Birth Expectations- To be filled out by the birth partner
This form should be filled out by the birth partner, while not in the presence of the mother! Please take your time to fill this out thoughtfully. I will bring a copy of both the mothers, and the partners answers to our prenatal appointment for you to keep. This exercise will allow us to get a full picture of the birth team, and their hopes and fears for this birth.
Describe your ideal birth. What would the environment be like? How would your birth team serve you and the mother? *
Your answer
What is your biggest goal or hope for this birth? (Besides a healthy baby and mom!) *
Your answer
What is your biggest fear about labor and birth? *
Your answer
When the mother is in pain, what types of physical comforts does she like to use? Ex: a quiet room, heat, cold, words spoken etc *
Your answer
Where does the mother hold tension in your body? *
Your answer
What role do you want to take in the birth of your child? *
Your answer
What do you believe your strengths are? *
Your answer
What do you anticipate you will need help with? *
Your answer
What would your "dream doula" experience be like? What role would you like your doula to fulfill? *
Your answer
What would your "nightmare doula" experience be like? *
Your answer
What do you anticipate the mothers needs to be for labor and delivery? *
Your answer
What do you anticipate your needs to be for postpartum? (both immediately postpartum and long term) *
Your answer
Is there any other information you would like me to be aware of so that I may serve you better?
Your answer
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