Find us on Facebook › This site is intended for U.S. Create an account at VisualBirthPlanner.com. Subject to the above, unless authorized by me, my personal information will not be sold or transferred to third parties, other than in the event of Ferring or its affiliates being sold. Purchases made through links on this page may earn us a commission. There are a lot of options, but don’t feel anxious. Thank you! We do not want to replace the medical personnel, but instead want to be informed of any procedures in advance, and to be allowed the chance to give informed consent. Birth Plan Template and Examples. I would like to have an epidural as soon as permissable. If available, would prefer erythromycin eye treatment or other antibiotic eye drops instead of silver nitrate. I would like to hold the baby through delivery of the placenta and any repair procedures. It is very importantthat you talk about the procedures and/or choices that appear your plan with your caregiver(s). Not only do obstetric practices often vary by caregiver, hospital, state and country, there are often important factors involved. I would like to have the epidural catheter placed upon my admission to the hospital. If you no longer wish to receive such communications from Ferring, you may “opt out” at any time by calling Ferring at 1-888-FERRING (1-888-337-7464), Monday through Friday, 8 AM to 7 PM ET to speak to a representative or leave a voicemail. I would like the baby in the nursery and brought to me on request and for breastfeeding. Your plan wont be saved if you quit now. By submitting my information, I agree to the conditions below regarding the use of my information. By selecting the Reset button, your information will be cleared from all the above fields. So I can stay as mobile as possible, I would prefer to have a heparin lock adminstered instead of an IV. Please suture tears only if necessary. The Bump birth plan tool breaks down all the key questions to help get you started. and another, more concise document (about a page long) for your caregiver and the hospital/birth center staff. The Only Birth Plan Template You Need. If conditions permit, the baby should be given to (coach) immediately after the birth. I understand that the information will be treated confidentially and will be accessed only by authorized personnel or third parties under contract with Ferring or its affiliates. Birth plans are best kept short and to the point -- lots of details may be lost on medical support staff.