Earth Mama Angel Baby Special - Baby Love Bundle

Free Birth Plan

Be prepared, mama! The Earth Mama Angel Baby mamas have put their celestial heads together to ask the birth preparedness questions you might be too tired, excited or overwhelmed to ask. The result is the Earth Mama Angel Baby Free Birth Plan gizmo that guides you through thinking about topics that are important to discuss with your healthcare provider and the birth place where you will be bringing your new angel into the world.

Whether you prefer a natural, non-medicated birth or a medically assisted (epidural) delivery, the Earth Mama Angel Baby Free Baby Birth Plan is a perfect tool for having your desires met during labor, and for communicating with your family, doctor, midwife, or doula before your angel arrives.

We've included a lot of choices, but don't be overwhelmed. Thoughtfully considering areas of concern is empowering and helps prepare you for better communication with your birth team.

Simply click on the options to select what is right for you, click "Create My Birth Plan" and your handy-dandy Free Birth Plan will be emailed to you, ready to print. We recommend printing five copies to present to your doctor, midwife, nurse, doula, birthing center or hospital and any attending family or friends before you start your labor.

Earth Mama Angel Baby's birth plan tool asks for your email address. We promise not to use your email to send you unwanted emails. If your email service has a SPAM filter, or a "bulk" or "junk" mail sorter, the email from us may go to this folder, so be sure to check for it, or add earthmamaangelbaby.com as an approved sender to your account.

And don't forget to sign up for Mama's monthly newsletter. It's chock full of the latest herbal information, research and tools, and special newsletter discount coupons for zero toxin products for mamas and babies. From your first trimester to baby's first boo-boo, you'll find just what you need to help comfort and nurture you and your new baby, all with zero toxins.

You'll also want to create a wish list at the Earth Mama Angel Baby Gift Registry — an easy tool to let inquiring minds know what you and your little angel could use!

So, settle back, sip a soothing cup of organic herbal tea, and get your homework started. All the mamas at Earth Mama Angel Baby hope this free birth plan helps you have a relaxed and thoughtfully prepared birth, and to be ready for that most blissful look into your new baby's face.

First Name (required)

Last Name (required)

Partner's Name

Due Date (required)

Address

City

State

Zip

Email (required)

My Doctor

Before Labor Begins


	As long as the baby and I are healthy, I would like to go at least 10 to 14 days over my due date before inducing labor.
	As long as the baby and I are healthy, I would like to have no time restrictions on the length of my pregnancy.
	I would like to discuss laboring at home as long as possible.
	I trust that my practitioner will seek out my opinion concerning all of the issues directly affecting my birth before deviating from my plan.
	If NST observation becomes necessary after my due date, I am flexible and support this procedure.
	I would like to discuss the option of induction before I reach my due date.
	If I go past my due date and the baby and I are fine, I prefer to go into labor naturally rather than be induced.
Vaginal exams
	Please obtain my permission before stripping my membranes during a vaginal exam.
	I prefer to have no vaginal exams until I go into labor.
	I prefer to have only 1 vaginal exam on or around my due date.
	During a vaginal exam, I prefer at no time to have my membranes broken unless there is an emergency situation.
	I prefer minimal internal vaginal exams or at my request only.
	I would like no internal vaginal exams, within reason, during my labor until I have an urge to push.
	I prefer to have minimal internal exams
Hospital Admittance
	I would like the option of staying in the hospital regardless of my dilation and the discussion of induction.
	If I am less than four centimeters dilated, I would like to discuss with my healthcare provider the option of going home.
	If I am less than five centimeters dilated and my water has broken, I would like the option of returning home.

