Home Birth Plan...For children

Dear Doula/Midwife/Birth companion

If you could take a minute, I/we would like to tell you somethings that we would or wouldn’t like during our mum’s labour, thank you!:

1. In the case that our mum has to be transferred to hospital we would like to stay with:

(Write here the name of relatives/friends or neighbours and in order of preference)

1. Friends
2. Neighbour

1. I want to see the birth:

            Yes / No

1. I want to be awaken for the event:

            Yes / No

1. The person I would like to explain to me what is happening is:

                    My mum’s doula

                    Dad

                    Grandma

                    Other__________________

1. Movies (or games, books, etc) I would like to watch while mum , dad are busy or to take with me if I need to stay somewhere else:

1. Other things I enjoy doing are:

1. When the baby is born I would like to hold the baby:

                     Yes / No

1. Special things I would like to do for the baby after the birth:

(i.e: Give the baby a present, sing happy birthday, eat a cake with my family)

1. Things I do not like:

(i.e To be ignored, people grabbing my cheeks, not knowing what is happening, needles, spiders, people taking too many pictures of me!)

Created by with the help of her children Euan & Kier