Recommended Birthing Plan Birth Preferences Worksheet Keep in mind your birth preferences are guidelines, but labor is unpredictable. At LLU Children’s Hospital, we want to honor your wishes and give you and your family a wonderful experience as you celebrate the birth of your child. We assure you that the health of you and your baby is our highest priority. If this means we cannot follow your birth preferences exactly, we promise to communicate with you and make recommendations based on guidelines developed through evidence-based practice.
Name: _______________________________________________________
Attendant(s) I would like the following people to be present during labor and/or birth: Partner: ______________________________________________________ Friend(s): _____________________________________________________ Relative(s): ___________________________________________________ Doula: _______________________________________________________ Children: _____________________________________________________
Important things to know about me (cultural, religious preferences, fun facts): ____________________________________________________ _____________________________________________________________
Name of baby (if you have a name chosen): _____________________________________________________________
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Labor and delivery
