Prenatal plan

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Pregnancy healthcare plan
Prenatal plan
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The prenatal plan is the first part of your pregnancy healthcare plan.

A pregnancy healthcare plan is a communication tool, a wish list and a reflection of your personal expectations about your pregnancy. Writing this document triggers and invites you and your partner to consider what’s important to you regarding your pregnancy. It’s good to realise that at any moment in time you can deviate from this plan, because changing insights or circumstances can make you change your mind.

In this document in particular you will write down your personal wishes, needs and goals considering your pregnancy. By writing it down and to make your points of interest a subject to talk about, it can help to put yourself in centre of the pregnancy care. A complete pregnancy healthcare plan (exists of 3 parts: your prenatal plan, birth plan and postpartum plan) can help you to feel and be more involved in the things that can happen during your pregnancy and the decisions that you might have to make. It could help you to feel confident and build trust in your own strength and in what you are able to. Also in times that you might not be able to talk about what you need or want.

Name *

Date of birth *

Phone number *

E-mail *

Due date *

Partners name

We don’t know if everything is possible but we will listen to your expectations and goals carefully, so feel free to share them with us.

Information

Are there topics, advises or guidelines where you wish to get more information about? *

Are you someone who asks questions yourself or would you like to get informed? *

Yes
No
Unsure

What subject do you certainly want to be informed about?

If this is not your first pregnancy, what will you take with you from your previous pregnancy(s) and are there things you would like to see differently?

Communication

How can we, as your caretakers, communicate in a way that’s most comfortable for you? *

Which form of communication suits you best?

Are there things that are important for us to know, to make sure that our care meets your expectations as good as possible? *

In what way can we help you best in considering making decisions for yourself or your unborn child? *

Points of interest during this pregnancy

Are there topics that are hard for you to discuss and in which you will need our help? *

Are there specific points of interest that we did not discuss during the first consultation? *

Do you have specific expectations during your pregnancy regarding the counseling in your pregnancy? *

Do you have specific expectations during your pregnancy regarding the medical care? *

Do you have specific wishes regarding the involvement of your partner and/or your other children during your pregnancy? *

The midwife or gynaecologist will sometimes take decisions about your medical plan. You can write these decisions down here so it is clear to you what has to be done or already has been done.

Name

Telefoon:

E-mail:

Prenatal plan

Prenatal plan

Information

Communication

Points of interest during this pregnancy

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