Page 3 of 4 SOCIAL SUPPORT Who will be attending the birth? * If you have a partner, how involved do they plan to be? Do you have other children? * Yes No If so, what are their names and ages? Will they be attending the birth? Yes No Not sure yet Who will be responsible for them during the birth? Do you have any pets? * Yes No If so, what types? Who currently lives in your home? * What kind of social and/or family support do you have? * Do you have any help planned for your postpartum recovery? * Yes No If so, for how long? Are you currently attending any support groups? * Yes No Do you plan to attend any support groups after birth? * Yes No Not sure yet Do you have any specific family traditions, cultural practices, or religious customs related to pregnancy, labor, and birth that are important to include in your birth plan? If so, describe: For example: Specific diet during labor/birth/postpartum; specific postpartum care Thank you!