Birth Plan Template

A birth plan is a document that outlines your preferences regarding labor and delivery. An expectant mother usually writes a birth plan, but anyone involved in a birthing situation can contribute to this plan.

Table of Contents

• What Is a Birth Plan?
• How to Write a Birth Plan
• Types of Births to Indicate in Your Birth Plan
• Tips for Writing a Birth Plan
• Birth Plan Sample
• Frequently Asked Questions

What Is a Birth Plan?

A birth plan is a written checklist of what to consider before, during, and after giving birth. Your birth plan may include who you want present during labor, whether you want pain medication or medical interventions, and the ideal environment.

This plan helps you emphasize your preferences and options so you can have a less stressful experience. It can also help you feel more comfortable if any issues or unforeseen circumstances arise.

How to Write a Birth Plan

Here’s a list of steps on how to write a birth plan:

Step 1 – Fill in the Basic Information

The first step in writing a birth plan is to fill in your basic details, such as your name and due date. You must also provide the following information:

• Where you want to give birth
  • You can give birth at home, in the hospital, at a birth center, or some other location you specify.
• Name of your doctor or main caregiver
• Name of your support person and their relationship to you

Step 2 – Decide What Happens Before Delivery

Specifying the conditions you’d like to have before giving birth is an option available to you as an expectant mother. Some example conditions could be one or a combination of any of the following:

• I would like it to be as quiet as possible.
• I would like music to play in the background.
• I would like the lights dimmed.
• I would like limited staff (no students, interns, etc.).
• I would like a birthing ball, tub, chair, or stool.

If you have anything else in mind, mention it here.

Step 3 – Decide What Happens During Delivery

There are multiple aspects of labor that you need to consider before you give birth:

Laboring

You can express preferences for baby monitoring while you’re in labor. Some people may want the medical team to monitor the baby’s heart rate regularly, while others may want monitoring to commence if the baby’s in distress.

You can also consider your desired positions for labor and birth to increase your comfort levels. Talk with your healthcare provider to determine if you want to sit, stand, lie down, or even walk around during this stage.

Pain Management

Speak with your healthcare provider about what your birth center or hospital provides and decide your preferences. Although it is common not to know what you want for pain relief until you are actually in labor, you can still consider your options for managing labor pain beforehand.

Some techniques will relieve labor pain without medications, whereas others are medical. For example, you can indicate that you want breathing techniques, cold therapy, meditation, or acupuncture. Or, you can express that you want an epidural when labor is painful.

Labor Augmentation

Labor augmentation helps make labor more efficient and increases the chance of achieving a vaginal delivery. Augmentation of labor is used to help labor back on its path when the process slows down or stops. Some mothers may prefer to have labor augmentation performed only when the baby is in distress.

Birthing & Pushing

In this section, you specify preferences for the birthing and pushing phase of labor. You can make decisions on the following:

• The method you plan to use to give birth
  • Vaginal, C-Section, etc.
• The position you prefer to give birth in
  • Squatting, standing, lying down, or on your hands and knees
• Your preferences for giving birth
  • Being coached on when to push
  • Pushing on your own as much as possible
  • A support person to catch the baby
  • Seeing your baby’s crown
  • Having a support person to suction
• Additional preferences
  • The use of forceps: Forceps are a medical tool that resembles the shape of large tongs. The doctor will grasp the baby’s head with forceps during a forceps delivery to gently guide them out of the birth canal.
  • The use of vacuum extraction: Vacuum extraction is a method to assist the delivery using a vacuum device.

Episiotomy

Episiotomy is a procedure where a doctor makes a small cut to widen the opening of the vagina when a woman is giving birth. You may choose to have this procedure as part of your birth plan to avoid bigger tears later in delivery. This procedure may also help if the fetus is stressed and needs to be delivered quickly.

Step 4 – Decide What Happens After Delivery

Once you’ve given birth, you can express preferences for several things:

• The use of Pitocin or Oxycontin
  • Pitocin can help some women go into labor faster. You should seek professional medical advice to discuss how any side effects could affect your body.
• When you want to hold your baby
  • E.g. Skin-to-skin contact after delivery
• Umbilical cord and placenta
  • Umbilical cord: You can choose to have the umbilical cord cut and decide who should do the cutting, e.g., your partner or a medical professional. Or you can bank or donate the cord blood. If you have other preferences, express them here.
  • Placenta: You can request to see the placenta before anything is done to it. Or you can have the placenta discarded, encapsulated, or delivered yourself. Again, if you have other preferences, you can express them here.
• Breastfeeding
  • If you would like to breastfeed your baby, you can decide when you want to do it. For example, you can choose to breastfeed as soon as possible or on a schedule.
• Baby’s treatment
  • You can express when you’d like your baby to stay in your room and when and how you’d like the doctor to give a medical exam (e.g., in front of you or your partner).
  • Examinations: Routine procedures are usually given to the newborn after delivery. Doctors commonly perform the heel stick procedure, hearing screen test, and Hepatitis B vaccination. You should speak with your caregiver or doctor about the purposes and effects beforehand to ensure what tests you want to include.
  • You can also express that you do not want the baby to receive the following treatments:
    • Vitamin K
    • Antibiotic eye treatment
    • Sugar water
    • Formula
    • A pacifier
• Circumcision
  • If you want your baby to be circumcised, you can detail your preferences as to how you would like the circumcision to be done in this section. It can be done as soon as possible or later with anesthesia. You can also indicate whether you or your partner would like to be present during the procedure.

