KG Hypnobirthing is a complete in-depth antenatal training programme designed to release fear and build confidence during birth.

  • Home
  • Birth Plan Template

Birth Plan Template

To be focussed on a calm and natural KGHypnobirthing birth, take time in your pregnancy to identify what is important to you.

Birth can sometimes be unpredictable, so be flexible and accept that things may not go to plan and each woman’s experience is personal. The course of labour can vary according to the health needs of you and your baby and you can be prepared by understanding your options and asking for full information at the time.

Look at various stages so that you are clear on the experience you would like, what is acceptable to you and how you want to consider your options if presented with them.

Complete this birth proposal and discuss it with your medical care-givers, as it will need to be right for your particular circumstances.


Below is an interactive birth plan

Click on the boxes to choose your preferences and use the free form box to add your own requests. Leave the boxes blank if the statement is not relevant, it will then not populate onto your birth plan. Once you have filled out the form click on 'create your birth plan' and you will be able to print out your personalised birth plan.





General

I / we would like
I / we would prefer not to have
Respect and support for our hypnobirthing
clear selection
I / we would like
I / we would prefer not to have
A midwife who is supportive of KGHypnobirthing
clear selection
I / we would like
I / we would prefer not to have
Any conversation to be with dad / partner in the first instance (Respect the fact that conversation with mother disturbs the neocortex and stimulates the production of adrenalin which inhibits the production of oxytocin)
clear selection
I / we would like
I / we would prefer not to have
Private time to discuss any procedure proposed
clear selection
I / we would like
I / we would prefer not to have
clear selection
I / we would like
I / we would prefer not to have
clear selection
I / we would like
I / we would prefer not to have
clear selection
I / we would like
I / we would prefer not to have
clear selection

+ Add another row

Induction / augmentation

I / we would like
I / we would prefer not to have
Induction by membrane sweep
clear selection
I / we would like
I / we would prefer not to have
Monitoring after 42 weeks rather than induction of labour
clear selection
I / we would like
I / we would prefer not to have
Induction for post-dates
clear selection
I / we would like
I / we would prefer not to have
Induction if labour does not start after the release of membranes
clear selection
I / we would like
I / we would prefer not to have
Augmentation of labour
clear selection
I / we would like
I / we would prefer not to have
Vaginal examinations after the release of membranes at start of labour
clear selection
I / we would like
I / we would prefer not to have
clear selection
I / we would like
I / we would prefer not to have
clear selection
I / we would like
I / we would prefer not to have
clear selection
I / we would like
I / we would prefer not to have
clear selection

+ Add another row

Environment during labour

I / we would like
I / we would prefer not to have
A calm, safe and natural place of birth
clear selection
I / we would like
I / we would prefer not to have
Peace and tranquillity in my room
clear selection
I / we would like
I / we would prefer not to have
Soft lighting
clear selection
I / we would like
I / we would prefer not to have
Facility to play relaxing music and KGHypnobirthing audio
clear selection
I / we would like
I / we would prefer not to have
My birth partner to remain with me throughout labour and birth and after the birth
clear selection
I / we would like
I / we would prefer not to have
Use of the pool during labour and birth (As hypnobirthing births can be quicker than other births please make sure the pool is filled in good time)
clear selection
I / we would like
I / we would prefer not to have
The use of the word 'pain' in labour
clear selection
I / we would like
I / we would prefer not to have
Conversation in my room throughout labour
clear selection
I / we would like
I / we would prefer not to have
clear selection
I / we would like
I / we would prefer not to have
clear selection
I / we would like
I / we would prefer not to have
clear selection
I / we would like
I / we would prefer not to have
clear selection

+ Add another row

Monitoring

I / we would like
I / we would prefer not to have
One vaginal examination at the beginning of labour
clear selection
I / we would like
I / we would prefer not to have
Vaginal examinations in labour
clear selection
I / we would like
I / we would prefer not to have
clear selection
I / we would like
I / we would prefer not to have
clear selection
I / we would like
I / we would prefer not to have
clear selection
I / we would like
I / we would prefer not to have
clear selection

+ Add another row

Labour and birth

I / we would like
I / we would prefer not to have
I would like to have a birth pool available
clear selection
I / we would like
I / we would prefer not to have
Artificial rupture of membranes in labour
clear selection
I / we would like
I / we would prefer not to have
Coaching during the second stage of labour
clear selection
I / we would like
I / we would prefer not to have
Natural expulsion of placenta
clear selection
I / we would like
I / we would prefer not to have
clear selection
I / we would like
I / we would prefer not to have
clear selection
I / we would like
I / we would prefer not to have
clear selection
I / we would like
I / we would prefer not to have
clear selection

+ Add another row

Baby care

I / we would like
I / we would prefer not to have
Dad / birth partner to cut the cord
clear selection
I / we would like
I / we would prefer not to have
Facilitate my baby to initiate breast feeding at or soon after birth
clear selection
I / we would like
I / we would prefer not to have
Infant feeding supplements (cows milk formula) to be given to my baby
clear selection
I / we would like
I / we would prefer not to have
Baby to receive vitamin K by injection
clear selection
I / we would like
I / we would prefer not to have
Baby to receive vitamin K orally
clear selection
I / we would like
I / we would prefer not to have
clear selection
I / we would like
I / we would prefer not to have
clear selection
I / we would like
I / we would prefer not to have
clear selection
I / we would like
I / we would prefer not to have
clear selection

+ Add another row

Environment after birth

I / we would like
I / we would prefer not to have
Optimal cord clamping and cutting (after pulsation has stopped)
clear selection
I / we would like
I / we would prefer not to have
To hold our baby undisturbed for at least one hour after birth
clear selection
I / we would like
I / we would prefer not to have
An injection of synthetic oxytocin
clear selection
I / we would like
I / we would prefer not to have
To hold baby skin to skin
clear selection
I / we would like
I / we would prefer not to have
clear selection
I / we would like
I / we would prefer not to have
clear selection
I / we would like
I / we would prefer not to have
clear selection
I / we would like
I / we would prefer not to have
clear selection

+ Add another row



KGHypnobirthing will not be retaining any of your decisions on the form as once it has been saved as a PDF by you, it will be deleted from our system.

KGHypnobirthing run face-to-face and online parents courses – to find out more, please tick the box

KGHypnobirthing has been featured in:

The Sunday Times The Guardian Radio 4 Woman's Hour Prima Baby & Pregnancy OK! Mother & Baby  The Telegraph Daily Mail

Shop

Hypnobirthing shop

Visit our online shop for:

The Hypnobirthing Book
CDs and MP3s

Shop

Hypnobirthing Free Resources

Hypnobirthing Free Resources

The Hypnobirthing Book first chapter, hypnobirthing relaxation audio, pregnancy affirmations, positive daily alerts and more...

Read More

Videos

Hypnobirthing videos

Real-life hypnobirthing experiences and interviews.

View Videos

Hypnobirthing Online Course

Hypnobirthing Online Course

Enjoy our full online antenatal programme at your own pace from home.

Read More

We use cookies to improve our website and your experience when using it. To find out more about the cookies we use see our Cookie Policy.

I accept cookies from this site
EU Cookie Directive plugin by www.channeldigital.co.uk