squiggly line divider

Media Kit

DOWNLOAD MEDIA KIT

Additional Resources

squiggly line divider

×

Step 1 of 23

Thank you for taking the time to complete The Birth Preparation Guide. As you anticipate your upcoming birth, you become stronger as you prepare yourself. The goal is to provide a place for you to reflect on your feelings and a space to write down your concerns. You will receive your results in an email to further assist in your preparation of your Birth Day and meeting your baby! Congratulations Mom!

Name
First
Email

To understand your desires, Reflect on the following statements:
Scale: 1 = Very uncomfortable
2 = Somewhat uncomfortable
3 = Neutral, flexible, okay
4 = Somewhat comfortable
5 = Very comfortable
? = Unsure right now, need to think about it more
N/A = Not applicable

How comfortable am I with placenta encapsulation?*
1 2 3 4 5 ? NA
1 = Very uncomfortable; 2 = Somewhat uncomfortable; 3 = Neutral, flexible, okay; 4 = Somewhat comfortable; 5 = Very comfortable

1 = Not important at all
3 = Neutral
5 = Very important
? = Questions
N/A = Not applicable

As I think about my delivery, I feel most comfortable with:*

As I think about my delivery, I have very strong feelings/opinions about:*

Before my delivery, I need to learn more about:*

My fears about my delivery are:*

Before my delivery, I need to discuss this with my partner:*

Before my delivery, I need to ask my doctor these questions:*

Due Date
MM slash DD slash YYYY