• Skip to main content
  • Skip to primary sidebar
  • Skip to footer

Legal Templates

Legal Templates
  • Business Forms
    Business & Contracts

    All of our legal contracts and documents are drafted and regularly updated by attorneys licensed in their respective jurisdictions, paralegals, or subject matter experts. Save your hard-earned money and time with Legal Templates.

    Top Business Forms
    Business Formation
    • Business Plan
    • LLC Operating Agreement
    • Articles of Incorporation
    • Corporate Bylaws
    • Buy-Sell Agreement
    Business Operations
    • Business Contract
    • Partnership Agreement
    • Non-Disclosure Agreement
    • Release of Liability
    • Letter of Intent
    Sales and Payments
    • Purchase Agreement
    • Sales Agreement
    • Invoice
    • Purchase Order
    • Business Purchase
    Employment and HR
    • Employment Contract
    • Employment Offer
    • Employment Verification
    • Freelance Contract
    • Non-Compete Agreement
    View All Business Forms
  • Real Estate Forms
    Real Estate

    All of our legal contracts and documents are drafted and regularly updated by attorneys licensed in their respective jurisdictions, paralegals, or subject matter experts. Save your hard-earned money and time with Legal Templates.

    Top Real Estate Forms
    Landlords
    • Lease Agreement
    • Property Management
    • Eviction Notice
    • Late Rent Notice
    • Lease Termination
    Tenants
    • Room Rental
    • Sublease Agreement
    • Roommate Agreement
    • Notice to Vacate
    • Early Lease Termination
    Home Ownership
    • Real Estate Purchase Agreement
    • Mortgage Deed
    • Quitclaim Deed
    • Deed of Trust
    • Moving Checklist
    View all Real Estate Forms
  • Personal & Family Forms
    Personal and Family

    All of our legal contracts and documents are drafted and regularly updated by attorneys licensed in their respective jurisdictions, paralegals, or subject matter experts. Save your hard-earned money and time with Legal Templates.

    Top Personal and Family Forms
    Estate Planning
    • Power of Attorney
    • Last Will & Testament
    • Living Will
    • Advance Directive
    • DNR Form
    Personal Finance
    • Bill of Sale
    • Loan Agreement
    • Purchase Agreement
    • Promissory Note
    • Sales Agreement
    Family Matters
    • Parenting Plan
    • Child Travel Consent
    • Divorce Agreement
    • Separation Agreement
    • Prenuptial Agreement
    Affidavits
    • General Affidavit
    • Gift Affidavit
    • Affidavit of Identity
    • Affidavit of Residence
    • Affidavit of Death
    View All Personal Forms
  • Support
    Resources
    • Business
    • Real Estate
    • Personal and Family
    • Financial
    • Estate Planning
    Support
    • About Us
    • Careers
    • Contact Us
    • All Legal Documents

    Monday - Friday | 9AM - 7PM EDT

    (855) 335-9779

  • Sign In
  • :email

Home Personal & Family Documents Birth Plan

Free Birth Plan Template

Use our Birth Plan template to design your ideal birthing situation. You can choose how you’d like to have labor and how you’d like your baby to be delivered.

Updated May 2, 2022

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 may create a birth plan. 

Table of Contents
  • What Is a Birth Plan?
  • How To Write a Birth Plan
  • Sample Birth Plan
  • Tips for Writing a Birth Plan
  • Birth Plan Frequently Asked Questions 

What Is a Birth Plan?

A birth plan functions as 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, medical interventions, or even if you wish to have music playing in the background. 

You should give a copy of the birth plan to everyone on the birthing team, including your health care providers and anyone else who will be in the room during the birth experience. 

There are numerous options available as birth plans can cover many birthing possibilities:

Natural Birth Plan

A natural birth plan consists of a vaginal delivery where your baby is born through the birth canal. There are no machines for continuous fetal monitoring. The birthing process can occur naturally, without pain medication or artificial medical intervention. The mother is usually guided through the birthing process by a trained midwife or a doula (labor assistant).

