NWH Mother-Baby Experience: Creating My Birth Profile
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NWH Mother-Baby
Experience: Creating My
Birth Profile
An expecting parent’s guide to admission,
delivery, and post-partum care.
Knowing your preferences in advance will help us provide
the best possible care to meet your individual needs.
Please answer everything you’re comfortable with at Questions about your birth experience?
this time. Call (914) 666-1840.
Your Mother-Baby Navigator will review this
information with you at your first appointment on:
Let’s get to know a little bit about you, partner, and baby!
Name: When is your due date?
Birthday: Do you know the baby’s sex?
Marital Status: Boy Girl It’s a surprise!
Preferred Language: Do you have other children?
Best contact number: Who is your pediatrician?
Email:
Who is your obstetrician?
Partner’s name:
Partner’s contact number:
You’ll be able to update this plan as needed – all the way
up to the big event!
*This is not part of the medical record – to be used for educational purposes*
Our main goals include putting you at
ease and helping you feel comfortable
throughout this exciting experience.
Cultural Preferences: Do you have any Things to discuss with your partner:
religious or cultural preferences that you - Childcare on the day of your delivery for
would like to share with us in relation to baby’s big brothers and sisters.
your delivery and post-partum care?
- Remind your partner to bring a change of
clothes and toiletries.
- Please know, your support person is entitled to
free meals during your stay.
Medical and Nursing Students:
o Yes, I am comfortable with medical and nursing
students being present during my delivery and
post-partum care.
Dietary needs: Please inform us of any o No, I am not comfortable with medical and
allergies, food restrictions or dietary preferences? nursing students being present during my
delivery and post-partum care.
Mom:
Partner:
Support in the Delivery Room: Who would
you like to be in the delivery room with you?
Please list their names and their relationship
to you.
My Baby’s Delivery
Play an active role in
making your childbirth
the kind of experience
you want.
Your delivery preferences: What is most important to you during labor
and birth?
o I would like a mirror placed at the foot of
my bed so I can watch my baby’s birth.
o I would like to touch my baby’s head as it
crowns.
o I would like ___________________
to cut the umbilical cord.
For Moms having a C-Section:
o If possible, I would like a Gentle C-section
if medically safe for both me and my baby.
o I would like ___________________ to cut
the umbilical cord after the C-section. Additional concerns:
Routine post-delivery
practices:
o Skin-to-skin contact with baby
o Delayed cord clamping
o Delayed newborn bath
o Rooming in
o Partner skin-to-skinCreating the perfect environment
Everyone’s idea of comfort is different.
Let us make your childbirth experience as relaxing as possible.
Preferences to create your perfect environment: Pain Management:
o I’d like music playing during childbirth. o I’m aware of my pain management options.
(If so, create a playlist with your partner!) o I desire to avoid pain-reducing medication.
o I prefer the lights to be dimmed.
o I prefer a warm or cool room (circle one).
o LED candles Please share any additional notes or comments
about your pain management plans:
I am interested in using the following natural
tools and techniques to support me during labor:
o Breathing techniques
o Changing positions/walking – I want to use a
variety of positions during labor.
o Shower
o Integrative therapies:
____ Aromatherapy (lavender/mandarin only)
____ Gentle touch
____ Birthing ball
____ Peanut ball
____ Use of CUB Questions about your birth profile?
Call (914) 666-1840.
____ Handheld massager
____ Stress ball
____ Eye mask
____ Hot/cold Pack Essential oils (lavender and
____ Hand fan
mandarin) will be provided upon
request. Please know, diffusers are
____ Open to all modalities
not permitted at the hospital.
Anything else?It’s exciting to know you can nourish
your baby no matter what feeding
choice works best for your family.
Let’s get to know your preferences...
Feeding my baby: Prenatal education:
o I plan on breastfeeding. I plan to or have already completed classes in:
o I plan on exclusively pumping. o Breastfeeding
o I plan to exclusively formula feed. o Newborn care
o I have concerns related to breastfeeding that o Childbirth preparation
need to be addressed prior to delivery.
o Infant/child safety
o I haven’t decided yet how I will feed
o I have completed or planned to attend classes at
my baby.
Other considerations:
o If I have a boy, I would like him to be Family education:
circumcised at the hospital.
o Grandparenting 101 class
o I am arranging for cord blood collection.
o Sibling class
o I do NOT want to receive any blood or
blood products, even in a life-saving
situation. I would like to speak with the
hospital’s Blood Avoidance Coordinator. To register for our classes, new mom
o I am interested in taking my placenta groups, car seat checks, and more,
home and I am aware of the process. visit nwhfamilycenter.eventbrite.com
Interested in speaking with a lacation
consultant? Call (914) 666-1370.Preparing for Discharge
Car Seat Safety Stay connected to us!
Schedule a free car seat safety check at about 36 weeks
with one of our Certified Child Passenger Safety Technicians. Add these phone numbers to your contacts
Register at nwhfamilycenter.eventbrite.com so we can help when/if you need us.
Mother-Baby Warm Line: (914) 666-1011.
Safe Sleep After discharge if you have any questions
Have you completed safe sleep education? regarding mother/baby care, call to speak with a
Yes _________ No __________ nurse, 24/7.
Where will your baby be sleeping when you go home? Lactation Center: (914) 666-1370.
____________________________ Continued breastfeeding support is offered all
the way up until weaning. We offer phone sup-
port 7 days per week. Consultations are available
Do you have the help you need at home? Monday through Friday upon request.
Planning to go home is different for each person. As you
get ready to leave the hospital, think about the help you
will need when you get home. Postpartum groups to consider...
Help at Home Tips: Breastfeeding Nook
- Don’t stress about housework. Accept help with Join this virtual group with your baby and
cleaning, cooking, laundry, grocery shopping, banking receive peer-to-peer support to help you
and bill paying, picking up your mail, and other chores. achieve your breastfeeding goals. Information,
- Sleep when baby sleeps. encouragement, and support are provided by a
- Line up help to get you to and from doctor’s appointments Board Certified Lactation Consultant.
Register at nwhfamilycenter.eventbrite.com
- If you have more children, let others help you with them.
Mom Squad Class
Join this virtual group with your baby and enjoy
an interactive, social get together. Meet other
moms and share information about caring for
To sign up for classes, new mom groups, your newborn. Facilitated by an experienced
and to access our photo tour, visit us at mother-baby registered nurse.
nwhfamilycenter.eventbrite.com Register at nwhfamilycenter.eventbrite.comYou can also read
