How To Create A Birth Plan: What To Include?

Learn why you should create a birth plan, and what information you should include about your preferences for labor, delivery, pain relief and newborn care.

From getting the house ready to packing a hospital bag, there are a lot of steps involved in preparing to welcome your new baby. 

One step to make sure you cover before your little one makes their entrance? Preparing a birth plan, or a document that covers all of your wishes and preferences for giving birth to your little one. 

Today, we're covering the most important sections and points to include in a birth plan, from the environment you would like during labor, to the use of pain relief methods, to the labor and delivery positions  you'd prefer.

Why Make A Birth Plan?

Yes, things can change --- and many aspects of birthing may move out of your control. Sometimes, doctors and nurses have no choice in how they need to proceed. So you'll likely need to be flexible.

But a prepared birth plan lets your doctors know how you'd like the birth of your little one to proceed, assuming there aren't any sudden curveballs. 

A birth plan makes it easy to express your wishes to a doctor or birthing assistant before the birth (which you should be doing anyway)! 

It also makes your wishes easy for them to remember, and makes advocating for yourself easy, even if you're unable to verbally communicate during moments of giving birth. 

And it lets you focus on what's most important: welcoming your new little one.

When To Write A Birth Plan?

You can start thinking about --- and possibly recording --- your wishes for baby's birth as early as the second trimester. 

Then, between week 32 and week 36, you should put your detailed birth plan in writing.

This should give you time to review your birth plan with:

  • Your doctor
  • Your partner
  • Your doula, midwife, or birthing assistant, if you'll have one
  • Anyone else who may be assisting with the birth

What To Include In A Birth Plan?

Although you'll want your birth plan to be easy to follow, it's still best to include all the essential information about your birth preferences. 

The purpose is to let your doctor know what you're okay with during labor, delivery, and the moments after giving birth, and what you want to avoid at all costs.

Mama Natural has a visual birth plan template that's fully customizable and simple for doctors to follow. Access the easy plan here.

Or, you can use the following template to help you write up your own birth plan:

Information:

  • Your name
  • Partner's name
  • Name of birthing assistant
  • Today's date
  • Due date or induction date
  • Doctor's name

My Birth Preferences:

  • Top 3 priorities
  • Type of delivery 
  • People in room with me
  • Labor environment preferences
  • Preferred labor position 
  • How I'd like baby to be monitored 
  • Pain relief preferences
    • Methods to use
    • Methods to avoid
  • Delivery position preferences 
  • Episiotomy?
    • Perform at all? (Yes/No)
    • Perform when?
    • Pain relief
  • Labor augmentation?
    • Perform when?
    • Preferences
  • Other labor/delivery preferences
  • Caring for baby?
    • When I want to hold baby
    • Skin-to-skin contact
    • Feeding
    • How often I want baby in the room
  • Other notes

Watch this video from the St. Louis Children's Hospital to learn more tips on how to develop a birth plan:

Key Information About You

At the top of the birth plan, include the following info. That way, your doctor can easily identify the birth plan as yours.

  • Your name
  • Your partner's name
  • The name of the main person you plan to have assist you with the birth, if different from your partner 
  • Date that you're filling out the birth plan 
  • Baby's due date or induction date
  • Doctor's name

Birth Plan Essentials

Right after you list your info, list the three most important points you'd like the doctors to prioritize during the birth (if circumstances allow). List them in the order of importance.

For example, is it key that you can walk around during the first stage of labor, if possible?

Or, is it most important that you get to hold baby skin-to-skin directly after giving birth?

You can go into detail about all your preferences below this section, but knowing what's most important to you is very helpful for your doctor.

Type Of Delivery Planned 

How do you plan to deliver your baby --- where, and with what type of delivery?

  • Vaginal birth in the hospital?
  • Vaginal birth at a birthing center?
  • At-home birth?
  • Water birth?
  • A "gentle cesarean section?"
  • A standard cesarean section?
  • VBAC (vaginal birth after a C-section?

Who Will Be In The Room?

Who would you like with you during the birth? List their names and their relationship to you: 

  • Your partner?
  • Your doula?
  • Your parent(s)?
  • Other children of yours?
  • Other family members?
  • Close friends?

Out of the people you've listed, who would you ideally like present before labor? During labor? Both?

And would you like your partner --- or another close family member or friend --- to be present for the entire time during labor?

Preferences For The Labor Environment 

While giving birth, would you like:

  • The lights dimmed, to help you relax and feel less exposed?
  • Calming music playing (that you'll bring with you)? 
  • Essential oils diffusing?
  • A room that's as quiet as possible?
  • A TV in the room?
  • Only your own doctor and nurses present, and no other hospital staff (no residents, students, or interns allowed)?
  • Interruptions to be minimized?
  • The fewest number of vaginal exams possible?
  • Hydration (clear liquids, ice chips) readily available?
  • Opportunities to eat and drink, if your doctor approves? (Many doctors don't allow eating and drinking during labor, but if you can eat or drink, it will help you keep your strength up when you need it most!)
  • Anything else that will make the environment more comfortable for you?

Preferences For Labor Position

  • Would you like to walk around as freely as possible during the first stage of labor?
    • Do you want to avoid IVs for any and all reasons, so you'll be able to move freely?
  • Would you prefer to stand up, or lie down, during labor?
  • Would you like to take a bath or shower during the first stage of labor? 

 

Preferences for Monitoring Baby

What kind of fetal monitoring do you prefer?

