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                                          Birth plan for labor and delivery             


To be adapted by  the mother and father to their desires and beliefs

No meal restrictions during labor.
Mother requires the freedom to walk around during labor.
No fetal monitor unless absolutely necessary and only after prolonged labor. (12 hrs plus)
Newborn is not to leave the delivery room without mother to accompany.
No eye-salves or disinfectants are to be applied to the newborn’s eyes.
No cutting of the umbilical cord for 20 minutes
Mother desires to breast-feed within ­two minutes of delivery.
No infant formulas are to be given to newborn.
No pacifiers.

Absolutely NO SHOTS are to be administered to newborn or mother including vaccines

Private room is requested (mother will pay difference in price).
Baby is to reside in room with mother at all times.
Newborn’s weight checks, exams, etc. will be performed in the room with mother present.
Circumcision of child will be delayed until the 8th day.



Delivery Doctor__________________________

Delivery Nurse___________________________

These are highly recommend actions for a pleasant labor and delivery. Feel free to modify the wishes as you like. A solid plan is key to
a blessed event and can prevent the nightmare of a medicalized childbirth. If the plan is rehearsed before onset of labor and the doctor
and nurse read and sign this, the delivery success rises.

Authored by Neurodevelopment Consultant Craig Stellpflug NDC, CNC
Healing Pathways Medical Clinic Scottsdale, AZ
Copyright 2012 Craig Stellpflug© Permission is hereby granted to copy and distribute this article but only in its entirety

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Birth plan for labor and delivery
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