Step 5 – Fill in the Final Details

You can specify how many visitors you want to see you and the baby. Remember to include their names so they have the necessary authorization. You can also decide when you would like to see them after delivery, such as immediately after delivery or after the baby’s first feeding.

If you have any other special requests regarding your birth, you can include them here. For example, you may want someone to record the birth process on video or take pictures.

Types of Births to Indicate in Your Birth Plan

Here are some preferences for delivery methods you can indicate in your birth plan:

Natural Birth Plan

A natural birth plan includes a vaginal delivery where your baby is born through the birth canal. There are no machines for continuous fetal monitoring.

Birthing can occur naturally without pain medication or artificial medical intervention. A trained midwife or a doula (labor assistant) usually guides the mother through the birthing process.

Vaginal Birth Plan

A vaginal birth plan includes a vaginal delivery where your baby is born through the birth canal. The delivery typically takes place in a medical facility, and the mother is usually guided through the birthing process by a licensed medical professional such as a doctor or nurse.

The birthing process can progress naturally, with or without pain medication or artificial medical intervention, such as an epidural injected into your lower back near your spinal nerves to block labor contractions.

Induction Birth Plan

An induction birth involves planned procedures where your doctor or midwife helps start your labor contractions, typically because they aren’t starting independently.

Methods include applying topical prostaglandin to the cervix, membrane sweeping to help your water break, or administering labor-inducing Pitocin meds through an IV.

C-Section Birth Plan

A Cesarean-section birth plan, or C-section, is the surgical delivery of a baby through a surgical cut or incision in a woman’s abdomen and uterus.

After a medical team removes the baby from the womb, they close the uterus and abdomen with stitches that later dissolve.

If you or your baby are under dire stress and you need to deliver the baby urgently, your doctor may decide to perform an emergency C-section. You can have any of the following preferences:

• I would like a second opinion.
• I would like to make sure other options have been exhausted.
• I would like to stay conscious.
• I would like my partner to remain with me the entire time.
• I would like the screen lowered so I can watch the baby come out.
• I would like my hands left free so that I can touch the baby.
• I would like the surgery explained as it happens.
• I would like an epidural for anesthesia.
• I would like my partner to hold the baby as soon as possible.

VBAC Birth Plan

VBAC is “vaginal birth after cesarean” delivery and refers to giving birth through the vaginal canal after a woman has already had a C-section. You’ll follow the same process for any natural vaginal delivery when you enter labor.

Home Birth Plan

A home birth occurs in a residence rather than a birthing center or hospital. A registered nurse-midwife, certified midwife, a trained doula with experience managing home births, a doctor, or an obstetrician usually attend home births.

To be less intrusive, only periodic monitoring of your temperature, pulse, blood pressure, and your baby’s heart rate takes place.

Home birth plans are customarily followed more closely to meet the birth mother’s preferences while giving birth in a home setting.

Tips for Writing a Birth Plan

Follow these tips when writing a birth plan:

Include a Contingency Plan

The labor and delivery process will go exactly as your birth plan describes in an ideal situation. But sometimes, complications can occur, and preferences such as having a home birth may no longer be safe for you or your unborn child.

If the unexpected happens, you should consider creating a contingency plan with backup options. For example, you may need to have an emergency C-section. In this case, you can specify you’d prefer a gentle C-section or a vaginal seeding procedure.

Educate Yourself

Consider completing a childbirth preparation program before attempting to write your birth plan. You can educate yourself on the different options for pain management, medical interventions, and other aspects.

If you are running out of time before delivery, try reading a book on childbirth preparation or watching a video course to enhance what you already know and present you with more possible choices.

Be Concise

Be concise in your birth plan by writing your preferences in short, clear sentences. Ask members of your birth team to proofread your birth plan for clarity so you can simplify any of your points if necessary.

Birth Plan Sample

Below is a sample natural birth plan template you can download in PDF or Word format.

Frequently Asked Questions