Burdett Birth Center | 2215 Burdett Avenue, Suite 200, Troy, NY 12180 | (518) 271-3393

Your birth experience… your way.Create your birth plan It’s all about creating the best experience for you and your baby. At Burdett Birth Center, we strive to tailor the birth experience around the wishes of new parents. Mothers are encouraged to design their birth experience using resources available. Print and fill out this birth plan and work with your provider to prepare for your upcoming labor and delivery.

Your name: ____________________________________________________Partner’s name: ____________________________________________________

Baby’s name (optional): ____________________________________________________Expected due date: ____________________________________________________

Before birth Support person None Partner Family Friend Doulanotes:______________________________________________________________________________________________________

Other requests: Eating or drinking during labor Movement during labor Water therapy Labor ball Taking photos or videos Music Lighting Reduced noise levels Labor/birth in my own clothes notes:______________________________________________________________________________________________________

During labor and delivery Pain management Natural Epidural Nitrous oxide Hydrotherapy Spinal blocknotes:______________________________________________________________________________________________________

Fetal monitoring Continuous Intermittent Only when needed notes:______________________________________________________________________________________________________

NotesPlease list any medical conditions or other questions or concerns that your provider and/or Burdett Birth Center should be aware of.________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Burdett Birth Center | 2215 Burdett Avenue, Suite 200, Troy, NY 12180 | (518) 271-3393

Delivery methods Vaginal C-section VBAC Water birthnotes:______________________________________________________________________________________________________

Newborn care I plan to feed my baby: Only with breastmilk Only with formula As needed I request a lactation consultant notes:_________________________________________________________________________________________________________

Other requests: Skin-to-skin Umbilical cord cutting Postponing weighing the baby and/or administering eye drops until after my baby and I greet each other Use of a nursery for medical observation in case I need a break notes:_________________________________________________________________________________________________________

Your birth experience… your way.