Personalized Preparation
Birth Information Questionnaire
Share your preferences and feelings so Rachael can best support you. Your answers are saved each time you click "Save Progress."
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How do you feel about this?
Select how you feel about each possible intervention or situation.
Stripping or sweeping your membranes
Induced labor
Pitocin augmentation
Artificial rupture of membranes
Wearing a hospital gown
Routine IV during labor and birth
Not being allowed to eat and/or drink during labor
Narcotic pain relief
Epidural
Urinary catheter
Continuous external fetal monitoring
Internal contraction monitoring (not a choice)
Internal fetal scalp monitoring (not a choice)
Breath holding (purple) pushing
Pushing in the supine position (on your back)
Perineal stretching (hands in vs. hands off)
Episiotomy
Perineal tear (this is not a procedure)
Vacuum extractor or forceps delivery
Surgical birth (Cesarean) WITHOUT your doula
Early cord clamping (before cord stops pulsating)
Deep suctioning of baby's airways
Erythromycin in baby's eyes
Vitamin K injection
Placenta being injected with Formalin
How can I help you most?
Tell me how you think you'll want my support during labor.
Help with breathing and relaxation
Massage/soothing touch
Ideas for comfort and progress
Help communicating with medical staff
Support for your goals
Remind you of your birth plan
Help communicating with your family
Take birth pictures (photos of baby emerging)
Videotape the birth (video of baby emerging)
Other
What helps you relax?
Which of these have you found useful in daily life?
Aromatherapy
Meditation or visualization
Yoga
Prayer
Massage
Music
Exercise
Water: bath, shower or hot tub
Other
What's most important to you?
Share what elements of the birth experience matter most.
Feeling in control of my labor
Feeling clear-headed and alert during labor
Having my partner be actively involved
Labor starting naturally
Avoiding medical interventions
Availability of medical intervention, if needed
Feeling minimal pain
Being active and mobile
Bonding with my baby immediately after birth
Seeing or touching my baby's head as it crowns
Letting my instincts guide me
Other
Your progress is saved each time you click "Save Progress." Submit when you're ready for Rachael to review.