Building Your Birth Plan: A Step-by-Step Template

A birth plan is a written document that communicates your preferences for labor, delivery, and immediate postpartum care to your medical team. It is not a rigid contract — birth is unpredictable, and flexibility is essential — but research published in the Journal of Perinatal Education shows that women who create birth plans report higher satisfaction with their birth experience, feel more in control, and communicate more effectively with their providers. ACOG supports the use of birth plans as a tool for shared decision-making between patients and their care teams. Include a copy in your hospital bag and review it alongside our natural birth vs. epidural comparison to clarify your pain management preferences.

📌 Key Takeaway: A birth plan is a communication tool, not a guarantee. Create it between weeks 28–32, review it with your provider, and bring printed copies to the hospital. Cover five key sections: labor environment, pain management, delivery preferences, newborn care, and emergency contingencies. Flexibility is essential — the ultimate goal is a safe delivery for you and your baby.

What Is a Birth Plan?

A birth plan is a one- to two-page summary of your wishes for labor and delivery. It helps your medical team understand your priorities quickly — especially useful since the nurse or doctor who assists you during delivery may not be the same provider you’ve seen throughout pregnancy.

Your birth plan should be:

• Clear and concise: One to two pages maximum. Long documents are less likely to be read during a busy labor ward.
• Flexible: Include phrases like “if possible” and “my preference is” rather than absolute demands.
• Discussed with your provider: Review your plan at a prenatal visit around weeks 30–32 so your OB or midwife can flag any concerns and confirm what your birth facility supports.
• Shared with your birth partner: Your partner or support person should know your preferences well enough to advocate on your behalf if needed.

💡 Tip: Bring three printed copies of your birth plan to the hospital — one for the nursing station, one for your labor nurse, and one for your personal reference. Digital backups on your phone are smart too, in case of shift changes.

When to Create Your Birth Plan

The ideal time to write your birth plan is between weeks 28 and 32 of pregnancy. This timing is strategic:

• By week 28, you’ve completed most prenatal education and have a clearer picture of your pregnancy health status.
• By week 32, you still have time to discuss the plan with your provider and make revisions.
• Before week 36, you want the plan finalized in case of early labor.

Use your Due Date Calculator to pinpoint exactly when to start drafting, and follow your progress with the Week-by-Week Tracker.

Section 1: Labor Environment Preferences

This section covers the atmosphere you want during labor:

• Who is in the room: Partner, doula, family member, no visitors until after delivery
• Lighting and sound: Dim lighting, music playlist, quiet environment
• Mobility: Freedom to walk, use a birthing ball, change positions freely
• Monitoring: Intermittent fetal monitoring (if low-risk) vs. continuous electronic fetal monitoring
• Hydration and nourishment: Ice chips only, clear liquids, light snacks (facility dependent)
• Photography or video: Whether you want photos/video during labor and delivery

📊 Key Data: A Cochrane Review of 5,218 women found that continuous one-on-one labor support (from a doula, partner, or dedicated nurse) reduced the likelihood of cesarean delivery by 25%, shortened labor by an average of 41 minutes, and decreased the use of pain medication. ACOG supports continuous labor support as beneficial for outcomes.

Section 2: Pain Management Options

Pain management is one of the most important sections of your birth plan. Understanding all available options beforehand allows you to make informed decisions during labor rather than reacting in the moment.

Pain Management Comparison Table

⚠️ Important: You do not need to commit to a single pain management strategy in your birth plan. Many women use a combination — for example, starting with breathing and hydrotherapy, then progressing to an epidural if needed. Write your plan as a preference order, not a rigid decision.

Section 3: Delivery Preferences

This section covers the actual birth:

• Pushing position: On back (lithotomy), side-lying, squatting, hands and knees, using a squat bar
• Directed vs. spontaneous pushing: Whether you want coached pushing (“Push now!”) or to follow your body’s urges
• Episiotomy: Your preference — ACOG does not recommend routine episiotomy and recommends it only when medically necessary
• Mirror: Whether you want a mirror to see the baby crowning
• Cord clamping: Delayed cord clamping (at least 30–60 seconds) is now recommended by both ACOG and the World Health Organization for full-term infants
• Cord cutting: Who cuts the cord — partner, provider, or you
• Skin-to-skin contact: Immediate skin-to-skin on your chest after delivery (recommended by ACOG for at least one hour)

Cesarean Section Preferences

Even if you’re planning a vaginal birth, include C-section preferences in case the situation changes:

• Gentle/family-centered cesarean: Lowered drape so you can see baby emerge, delayed cord clamping, immediate skin-to-skin in the OR
• Support person: Who is present in the operating room
• Music or narration: Whether you want your provider to describe what’s happening
• Breastfeeding: Initiation in the recovery room as soon as possible

Section 4: Newborn Care Preferences

Your birth plan should include decisions about your baby’s immediate care:

💡 Tip: If you plan to breastfeed, include a note requesting no formula supplementation without your consent, and ask for a lactation consultant visit within the first 24 hours. Early support significantly improves breastfeeding success rates.

