Visual Birth Plan – Voices of Eve

My name *

My e-mail address *

This will be for billing and general communication through your pregnancy and through the postpartum period.

My phone number *

My partner's phone number

Name of anyone else attending you at your birth and their relation to you *

Any other legal names that may be used by our birthing place *

There have been times when I was delayed getting to a client because their hospital had their maiden name instead of their married name on file.

Baby's Name

Estimated Due Date *

Home Address

This is used for if Abbey will serve you at home before going to the birthing place or if you are having a homebirth.

Birth Place location

Address if you can or a name that Abbey can search for

My Baby: Select and/all you would like represented on your birth plan.

Birthing Location: Select where your birth is planned to take place (If you are choosing a C-section there will be other C-section options further down)

My Personal History: Select and/all you would like represented on your birth plan.

Medical History/Needs: Select and/all you would like represented on your birth plan.

My Labor and Birth is Planned as.: Select and/all you would like represented on your birth plan.

Care Provider Choices: Select and/all you would like represented on your birth plan.

My Birth Environment: Select and/all you would like represented on your birth plan.

Spiritual and Cultural Aspects of My Birth: Select if any you would like represented on your birth plan.

I Am Celebrating My Culture in My Labor and Birth
I Am Celebrating my Beliefs in My Labor and Birth
I Am Celebrating My Culture and My Beliefs in My Labor and Birth

Coping Strategy:Select and/all you would like represented on your birth plan.

Even if you are planning a medically managed birth Voices of Eve strongly encourages choosing some non-medical coping tools to help you until the medical management is in place, in case it becomes not an option, or in case it fails.

Augmentation Preferences: Select and/all you would like represented on your birth plan.