Induction


	If induction becomes necessary, I would like to try natural induction techniques first (with the guidance of my practitioner)
Natural induction techniques I would like to try (check all that apply) :
	Breast stimulation
	Walking
	Herbs
	Enema
	Castor oil
	Chiropractic
	Acupuncture
	Sexual intercourse
If Medical induction becomes necessary, I prefer to try (check all that apply) :
	Stripping membranes
	Prostaglandin gels
	Pitocin
	Rupturing membranes
If my water breaks before I go into labor, I would like to:
	wait 6 hours before being induced
	wait 12 hours before being induced
	wait 24 hours before being induced
	wait 48 hours before being induced
	Talk to my practitioner about alternatives to treatments such as antibiotics

Environment


	Upon arrival at the hospital, I prefer to have my partner with me at all times.
	Please, no residents or students attending my birth.
I request the following people to be present during my labor and/or 2nd stage labor:
	Partner Name:
	Relative(s) Name(s):
	Friend(s) Name(s):
	Doula Name:
	Sibling(s) Name(s):
	Please do not allow	in my room at any time.
I prefer to give birth in a:
	Birthing room
	Room with a shower and/or bath
	Delivery room
	At home
If birth equipment is available, I would like to use (check all that apply) :
	Birthing bed
	Birthing ball
	Bean bag chair
	Birthing tub/pool/shower
	Birthing stool
	Squatting bar
Miscellaneous environment items (check all that apply):
	I would like to have dimmed lights.
	I would like for people entering the room to speak softly.
	I would like to play music.
	I would like no one to speak during the actual delivery.
	I would like to wear hospital clothing.
	I would like to wear my own clothes during labor and delivery.
	I would like to be reminded to remove my clothing during the actual delivery.
	I would like to have a TV available.
	I would like to have a VCR available.
	I would like to wear headsets during my labor and delivery.
	I would like to have my birth photographed.
	I would like to have my birth filmed/videotaped.
	I would like to wear my glasses or contact lenses unless removal becomes medically necessary.

Pain Relief

	Please only offer pain medications if I ask for them.
	Please suggest pain management options for me if you see that I am too uncomfortable to handle the pain.
	Please discuss pain management options for me as soon as possible.
	After medical guidance for pain relief, I would appreciate some private time with my partner to discuss which pain management technique or medication I would like to use.
I am prepared to try to handle pain with these natural and alternative methods (check all that apply):
	Breathing techniques
	Distraction techniques
	Hypnotherapy
	Acupressure
	Acupuncture
	Massage
	Visual imaging work
	Color therapy
	Deep (or guided) relaxation
	Water/bath/shower
If I choose to use drugs, my preference is:
	Walking epidural
	Classic epidural
	Sedative
	Tranquilizer
	Narcotics
Other Considerations
	Ultimately, I want to be able to walk around and move as I wish while in labor.
	Ultimately, I would like to feel unrestricted in accessing any sounds of chanting, grunting, or moaning during labor.
	Please keep my door always closed during labor.

Monitoring


I prefer the baby to be monitored:
	Continuous fetal monitoring
	Intermittently monitored to allow for as much mobility as possible
I have prepared for this birth with:
	Lamaze techniques
	Bradley techniques
	Hypbirth (childbirth hypnosis)
	Other:

	I am seeking my practitioner's assistance with this technique.

Second Stage Labor


	As long as the baby and I are healthy, I prefer to have no time limits on pushing.
	If pushing for more than several hours, I am open to medical intervention in 2nd stage labor.
I would like to be encouraged to try the following different positions for labor (check all that apply) :
	Squatting
	Classic semi-recline
	Hands and knees
	On the toilet
	Standing upright
	Side Lying
	Whatever feels right at the time

Enemas

	I will ask for an enema if I feel that I need one.
	I would like to have an enema upon being admitted.

