Table 2.

Suggested Contents of the Written Delivery Plan.^a

Content Item	Comments
Statement that plan was developed in consultation with parent(s)
Planned site for delivery
Planned mode of delivery	Include indications for deviating from this plan
Hemostatic therapy for delivery for mother, if indicated	Develop in consultation with adult hematologist
Plans or contraindications to regional anesthesia for mother	Develop in consultation with adult hematologist and obstetric anesthesiologist
Services to be notified at onset of labor: NICU, HTC, coagulation laboratory, blood bank (if factor stored there)	Include specific contact information: names, pager, or phone numbers. Coagulation laboratory should prepare to measure FVIII or FIX level “stat”
Avoid operative vaginal delivery (vacuum, forceps)
Avoid invasive monitoring of fetus (scalp electrode)
Obtain cord blood sample for confirmation of diagnosis	Send to coagulation laboratory “stat”
Factor concentrate to be used	Identify specific person(s) or other resource (printed or online material) that can give information about reconstitution
Location of factor concentrate
Ensure availability of factor concentrate at onset of labor
Plan for prophylactic factor replacement for newborn	Include specific product, dose, vial size, and instruction about whether to use entire vial
Plan for empiric factor replacement for newborn	Include specific product, dose, vial size, and instruction about whether to use entire vial
Plan for screening neuroimaging for newborn	Include modality and timing
Planned route and dose of vitamin K	If PO, include plan for ensuring all doses are given. If IM/SC, apply pressure to the site for 5 minutes
Statement about other heel pokes, venipuncture, and other needle pokes	Use smallest possible needle/lancet. Apply pressure to the site for 5 minutes

Abbreviations: HTC, Hemophilia Treatment Center; IM, intramuscularly; NICU, neonatal intensive care unit; PO, orally; SC, subcutaneously.

^aA copy of the written delivery plan should be given to the parents to bring to the delivery. The written delivery plan should be available in the caseroom where delivery is planned to occur, and it should also be on file at the Hemophilia Treatment Centre (HTC).