Previous Birth/s
Doula Services by Doula Noleen
If you've had more than one birth, please number your answers as follows: #1, #2, etc
Name
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First Name
Last Name
Vaginal birth/s
Cesarean birth/s
VBAC birth/s
Where did you birth and who was the provider?
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Did labor start on its on or were you induced and how many weeks gestation?
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If it was an induction, what type and why?
Did your waters release on their own or with medical help?
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Were you medicated or unmedicated? If you chose an epidural, was it a positive experience?
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Any other pain medication?
How long was labor, start to birth?
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How long was the pushing phase?
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If you had a cesarean, why?
Any complications for the birth/s?
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What was baby's birth weight?
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How did your postpartum healing go?
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What was the best part of your previous birth/s?
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Would you have changed anything or wanted something to have been different?
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Did you breastfeed? If so, for how long and how was that experience?
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What are your plans for your child/children for this birth?
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Names and ages of your child/children?
*
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