , t radi t ional or re l ig ious considerat ions that you would l ike to share? BABY CARE Immediate skin- to-skin wi th your baby? Yes/no/unsureVi tamin K? Yes/no/unsureEye ointment? Yes/no/unsureI f you are having a boy, do you plan to c i rcumcise? Yes/no/unsureAre you planning to breast feed? Yes/no/unsureDo you want to room-in wi th your baby? Yes/no/unsure WHAT ELSE? Is there anything else you’d l ike us to know, to help us take the best care of you and your fami ly dur ing and af ter your bi r th?
HOPES + FEARS
LABOR/BIRTH When you th ink about you bi r th , what fears come up?
For each fear, can you ident i fy why you are afra id of i t?
What st rategies can you use to overcome each fear?
PARENTHOOD When you th ink about becoming a parent , what fears come up?
For each fear, can you ident i fy why you are afra id of i t?
What st rategies can you use to overcome each fear?
MY WATER BROKE LOG
Date:
Time:
Amount :
Color :
Odor :
Baby moving (yes/no, same as usual , more than usual , less than usual ) :
•Cal l your doctor or midwife to not i fy them and discuss the plan.
T ime cal led doctor/midwife:
Plan:
Notes:
CONTRACTION LOG COPING SKILLS REMINDER SHEET
•Dance/sway•Lunge•Squat•Hip press•Lower back diamond press •Bir th bal l•Sway s ide to s ide•Hip c i rc les•Lean forward on partner•Hip press•Lower back diamond press •Rebozo/Woven Cloth -Support lower back Water -Bathtub -Shower -Washcloth •Music•Relaxat ion mp3s•Vocal izat ion•Breathing•Pleasant smel ls•Mantras
MANTRA SHEET 1
Cut out and br ing the mantra(s ) the resonates most wi th you to your bi r th , or make your own!
MANTRA SHEET 2
Cut out and br ing the mantra(s ) the resonates most wi th you to your bi r th , or make your own!
BIRTH PREFERENCES WORKSHEET
THE BIRTH
Where would you l ike to give bi r th (c i rc le )— hospi ta l /b i r th center/home
Who wi l l take care of you in labor— obstetr ic ian/midwife/doctor of osteopathy/ fami ly physic ian (c i rc le ) YOUR TEAM
I f you have a partner, wi l l they at tend your bi r th? Yes/no/unsureWi l l you hi re a doula? Yes/no/unsureOther fami ly members or f r iends that wi l l a t tend your bi r th
How wi l l you handle v is i tors in the f i rs t 24 hours of your baby’s l i fe?
First week?
First month?
CIRCLE YOUR FAVORITE COPING SKILLS
Dancing LungingSquatt ingHip press/ lower back diamondBir th bal lRebozo/woven c lothBathtubShowerWashclothMusicRelaxat ion MP3sBreathingPleasant smel lsMantras
PAIN MEDS
Do you want pain medicat ions to be of fered to you dur ing your bi r th? Yes/no/undecided
I f so, how? (example: only when I ask for them, or of fer as soon as possible) PLACENTA
Are you planning to bank your cord blood?I f so, have you arranged a serv ice?Do you want delayed cord c lamping? Yes/no/unsureDo you want to see you placenta af ter i t is born? Yes/no/unsureDo you want to have your placenta encapsulated? Yes/no/unsureI f so, have you contacted a specia l is t?Would you l ike to take your placenta home for other use? Yes/no/unsure CULTURAL CONSIDERATIONS Do you have any cul tura l , t radi t ional or re l ig ious considerat ions that you would l ike to share? BABY CARE Immediate skin- to-skin wi th your baby? Yes/no/unsureVi tamin K? Yes/no/unsureEye ointment? Yes/no/unsureI f you are having a boy, do you plan to c i rcumcise? Yes/no/unsureAre you planning to breast feed? Yes/no/unsureDo you want to room-in wi th your baby? Yes/no/unsure WHAT ELSE? Is there anything else you’d l ike us to know, to help us take the best care of you and your fami ly dur ing and af ter your bi r th?
HOPES + FEARS
LABOR/BIRTH When you th ink about you bi r th , what fears come up?
For each fear, can you ident i fy why you are afra id of i t?
What st rategies can you use to overcome each fear?
PARENTHOOD When you th ink about becoming a parent , what fears come up?
For each fear, can you ident i fy why you are afra id of i t?
What st rategies can you use to overcome each fear?