Vaginal Birth Plan

A vaginal birth plan consists of 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, which is 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 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 the baby is removed from the womb and handed to the pediatricians, the uterus and abdomen are closed with stitches that later dissolve.

Gentle C-Section Birth Plan

A gentle C-section is essentially a surgical birth incorporating aspects of vaginal birth, with similar treatment of the baby immediately after the surgery. In a gentle c-section, the medical professional gently pulls the baby’s head from the womb, then slowly, the rest of the baby’s body is delivered. The umbilical cord is not cut immediately. This procedure allows the baby to be placed on the mother’s chest for immediate skin-to-skin contact and initiate breastfeeding if that is the mother’s choice.

VBAC Birth Plan

VBAC stands for “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 used for any natural vaginal delivery when you go into labor. 

Home Birth Plan

A home birth takes place 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.

How To Write a Birth Plan

Step 1: Fill in 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 choose to give birth at home, in the hospital, at a birth center, or some other location you specify. 
  • Name of doctor or main caregiver 
  • Name of your support person and their relationship to you 

    • A support person should be someone you can feel comfortable with during the delivery. It is also essential to choose a person who will be there when you go into labor. Some prefer having a woman in the room. You should check with your doctor, midwife, hospital, or birthing center about how many support people can be in the room with 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 playing in the background
  • I would like the light dimmed
  • I would like limited staff (no students, interns, etc.)
  • I would like a birthing ball
  • I would like a birthing tub
  • I would like a birthing 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. This is where the baby’s heart rate is monitored regularly through labor to assess the baby’s well-being. You may only want the baby to be monitored if in distress. 

The position you choose for labor and birth is important; it can help you be more comfortable during the labor process. Some positions may even help speed up the process of labor. Having preferences for the first stage of labor is also common. You may want to sit, stand, lie down or even walk around during this stage. 

Pain Management

Speak with your health care provider about what is provided at your birth center or hospital, and decide your preferences. Although it is common not to know what you want for pain relief until you are actually in labor, it is recommended that you consider options for managing labor pain beforehand. 

Some techniques will relieve labor pain without medications, whereas others are medical. For example, you can express that you would like an epidural when labor becomes particularly 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

This section is where 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 crown
      • Having a support person to suction
  • Additional preferences
    • Using 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.
    • Vacuum extraction: a method to assist the delivery using a vacuum device. 

Both forceps and vacuum extraction are delivery methods that guide the baby out of the birth canal. There are certain risks related to both methods. Therefore you must discuss the effects they may have on your delivery.

Episiotomy

Episiotomy is a procedure where a small cut is made to widen the opening of the vagina when a woman is giving birth. Situations where an episiotomy will help could include when the fetus is stressed and needs to be delivered with assistance rather quickly or to avoid bigger tears later on during delivery.

C-Section

If you or/and your baby are in dire stress and immediate delivery is required, 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

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 avoid serious medical interventions. It is recommended that you 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, 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 vaccinate the baby for Hepatitis B. You should speak with your caregiver or doctor about the purposes and effects beforehand to make sure what methods 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 at a later time, with anesthesia or 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 would like to see you and the baby. Remember to include their names, so they have the necessary authorization. You can also decide when after delivery you would like to see them, such as immediately after delivery or after the baby has had its first feeding. 

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

Should Be Included in a Birth Plan

When deciding what to put on your birth plan, include the following information to help provide the birthing team with an outline of your preferred birthing experience: 

  • Primary Information: List your name, your partner’s name, your doctor’s name, and complete contact information. Name your selected birthing facility.
  • Pain management: You can state early on that you want to have a birth plan epidural. Even if you may not plan to have one, you could change your mind during labor. 
  • Environment: Depending on where you choose to give birth, you can indicate your preferences regarding lighting, sounds, music, or even have photos/videos taken during and after labor.
  • People present: While you can’t control the number of medical providers present, you can designate which family members or support people will attend the birth and be allowed visitation rights.
  • Labor & Delivery preferences: You can indicate whether you’d prefer to labor in water or use a birthing chair, ball, or stool. You can also state what medical procedures are acceptable, like having an episiotomy, with or without local anesthesia. Or you can specify that you want to use a mirror to see your baby crowning. 
  • Post-delivery preferences:  In this section, you can decide if you would like your partner to cut the umbilical cord and whether the baby should be placed on your abdomen right after the delivery or c-section.
  • Feeding and care in the hospital: You may request uninterrupted skin-to-skin contact with your newborn or include instructions for the baby’s first bath, where the baby will sleep, and if the newborn is a boy, whether a circumcision should be performed. 

