Interactive Tool

Hospital Birth Preference Builder

Create a clear, one-page birth preference summary for your Certified Nurse-Midwife and Arizona hospital team.

Hospital Birth Preference Builder

1. Patient, hospital & obstetric history

VBAC eligibility depends on clinical history and hospital policy. Use this field only as a conversation starter with your CNM.

2. Environment & room atmosphere

3. Labor comfort & pain management

4. Pushing & birth preferences

5. Medical interventions & monitoring

6. Immediate postpartum & newborn care

7. Special instructions & communication

Live document preview

Hospital birth plan summary

MY HOSPITAL BIRTH PLAN PREFERENCES
Patient:Optional
Partner:Optional
Due date:Not set
Hospital:Chandler Regional Medical Center
Prior cesarean / VBAC:No prior cesarean
Environment

Soft ambient lighting, Freedom to walk & move, Hydrotherapy tub / shower access, Personal music playlist

Pain relief

Desire natural comfort measures first (hydrotherapy, movement), with full access to an epidural if requested during active labor.

Pushing & birth

Side-lying or squatting, Spontaneous pushing when ready, Mirror available to view birth

Medical interventions

Fetal telemetry / wireless monitoring when available, Heparin / saline lock IV access (freedom of movement), Spontaneous membrane rupture (avoid routine AROM), Perineal massage & warm compresses for tear prevention

Postpartum & newborn

Immediate skin-to-skin for minimum 60 minutes, Golden Hour bonding uninterrupted, Lactation support consult, Rooming-in 24/7

Special instructions

Please explain options before examinations or interventions. Collaborative OB/GYN backup is appreciated for safety.

Locations to discuss
  • Chandler: Chandler Regional, Mercy Gilbert

Download this PDF, bring it to your next prenatal visit, and review every item with your CNM. Preferences are discussion points, not guarantees.

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