MY WATER BROKE LOG
Date:
Time:
Amount :
Color :
Odor :
Baby moving (yes/no, same as usual , more than usual , less than usual ) :
•Cal l your doctor or midwife to not i fy them and discuss the plan.
T ime cal led doctor/midwife:
Plan:
Notes:
CONTRACTION LOG COPING SKILLS REMINDER SHEET
•Dance/sway•Lunge•Squat•Hip press•Lower back diamond press •Bir th bal l•Sway s ide to s ide•Hip c i rc les•Lean forward on partner•Hip press•Lower back diamond press •Rebozo/Woven Cloth -Support lower back Water -Bathtub -Shower -Washcloth •Music•Relaxat ion mp3s•Vocal izat ion•Breathing•Pleasant smel ls•Mantras
MANTRA SHEET 1
Cut out and br ing the mantra(s ) the resonates most wi th you to your bi r th , or make your own!
MANTRA SHEET 2
Cut out and br ing the mantra(s ) the resonates most wi th you to your bi r th , or make your own!
BIRTH PREFERENCES WORKSHEET
THE BIRTH
Where would you l ike to give bi r th (c i rc le )— hospi ta l /b i r th center/home
Who wi l l take care of you in labor— obstetr ic ian/midwife/doctor of osteopathy/ fami ly physic ian (c i rc le ) YOUR TEAM
I f you have a partner, wi l l they at tend your bi r th? Yes/no/unsureWi l l you hi re a doula? Yes/no/unsureOther fami ly members or f r iends that wi l l a t tend your bi r th
How wi l l you handle v is i tors in the f i rs t 24 hours of your baby’s l i fe?
First week?
First month?
CIRCLE YOUR FAVORITE COPING SKILLS
Dancing LungingSquatt ingHip press/ lower back diamondBir th bal lRebozo/woven c lothBathtubShowerWashclothMusicRelaxat ion MP3sBreathingPleasant smel lsMantras
PAIN MEDS
Do you want pain medicat ions to be of fered to you dur ing your bi r th? Yes/no/undecided
I f so, how? (example: only when I ask for them, or of fer as soon as possible) PLACENTA
Are you planning to bank your cord blood?I f so, have you arranged a serv ice?Do you want delayed cord c lamping? Yes/no/unsureDo you want to see you placenta af ter i t is born? Yes/no/unsureDo you want to have your placenta encapsulated? Yes/no/unsureI f so, have you contacted a specia l is t?Would you l ike to take your placenta home for other use? Yes/no/unsure CULTURAL CONSIDERATIONS Do you have any cul tura l , t radi t ional or re l ig ious considerat ions that you would l ike to share? BABY CARE Immediate skin- to-skin wi th your baby? Yes/no/unsureVi tamin K? Yes/no/unsureEye ointment? Yes/no/unsureI f you are having a boy, do you plan to c i rcumcise? Yes/no/unsureAre you planning to breast feed? Yes/no/unsureDo you want to room-in wi th your baby? Yes/no/unsure WHAT ELSE? Is there anything else you’d l ike us to know, to help us take the best care of you and your fami ly dur ing and af ter your bi r th?
HOPES + FEARS
LABOR/BIRTH When you th ink about you bi r th , what fears come up?
For each fear, can you ident i fy why you are afra id of i t?
What st rategies can you use to overcome each fear?
PARENTHOOD When you th ink about becoming a parent , what fears come up?
For each fear, can you ident i fy why you are afra id of i t?
What st rategies can you use to overcome each fear?
MY WATER BROKE LOG
Date:
Time:
Amount :
Color :
Odor :
Baby moving (yes/no, same as usual , more than usual , less than usual ) :
•Cal l your doctor or midwife to not i fy them and discuss the plan.
T ime cal led doctor/midwife:
Plan:
Notes:
CONTRACTION LOG COPING SKILLS REMINDER SHEET
•Dance/sway•Lunge•Squat•Hip press•Lower back diamond press •Bir th bal l•Sway s ide to s ide•Hip c i rc les•Lean forward on partner•Hip press•Lower back diamond press •Rebozo/Woven Cloth -Support lower back Water -Bathtub -Shower -Washcloth •Music•Relaxat ion mp3s•Vocal izat ion•Breathing•Pleasant smel ls•Mantras
MANTRA SHEET 1
Cut out and br ing the mantra(s ) the resonates most wi th you to your bi r th , or make your own!
MANTRA SHEET 2
Cut out and br ing the mantra(s ) the resonates most wi th you to your bi r th , or make your own!
