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Birth Intentions & Preference Guide

Mossy Moon - Woven Wisdom BirthWork
Welcome! This guide was created to support the unfolding of birth with presence, clarity, and intention. To bring empowerment into spaces where those things are often overlooked.

Rooted in trust and flexibility, it offers space to explore what feels important to you — from how you’re cared for to how you move, speak, and make decisions in your birthing space.

Hospital and birth center births are no less sacred. Your experience matters— How you are spoken to, how you are touched, how you are witnessed. You deserve to be seen, heard, and deeply respected in every room you walk into.
✨ You can use it privately or choose to share it with me for support.
✨ You can download and/or print your responses at the end.

Parent (s) Name (s)

Estimated Due Date

Birth Location

Care Provider ( midwife/OB )

Type of birth

Type of birth

Support person (s) / Birth team ( doula, acupuncturist, massage therapist )

Cultural practices, ceremonies & Rituals

Labor Preferences:

Atmosphere

Atmosphere
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scents I prefer
What I prefer to burn - ( sage, palo santo, etc. )
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Support me best by..

Movement & Monitoring:

Movement & Monitoring:

Support me best by..

Mindful Pain Management:

Mindful Pain Management:

Support me best by..

Positions & Pushing:

Positions & Pushing:

Support me best by..

Intentional Delivery & Welcoming Baby:

Intentional Delivery & Welcoming Baby:

Support me best by..

Intentional Placenta Delivery & Rituals:

Intentional Placenta Delivery & Rituals:

Support me best by..

Feeding & Newborn Care Preferences:

Feeding & Newborn Care Preferences:

Support me best by..

Intentional Postpartum Care:

Intentional Postpartum Care:

Support me best by..

Intentional Cesarean Section Preferences :

Environment & Atmosphere

Environment & Atmosphere

Support me best by..

Mindfulness & Spiritual Practices :

Mindfulness & Spiritual Practices :

Support me best by..

Baby's Arrival & Connection:

Baby's Arrival & Connection:

Support me best by..

Bonding & Recovery :

Bonding & Recovery :

Support me best by..

Pictures are welcomed and encouraged during

Pictures are welcomed and encouraged during

Special Notes or Additional Preferences :

Date

Signature