Custom Kit Form for Midwives Only!

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	MIDWIVES! CLICK HERE TO SET UP A BIRTH KIT AND GET 10% OFF PLUS A $25 GIFT CERTIFICATE!!

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THIS FORM IS FOR MIDWIVES ONLY!
Set up your custom kit with us and get a coupon for 10% off your next purchase with us! And don't forget, once we've received 5 orders of your birth kit, we send you an additional $25 Gift Certificate!!
10% discount may not be used on pools, dopplers or hemoglobinometers.

If you are a private client of a midwife or planning an unassisted birth and wish to formulate a birth kit of your own choosing, you may use this form as a guide, but use the shopping cart to place your order. THANK YOU!
Please include quantity, sizes and types in the fields provided.

Basic Underpads 23x24":

Basic Underpads 23x36":

Deluxe Underpads 23x36":

Deluxe Underpads 30x36":

Alcohol Prep Pads:

Plastic Sitzbath:

Plastic Backed Sheet:

OB Pads: Choose from (1) Sterile, (2) Non-sterile, and (3) Non-sterile with wings - packs of 12; and Peach Contour OB pads, 7x13" in packs of 20 or as singles; Capri Regular, Large, and X-Large in any amount combination (compare Capri to Molimeds) Please include Type AND Amount:

OB Pad for Heavy Afterbirth with Adhesive, 28" in length:

Sterile Gloves Pairs: Choose Latex (S/M/L), Synthetic (S/M/L), Aloetouch (S/M/L), Dynarex (S/M), Protegrity (6/6.5/7/7.5/8/8.5) and Please include Size, Type AND Amount):

Sterile Gloves Single: Choose Latex (S/M/L), Synthetic (S/M/L) & Aloetouch (S/M/L) and Please include Size, Type AND Amount:

Mesh Panty (any amount), Protection Plus Underwear (Depends-style, any amount), or Smart Choices Hipster (Box of 3)Please include Type AND Amount:

Perineal Bottle:

Perineal Packs: Choose (1) Cold w/adhesive; (2) Warm w/adhesive, (3) Cold w/o adhesive and (4) Hourglass Cold w/o adhesive Please include Type AND Amount:

Bulb Syringe (2 or 3 ounce, choose Davol or Economy) Please include Type AND Amount:

Digital Thermometer (Standard - 60 sec or Flexible tip - 9 sec):

Gauze: (1) AMD 12-ply, (2) Medline 8-ply, (3) Medline 12-ply, (4) Tray of 10 - 12 ply, (5) Curity Nonwoven Fabric 12-ply, (6) McKesson Non-woven Sponges 4-ply), (7) Avant Gauze Sponges, 6-ply Please include Type AND Amount:

Straws:

Paper Tape Measure, 36 or 72":

Newborn Hat (Choose Economy or 100% Cotton and indicate number desired) Please include Type AND Amount:

With 100% Cotton Hat, clients can choose white, blue or pink.

Povidone Solution (Choose from 4 oz or 8 oz) or PeriClens by Shonda Parker:

Povidone Scrub Brush:

Dyna-hex (Hibiclens) Solution (4 oz. size):

Dyna-hex (Hibiclens) Scrub Brush:

Lubricating Jelly (choose 3g, 5g, 2 oz, and 4 oz) Please include Type AND Amount:

Mattress Cover (clients choose from king or queen):

Cord Clamps, Cord Rings, Cord Bands or Sterile Cord Tape Please include Type AND Amount:

Emesis Basin (Choose Kidney-shaped or 6-Quart):

Fracture Bedpan:

Kleenprint Footprinter:

Homebirth Certificate, clients choose from 3 styles:

Afterbirth Sitz 4 oz, Choose from Soothing Sitz - $6.50, Wishgarden - $8.50, Intimate Solutions Sitz - $6.95; Other sizes available in Soothing Sitz (8, 16 oz) and Intimate Solutions (8 oz):

Perineal Massage Oil, Wishgarden - 4 oz or Olive Oil in 4 or 8 oz:

Infant Heel Warmer:

Lansinoh Lanolin, 1.41 oz or 0.25 oz:

Birth Pool Liner, specify type (Aquaborn, La Bassine, BPIAB or Generic for All Pools:

Shoulder Length Gloves:

Waterbirth Net:

Delee Trap (8 or 10 Fr), Available in regular with contro-vac valve or Argyle style Please include Type AND Amount:

Oral Vitamin K for baby - K-Quinone:

Amnihook:

Amnicot:

Amnicator:

Infant Lancet, choose from these lancets: