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HTML Preview Parental Birth Plan page number 1.
1
Use this easy fill-in-blank birth plan to communicate your wants and
needs to your medical team.
I’d like the following people to be pr
esent during labour and/or birth:
I’d also like:
T
o bring my own music.
T
o dim the lights.
T
o wear my own clothes during labour and delivery
.
T
o have pictures and/or video tak
en during labour and delivery
.
Name:
Personal Details
Partner:
Friends:
Relatives:
Doula:
Children:
Partner:
Due Date:
My obstetrician and/or midwife:
Hospital:
Birth Plan
Page 1 of 6
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