Episiotomy

	I prefer to have an episiotomy
	I prefer to have no episiotomy and risk tearing (unless I'm having a medical emergency)
	If I need an episiotomy, I prefer a pressure episiotomy.
To help prevent tearing, please apply:
	Hot compresses
	Oil
	Perineal massage
	Encourage me to breathe properly for slower crowning.
Other labor considerations
	If possible, please allow the shoulders and body of my baby to be born spontaneously, on their own.
	Please use a local anesthetic for repairs.
	No stirrups please unless I'm having a medical emergency

The Delivery

Misc. (check all that apply):
	I would like to view the birth using a mirror.
	I would like to touch my baby's head as it crowns.
	I would like to catch my baby and pull it onto my abdomen as it is born.
	I would like my partner to catch my baby.
	I would like the doctor to catch my baby.
	For spiritual or religious reasons, I would like the room to be totally silent as the baby is born.
	I would like for our baby to hear our voices first.
	I prefer to have the lights dimmed for delivery or, if it is daylight, to access only natural light.
Pushing
	It's important to me to push instinctively. I do not want to be told how or when to push.
	Please tell me when to push
After Baby is Born
	As long as my baby is healthy, I would like my baby placed immediately on my abdomen following the birth.
	Please put my baby skin-to-skin on my abdomen with a warm blanket over it.
	Please do not separate me and my baby until after my baby has successfully breastfed on both breasts.
	Please delay all essential routine procedures on my baby until after the bonding and breastfeeding period (i.e., bathing).

Cesarean

	If a C-Section is not an emergency, please give us time alone to think about it before asking for our written consent.
	My partner(s) is(are) to be present at all times during the c-section.
	Ideally, I would like to remain conscious during the procedure.
	I would like the baby to be shown to me immediately after it's born.
	I would like to have contact with the baby as soon as it is possible in the delivery room.
	I prefer to have a hand free to touch the baby.
	We would like to photograph or film the operation as the baby comes out.
	We would like to film or photograph only the baby after delivery.
	If possible, please discuss anesthesia options with me (including morphine options).
	I prefer a low transverse incision on my abdomen and uterus.
	Please respect my wishes to be quiet during the operation (e.g., avoiding "small talk" with other practitioners in the room).
Recovery (check all that apply)
	If my baby is healthy, I would like to hold my baby and nurse it immediately in recovery.
	I would like to sign any waivers necessary to permit me to be with my baby in recovery.
	As long as my baby is healthy, I would like my partner to be the baby's constant source of attention until I am free to bond with it (i.e., holding, skin-to-skin contact, etc.).
	I would like my baby to be sent to the nursery while I am in recovery.
	Please pay special attention to our nursing needs in recovery. I may need some "extra help" nursing after the operation.
	I would like to have my catheter and IV removed ASAP after my recovery period.
	Please discuss with me what I can expect to feel immediately following the procedure.
	Please discuss my post-operative pain medication options with me before or immediately following the procedure.

Third Stage Labor

	Please wait for the umbilical cord to stop pulsating before it is clamped.
	Please allow my partner to cut the umbilical cord.
Placenta (check all that apply):
	I would prefer for the placenta to be born spontaneously without the use of pitocin, and/or controlled traction on the umbilical cord.
	I would like to have routine pitocin given to me after the placenta is born.
	I would like to delay routine pitocin after the placenta is born unless there are any signs of hemorrhaging.
	I would like the option of taking home the placenta.
	I would like to bank my baby's cord blood and have made arrangements for this procedure prior to the birth.