Section 5: Emergency Scenarios

No one wants to think about complications, but having preferences documented in advance reduces stress if the unexpected happens.

Include preferences for:

• Emergency cesarean: Who stays with you, skin-to-skin if possible, who goes with the baby to NICU
• Postpartum hemorrhage: You trust your medical team to act; any blood product preferences or restrictions
• NICU admission: Whether your partner goes with the baby or stays with you, whether you want pumping support started immediately, when you’d like updates
• Unexpected outcomes: Whether you want clergy, chaplain, or specific family members contacted

⚠️ Important: Emergency situations require your medical team to act quickly. Your birth plan should acknowledge this with a statement like: “In an emergency, we trust our medical team to make decisions necessary for the health and safety of mother and baby.”

How to Discuss Your Birth Plan with Your Provider

Schedule a dedicated prenatal visit around weeks 30–32 to review your birth plan. Come prepared with questions:

1. “Does the hospital support this?” Not all facilities offer nitrous oxide, water birth, or wireless monitoring.
2. “Under what circumstances would you recommend deviating from my plan?” This helps you understand realistic scenarios.
3. “Can you add a copy to my chart?” Ensures the plan is accessible even if you forget printed copies.
4. “Who will be on call when I deliver?” If your provider works in a group practice, other doctors may attend your delivery.

A productive conversation with your provider ensures your plan is realistic for your specific health situation and your chosen facility’s capabilities.

Sample Birth Plan Template

Here is a condensed template you can customize:

Patient: [Your name] | Due date: [Date] | Provider: [Name] | Hospital: [Name]

Labor Preferences:

• Support people: [Names]
• Environment: [Dim lights, music, quiet]
• Mobility: I prefer to move freely during labor
• Monitoring: Intermittent monitoring if baby and I are low-risk

Pain Management (in order of preference):

1. [Non-medical options first — breathing, movement, hydrotherapy]
2. [Nitrous oxide if available]
3. [Epidural if I request it — please do not offer repeatedly]

Delivery:

• Pushing position: [Preference, but flexible]
• Delayed cord clamping: Yes, at least 60 seconds
• Cord cutting: [Partner / provider]
• Immediate skin-to-skin: Yes, for at least one hour

Newborn Care:

• Feeding: [Breastfeeding / formula / combo]
• Delay first bath: Yes, 24 hours
• Vitamin K: Accept
• Rooming-in: Yes

Emergency:

• In an emergency, we trust our medical team to act in the best interest of mother and baby
• Partner goes with baby to NICU; please update me as soon as possible

FAQ

Do I really need a birth plan?

A birth plan is not required, but it is strongly recommended by ACOG as a communication tool. It helps your labor team understand your priorities quickly, especially if they have not met you before. Women who create birth plans consistently report feeling more in control and more satisfied with their birth experience, according to research in the Journal of Perinatal Education.

What if my birth doesn’t go according to plan?

This is expected and normal. A birth plan documents your preferences, not guarantees. Approximately 30% of births in the United States involve unplanned interventions. The plan ensures your team knows your preferences while acknowledging that medical decisions may need to override them. Include flexible language and an emergency section to prepare for this.

Should I include a birth plan for a scheduled cesarean?

Absolutely. Even for a planned cesarean, you have choices: gentle/family-centered cesarean with lowered drape, delayed cord clamping, immediate skin-to-skin in the OR, who is present, music in the operating room, and breastfeeding initiation in recovery. Document these preferences just as you would for a vaginal birth.

How long should my birth plan be?

One page is ideal; two pages maximum. Labor nurses are busy and need to absorb your key preferences quickly. Use bullet points and clear headers. Avoid lengthy paragraphs or explanations of your research — the plan should communicate decisions, not reasoning. Highlight your top three priorities at the very top for quick reference.

References

• American College of Obstetricians and Gynecologists. “Preparing for Labor and Delivery.” acog.org
• World Health Organization. “Delayed Cord Clamping.” who.int
• Bohren, M.A. et al. (2017). “Continuous Support for Women During Childbirth.” Cochrane Database of Systematic Reviews. cochrane.org
• Mayo Clinic. “Birth Plan: How to Prepare.” mayoclinic.org
• American Academy of Pediatrics. “Vitamin K and the Newborn.” aap.org

Written by

Vega Lin

Founder & Editor — Mother of 2 (Taiwan)

Vega writes Pregnancy Guide from the intersection of evidence-based research (ACOG, CDC, WHO) and her own experience as a mother of two. Completing her Master's in Digital Innovation at Tunghai University. Read more →

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