  • Continuous external fetal monitoring? (You'll likely need to stay in bed for this)
  • Intermittent external fetal monitoring? (This will let you move freely, and often makes it easier for you to relax and focus on giving birth)
  • Internal fetal monitoring?
  • Fetal monitoring only if baby is in distress?
  • Fetal monitoring using a Doppler (heartbeat monitor) only?

Pain Relief Preferences

  • Would you like an epidural for pain relief?
    • Would you like it in all scenarios?
    •  Do you plan to ask for an epidural only if necessary? Or, would you like to avoid the epidural at all costs?
    • Do you want  a standard epidural, or one that will allow you to move freely?
  • Would you like an IV with narcotics (pain medication) if necessary? 
    • Or do you not want narcotics to be given at all, under any circumstances?
  • Are you interested in other forms of pain relief, such as:
    • Massages?
    • Breathing techniques?
    • Acupuncture/Acupressure?
    • Cool therapy?
    • Heat therapy?
    • Nitrous oxide?
    • Meditation?
    • Reflexology?
    • TENS (electrical nerve therapy)?
    • Distraction?
    • Another option?

Preferences For Delivery Location 

  • Would you like to use a birthing bed?
  • Do you plan to bring a birthing chair, ball or stool?
  • Are you interested in delivering in a birthing tub?
  • Would you like to deliver in the shower?
  • Do you want a birth bar available to support you?

Preferences For Delivery Position

Would you like to:

  • Lie down with your legs elevated?
  • Deliver while on your hands and knees?
  • Lie on your side with one leg elevated?
  • Kneel on the lower part of the bed and support your upper body with the upper section of the bed?
  • Give birth in a seated position?
  • Give birth while squatting?
  • Stand to give birth?
  • Lean on your partner?
  • Have people support your legs?

Episiotomy Preferences

Are you okay with an episiotomy (incision to enlarge the vaginal opening and help prevent tearing)?

  • Under what circumstances?
    • Have it performed if there's any risk of tearing?
    • Only if a doctor requires it?
    • Only as a last resort?
    • Not at all?
  • What sort of pain relief do you want for the procedure?
    • Local anesthesia during?
    • Local anesthesia afterwards, if repair is needed?
    • Warm compresses and massages prior to the procedure
    • None --- just have it performed using pressure?

Keep in mind that often, episiotomy recovery can be longer and more painful than recovery from a natural tear. And there are ways to reduce the likelihood of tearing without this procedure. 

  • If you don't want this procedure, would you like massages, warm compresses, or other ways to reduce discomfort and help prevent tearing?

If Labor Augmentation Is Needed

Sometimes, your doctor will recommend labor augmentation, which encourages your uterus to develop longer, more frequent, and more intense contractions.

  • Can labor augmentation be performed at will if your doctor recommends it?
  • Do you only want labor augmentation if baby is in distress?
  • Is it ok for the membrane to be stripped or ruptured artificially during the process?
  • Or, do you want the doctor to avoid artificially stripping or rupturing the membrane? (Avoiding the artificial rupture may lead to less pain, and keep contractions from becoming too intense.)
  • Can your doctor use prostaglandin gel?
  • Should your doctor avoid Pitocin?

Other Preferences For During/After Delivery 

During delivery, do you want to:

  • Push whenever you feel like, as guided by your body?
  • Push when directed?
  • Push with no time limits, as long as there's no risk to you or baby?
  • Have a full epidural during pushing?
  • Let the previous epidural wear off during pushing (or not have epidural during pushing)?
  • See the baby crown while pushing, using a mirror?
  • Avoid use of a vacuum or forceps to extract baby?
  • Let your partner catch baby?
  • Let your partner cut the umbilical cord?
  • Only have the cord be cut once it isn't pulsating?
  • Let the cord disconnect naturally after a few days (known as a Lotus birth)?
  • Let your doctor guide the entire process and methods used?

After the delivery, do you want to:

  • Donate or save the umbilical cord blood?
  • Deliver the placenta unaided?
  • Save the placenta?
  • Avoid taking oxytocin or similar medications?

Preferences For Baby's Care

Right after birth, when do you want to first hold your little one?

  • As soon as possible?
  • After they are cleaned?
  • After they are weighed?
  • Should baby's exams be delayed until after you hold them?

Is skin-to-skin contact key for you? 

  • If so, would you like this to happen immediately after baby is born?

How do you plan to feed baby?

  • Breastfeeding, starting as soon as possible, with no formula feeding allowed 
  • Breastfeeding later, but formula-feeding to start
  • Combination breastfeeding and formula feeding
  • Continued formula-feeding 

And with what type of schedule?

  • On demand
  • Every X hours

Do you want doctors to avoid giving baby certain medications or performing certain procedures? Or are certain procedures okay?

  • For example, do you want to skip baby's Vitamin K shot, and have baby receive Vitamin K by mouth instead?
  • Would you like baby to be bathed, or skip the bath?
  • Do you want baby to receive eye drops or eye ointment shortly after birth? Or would you like to opt out since these medicines are antibiotics?
  • Or, if baby's a boy, are you interested in having them circumcised, or do you want to skip this?

How often do you want baby with you?

  • Do you want baby to be in your room with you at all times, from the moment of birth?
    • Or, as much as possible after the initial recovery?
  • Do you want baby with you as much as possible during the daytime hours, but have them stay in the nursery at night?
    • Or, as much as possible when you're awake?
  • Do you want baby to stay in the nursery most of the time, but be brought to you when they need you?

Do you want visitors to be limited?

  • If so, who will be allowed to visit?

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