New Born Procedures

	If the baby has any problems, I would like my partner to be present with the baby at all times, if possible.
	I would like to have routine newborn procedures delayed until bonding and breastfeeding have occurred.
	I would like all newborn routine procedures to be performed in my presence.
	I would like all newborn routine procedures to be performed right away.
Administration of Eye drops
	I would like my baby to have eye drops administered immediately after birth.
	I would like to delay the administration of eye drops until after breastfeeding and bonding has occurred.
	Please do not administer eye drops to my baby, I am willing to sign a formal waiver if need be.
Vitamin K
	I would like my baby to receive a routine injection of vitamin K immediately after birth.
	I would like to delay the administration of vitamin K up to 1 hour after birth, after breastfeeding and bonding, unless medically necessary.
	I would like only the orally administered vitamin K to be given to my baby.
	Please do not administer vitamin K to my baby, I am willing to sign a formal waiver if need be.
Immunizations
	I prefer any immunizations be postponed to a later time
	Immunize the baby according to normal procedures.
Bathing Baby
	Please bathe my baby after we have had time to bond.
	Please do not bathe my baby at all.
	We would like to give our baby his/her first bath using our own non-toxic baby products.
Circumcision:
	Please do not circumcise him.
	I would like him circumcised
Other circumcision options:
	Please use a local anesthetic
	Please delay procedure as long as possible
PKU
	Routine PKU Testing right away
	We would like routine PKU testing to be done before we leave the hospital.
	We decline routine PKU testing at the hospital and have made other arrangements for this procedure at a later date this week.
	We would like to wait, and delay the PKU testing until we are ready to leave the hospital
Feedings
	My baby is to be exclusively breastfed.
	My baby is to be formula-fed exclusively.
	I would like to combine breastfeeding and formula feeding.
	Please offer guidance on the issue of formula versus breastfeeding.
	I would like to see a lactation consultant as soon as possible for further recommendations and guidance.
Do not offer my baby the following without my consent (check all that apply):
	Formula
	Pacifiers
	Any artificial nipples
	Sugar water
If my baby's health is in jeopardy, I would like (check all that apply):
	To be transported with my baby if possible.
	My partner to go with the baby.
	To breastfeed or express my milk for my baby.
	To have as much bodily contact with my baby as possible.
	To be offered a room at the hospital for the duration of my baby's stay (within reason).
I would like my in-hospital routine to be:
	Full rooming in, no separation, no exceptions, unless my baby is sick.
	Delayed rooming in until I have had time to rest.
	Partial rooming in. I prefer to have the baby sent to the nursery at night so that I can rest.
	Nursery care: I would like the nursery to fully care for my baby and bring it to me for feedings.

My Hospital Stay

I prefer to have my hospital stay:
	As short as it can be.
	As long as it can be.
Other hospital preferences:
	I prefer a private room.
	I prefer to have my partner stay with me for the duration of my hospital stay.
	I would like my other children (regardless of age) to be allowed to visit with me for as long as they wish or as long as hospital policy permits.
	I would like my guests to be permitted to stay as long as they wish.
	I want privacy during my stay and for my guests to limit the time they are visiting me.

Free Birth Plan

Before Labor Begins

Vaginal exams

Hospital Admittance

Induction

Natural induction techniques I would like to try (check all that apply) :

If Medical induction becomes necessary, I prefer to try (check all that apply) :

If my water breaks before I go into labor, I would like to:

Environment

I request the following people to be present during my labor and/or 2nd stage labor:

I prefer to give birth in a:

If birth equipment is available, I would like to use (check all that apply) :

Miscellaneous environment items (check all that apply):

IV

Pain Relief

I am prepared to try to handle pain with these natural and alternative methods (check all that apply):

If I choose to use drugs, my preference is:

Other Considerations

Monitoring

I prefer the baby to be monitored:

I have prepared for this birth with:

Second Stage Labor

I would like to be encouraged to try the following different positions for labor (check all that apply) :

Enemas

Episiotomy

To help prevent tearing, please apply:

Other labor considerations

The Delivery

Misc. (check all that apply):

Pushing

After Baby is Born

Cesarean

Recovery (check all that apply)

Third Stage Labor

Placenta (check all that apply):

New Born Procedures

Administration of Eye drops

Vitamin K

Immunizations

Bathing Baby

Circumcision:

Other circumcision options:

PKU

Feedings

Do not offer my baby the following without my consent (check all that apply):

If my baby's health is in jeopardy, I would like (check all that apply):

I would like my in-hospital routine to be:

My Hospital Stay

I prefer to have my hospital stay:

Other hospital preferences:

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