Birth Plan for Pregnancy Loss

The “Birth Plan for Pregnancy Loss” is a powerful tool for assisting the pregnant woman who has received a diagnosis of expected loss in childbirth from their care provider. This two-page birth plan allows doulas to prepare the pregnant woman and her family for the grieving process. It will reduce the trauma and stress of having to make difficult decisions in the moments immediate before, during, and after birth.

Included in this form are checklists for:

  • support techniques
  • medical interventions
  • pushing options
  • cord cutting
  • comfort care
  • postpartum requests

This download includes both a colored and black and white version of the birth plan, available exclusively in PDF format.

Download Options:

To access downloadable copies you must first be registered for a paying option.

  • Format PDF
  • Pages 2
  • File Size 58.4 Kb, 54.2 Kb
  • Layout Portrait
  • Dimensions 8.5" x 11"