‌By including this information in your plan, you will avoid having to explain your preferences at an inconvenient time, such as during labor. However, keep in mind that in the event of an emergency, the medical team may override your preferences if they believe your health or the health of your unborn child is at risk

Sample Birth Plan

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

Birth Plan

Birth Plan Template screenshot

Download PDF
Download MS Word

Tips for Writing a Birth Plan

Include a contingency plan

The labor and delivery process will go exactly as described in your birth plan 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. You should consider creating a contingency plan with backup options in case the unexpected happens. For example, you may need to have an emergency caesarian. In which case, you can specify you’d prefer a gentle c-section or for the medical team to perform a vaginal seeding procedure.

Educate yourself about your choices

Consider completing a childbirth preparation program before attempting to write your birth plan.  When it comes to pain management, medical interventions, and c-sections, doctors want to know that you understand what you are requesting them to do.

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. To learn about options for pain control, birthing positions, delivery methods, and newborn care, take a tour of your birthing facility before you deliver and discover what’s available.

Birth Plan Frequently Asked Questions 

When should I write a birth plan?

You should write a birth plan as early as possible. In general, the second trimester is a good time to start thinking about creating one. As some babies arrive early, it may be a good idea to write a birth plan between weeks 32 through 36.

Do you have to have a birth plan?

No, you do not have to have a birth plan in place. However, consider that creating a birth plan allows you to design an ideal labor situation and may positively affect your overall labor experience.

Related Health & Medical Documents

View All Documents

Establish End-of-Life Wishes

  • Advance Directive
  • DNR Form
Birth Plan Template screenshot

Free Birth Plan Template

Create Your Birth Plan in Minutes!

Legal Documents

  • All Legal Forms
  • Business Forms
  • Real Estate Forms
  • Personal and Family Forms

Popular Forms

  • Lease Agreements
  • Power of Attorney Forms
  • Eviction Notice
  • Living Will
  • Non-Disclosure Agreement

Resources

  • Legal Resources
  • Business
  • Real Estate
  • Personal & Family
  • Estate Planning
  • Financial
  • Covid-19 Resources

Company

  • Pricing
  • About Us
  • Careers
  • Contact Us
  • Partner With Us
  • Legal Dictionary

Users

  • Account
  • Terms of Use
  • Privacy Policy
  • Do Not Sell My Personal Information
McAfee - Together is power.
Trustpilot
Legal Templates BBB Accredited Business

(855) 335-9779, Monday-Friday, 9AM - 7PM EDT

Facebook Twitter LinkedIn

Copyright 2023 Legal Templates LLC. Legal Templates LLC is not a lawyer, or a law firm and does not engage in the practice of law. Legal Templates cannot and does not provide legal advice or legal representation. All information, software and services provided on the site are for informational purposes and self-help only and are not intended to be a substitute for a lawyer or professional legal advice. Our legal contracts and documents are drafted and regularly updated by attorneys licensed in their respective jurisdictions, paralegals, or subject matter experts. Use of this site is subject to our Terms of Use. Legaltemplates.net is owned and operated by Resume Technologies Limited, London with offices in London United Kingdom.

Thank you for downloading one of our free legal templates!

Would you leave us a review?

We hope you've found what you need and are able to avoid the time, costs, and stress associated with dealing with a lawyer.

A review would mean the world to us (it only takes about 15 seconds).

Please check your download folder for MS Word or open tabs for PDF so you can access your FREE Legal Template Sample

Thanks again, and good luck!

Leave My Review