Documentation: Early Labor Client name * First Name Last Name Date notified * MM DD YYYY Time notified * Hour Minute Second AM PM Notified by * client client's partner client's relative client's friend doula colleague management L&D staff other Location(s) of services * client's home office space community space hospital birth center virtual other Initial symptoms reported * increased braxton hicks labor contractions menstrual-like cramps spontaneous rupture of membranes loss of mucus plug (with blood) loss of mucus plug (without blood) vomiting nausea general illness irregular bowel movements mood changes other induction of labor (client-initiated) induction of labor (clinical) General disposition * GBS status * If positive, client should be counseled on the protocol of antibiotics. negative positive unknown Is the client at risk for any complications? * gestational diabetes gestational hypertension preeclampsia preterm delivery placental condition blood condition intrauterine growth restriction low amniotic fluid insufficient cervix other none Has the client been diagnosed with any conditions? * gestational diabetes gestational hypertension preeclampsia preterm labor placental condition blood condition intrauterine growth restriction low amniotic fluid insufficient cervix other none Services provided * observed contractions provided reminders for breath work recited positive affirmations advised client to contact on-call provider constructed custom circuit reviewed comfort measures reviewed laboring positions counseled labor support people provided reminder for car seat provided reminder for hospital bag provided reminder for breast pump/breast milk counseled client on nutrition/hydration supported client in arranging plans for other household members counseled client on when to report to hospital/birth center Follow-up plan * doula to report to client's home doula to meet client at hospital/birth center doula to return to hospital/birth center for active labor doula to check in with client periodically client to inform doula on transfer timeline other General concerns * Recommendations * Resources * Total number of early labor support hours provided * Signed (doula provider) * Your changes have been saved.
