Free Birth Plan Template 41Free Birth Plan Template 41
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Women’s Health Matters
Birth Plan/Preference List
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Date:

Reviewed with:

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The following concerns are often important to expectant families. We encourage you to think about
them carefully and to discuss them with your partner and your health care provider. When complete,
share this birth plan with your health care provider.

1. All babies are monitored externally on admission to the UCSF Center for Mothers and Newborns
for 20–30 minutes. If this monitoring period does not indicate any problems, you may choose to be
monitored intermittently, unless continuous monitoring becomes medically necessary.
Notes:_ _________________________________________________________________________________
2. Intravenous (IV) fluids may be necessary if you are dehydrated from vomiting, long labor or to
administer medication. You may choose to labor without IV fluids unless it becomes medically
required.
Notes:_ ______________