Client's Full Name *

Client's Email *

Time *

Date *

Gestational Age

Stage of Labor upon Arrival *

Contraction rate in the last hour *

2 Hour Birth Log

Client Mood *

Time of last meal *

Nausea/vomiting *

Comfort Measures Provided *

Dilation *

Effacement *

Station *

Medical Interventions *

Birth Outcome *

APGAR Score 1 *

APGAR Score 1 *

APGAR Score 2 *

APGAR Score 2 *

Immediate postpartum complication *

Time of Baby's First Feed *

Baby's Weight *

Other Intake Notes

Charting personnel *

Personnel Signature

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