BIRTH PREFERENCES WORKSHEET
THE BIRTH
Where would you l ike to give bi r th (c i rc le )— hospi ta l /b i r th center/home
Who wi l l take care of you in labor— obstetr ic ian/midwife/doctor of osteopathy/ fami ly physic ian (c i rc le ) YOUR TEAM
I f you have a partner, wi l l they at tend your bi r th? Yes/no/unsureWi l l you hi re a doula? Yes/no/unsureOther fami ly members or f r iends that wi l l a t tend your bi r th
How wi l l you handle v is i tors in the f i rs t 24 hours of your baby’s l i fe?
First week?
First month?
CIRCLE YOUR FAVORITE COPING SKILLS
Dancing LungingSquatt ingHip press/ lower back diamondBir th bal lRebozo/woven c lothBathtubShowerWashclothMusicRelaxat ion MP3sBreathingPleasant smel lsMantras
PAIN MEDS
Do you want pain medicat ions to be of fered to you dur ing your bi r th? Yes/no/undecided
I f so, how? (example: only when I ask for them, or of fer as soon as possible) PLACENTA
Are you planning to bank your cord blood?I f so, have you arranged a serv ice?Do you want delayed cord c lamping? Yes/no/unsureDo you want to see you placenta af ter i t is born? Yes/no/unsureDo you want to have your placenta encapsulated? Yes/no/unsureI f so, have you contacted a specia l is t?Would you l ike to take your placenta home for other use? Yes/no/unsure CULTURAL CONSIDERATIONS Do you have any cul tura l , t radi t ional or re l ig ious considerat ions that you would l ike to share? BABY CARE Immediate skin- to-skin wi th your baby? Yes/no/unsureVi tamin K? Yes/no/unsureEye ointment? Yes/no/unsureI f you are having a boy, do you plan to c i rcumcise? Yes/no/unsureAre you planning to breast feed? Yes/no/unsureDo you want to room-in wi th your baby? Yes/no/unsure WHAT ELSE? Is there anything else you’d l ike us to know, to help us take the best care of you and your fami ly dur ing and af ter your bi r th?
HOPES + FEARS
LABOR/BIRTH When you th ink about you bi r th , what fears come up?
For each fear, can you ident i fy why you are afra id of i t?
What st rategies can you use to overcome each fear?
PARENTHOOD When you th ink about becoming a parent , what fears come up?
For each fear, can you ident i fy why you are afra id of i t?
What st rategies can you use to overcome each fear?
THE ULTIMATE BIRTH PACKING LIST
Mama
Pa�ner
BabyGeneralCLOTHING
2 changes of c lothes
Robe
Materni ty leggings
Breast feeding f r iendly top
Nurs ing bra
Socks
Comfy undies
Going home out f i t
F l ip f lops
Glasses ( i f you wear them)
COSMETICS
Toothbrush
Toothpaste/mouthwash
Shampoo/condi t ioner
Cosmet ics or to i let r ies
Body washes + lot ions
Deodorant
Chapst ick
Hair brush
Hair t ies
Breast pads
Nipple ointment
Picture ID
Insurance card
Hospi ta l paperwork
Phone/camera
Bat tery charger *w/ long cord
Snacks
Comfy pi l low
Gatorade/coconut water/ ju ice
Notebook and pen
Magazine/book
Quarters ( for vending machine)
Extra plast ic bag
Earplugs
2 changes of c lothes Toi letr ies
Bathing sui t *water b i r th
Sneakers and f l ip f lops
Snacks
Magazine/book
Important phone numbers (relat ives, doula , b i r th photographer,
p lacenta encapsulator )
Cute out f i t for baby
Carseat
Blanket
Bi r th preference sheet Bi r th bal l
Rebozo
MP3s
Essent ia l o i ls
Visual e lement (beaut i fu l photo)
Mantras
Earplugs
Bi�hing
POSTPARTUM PREP CHECK LIST
Items to Have Ready F�d Prep
Big cup wi th st raw
Comfortable underwear
Pads
Padsic les
Hemorrhoid cream
Witch hazel pads
Nipple ointment
Comfortable pjs
Nurs ing bra
Robe
Nipple ointment
Nurs ing pi l low
Changing stat ion on each f loor of house
Nursing stat ion on each f loor of house
Snacks *easy to eat wi th one hand
Trai l mix
Granola bars
Cheese st icks
Frozen meals
Take out menus
Postpartum doula and/or baby nurse
Babysi t ter for o lder s ib l ingsHouse c leaner
Schedule relat ives/ f r iends to come help
He lpers to Consider
Home PrepO�er