Creating a Birth Plan: What to Include and What to Skip

Medical Disclaimer: This article is for informational purposes only and is not a substitute for professional medical advice. Birth plans are preferences, not guarantees. Always follow your healthcare provider's guidance during labor and delivery.

A birth plan is a document that communicates your preferences for labor, delivery, and immediate postpartum care. While no birth goes exactly as planned, having thought through your options and communicated your wishes helps you feel more prepared and helps your care team support you better.

Why Create a Birth Plan?

Writing a birth plan isn't about controlling every aspect of birth - that's impossible. Instead, it's about educating yourself on your options, thinking through scenarios in advance, communicating with your partner and care team, and feeling more confident going into labor.

Research shows that women who feel informed and involved in decisions during birth report more positive birth experiences, regardless of whether everything went according to their initial preferences.

What to Include in Your Birth Plan

Labor Environment Preferences

Worth including:

• Lighting preferences (dimmed lights, natural light)

• Music or sound preferences (playlist, silence, nature sounds)

• Who you want in the room (partner, doula, family members)

• Movement preferences (ability to walk, use birth ball, change positions)

• Desire for minimal interruptions during active labor

Pain Management

Worth including:

• Your general approach (prefer to try natural methods first, want epidural early, undecided)

• Specific natural methods you want to try (hydrotherapy, breathing techniques, massage)

• Whether you want staff to offer pain medication or wait for you to ask

• Any allergies or past reactions to medications

Medical Interventions

Worth including:

• Feelings about IV fluids versus hep-lock

• Continuous versus intermittent fetal monitoring preferences

• Preferences about induction methods if needed

• Thoughts on episiotomy (routine versus only if necessary)

• Preferences regarding assisted delivery (vacuum, forceps) if needed

Cesarean Birth Preferences

Even if you're planning a vaginal birth, including C-section preferences is wise.

Worth including:

• Desire for clear drape or lowered drape to see baby born

• Skin-to-skin in the operating room if possible

• Whether your partner can be present

• Music during the procedure

• Who cuts the cord

Immediately After Birth

Worth including:

• Delayed cord clamping preferences

• Skin-to-skin immediately after birth

• Who you want to announce the sex if you don't know it

• Preferences about newborn procedures timing (eye ointment, vitamin K, bath)

• Feeding intentions (breastfeeding, formula, both)

• Placenta preferences if any

Newborn Care

Worth including:

• Rooming-in preferences versus nursery time

• Circumcision decision if applicable

• Whether to allow pacifiers

• Who can and cannot visit

What to Skip

Some items aren't worth including because they're standard practice, impossible to guarantee, or better discussed in conversation than written on paper.

Skip these:

• Extremely detailed step-by-step scripts

• Demands or ultimatums (e.g., "under no circumstances will...")

• Standard practices at your facility (research what's already the default)

• Things outside anyone's control (e.g., "I will not tear")

• Excessive length (more than 1-2 pages becomes hard to follow)

• Medical advice you're unqualified to give yourself

Tips for an Effective Birth Plan

Keep It Short and Skimmable

Labor and delivery nurses are busy. A one-page, bullet-pointed plan is more likely to be read and followed than a multi-page essay. Use headers, bold text, and clear formatting.

Use Positive Language

Instead of "Do not give me an episiotomy," try "I prefer to tear naturally rather than have an episiotomy unless medically necessary." Frame preferences as what you want, not just what you don't want.

Build in Flexibility

Use language like "if possible," "I prefer," and "unless medically necessary." This shows you understand that circumstances may require adjustments.

Discuss It With Your Provider in Advance

Don't surprise your provider with your birth plan in labor. Review it at a prenatal appointment to make sure your preferences align with what's possible at your birth location and with your health situation.

Make Multiple Copies

Bring several copies to the hospital. Shifts change, and having extras ensures everyone on your care team has access.

Have a Backup Decision-Maker

Include who should make decisions if you're unable to, and make sure that person knows your priorities.

Sample Birth Plan Structure

Header: Your name, due date, provider name, any relevant medical information

Section 1: Labor preferences (environment, movement, monitoring)

Section 2: Pain management approach

Section 3: Delivery preferences (pushing positions, cord clamping)

Section 4: C-section preferences if applicable

Section 5: Newborn and postpartum preferences

When Plans Change

Even the most carefully considered birth plan may need to change based on how labor progresses. This isn't failure - it's just birth. The goal is a healthy parent and healthy baby, and sometimes the path to get there looks different than expected.

If interventions become necessary, ask questions when time allows: What are the benefits? What are the risks? Are there alternatives? What if we wait?

The Bottom Line

A birth plan is a communication tool, not a contract. It helps you think through options, communicate with your care team, and feel more prepared for the big day. Approach it as a thoughtful guide rather than a rigid script, and remember that the best birth plan is one that can flex when needed while still honoring your core values and preferences.