You have researched, prepared, and imagined your birth. Now comes the moment to put it all on paper — and hand it to the people who will be in the room with you.
A birth plan is not a contract. It is a conversation starter — a document that tells your care team who you are, what matters to you, and how you hope to be supported when words might be harder to find. Research published in BMC Pregnancy and Childbirth found that women who used a birth plan reported better childbirth experiences, higher perceived support and control during labor, reduced fear, and lower rates of emergency caesarean section compared to women without one — a significant finding worth taking seriously.
The challenge is knowing what to actually include. Go too vague and it communicates nothing. Go too exhaustive and it becomes a wall of text that nobody reads mid-contraction. This guide walks you through every major section, item by item, so you can build a birth plan that is clear, complete, and genuinely useful.
What Is a Birth Plan — And What It Is Not
A birth plan is a written summary of your preferences for labor, delivery, and the immediate postpartum period. It typically runs one to two pages and covers everything from who you want in the room to what happens in the first hour after your baby is born.
The American College of Obstetricians and Gynecologists (ACOG) defines it simply as "a written outline of what you would like to happen during labor and delivery." ACOG also notes that birth plans are a great starting point — but that flexibility is essential, because birth is unpredictable.
That combination — clear intentions plus genuine openness — is the sweet spot. You are not demanding a specific outcome. You are communicating your values so your team can support you as skillfully as possible.
Keep your plan to one page if at all possible, or two at most. Use bullet points, short sentences, and simple language. Bring multiple copies — one for your chart, one for your nurse, one for your birth partner, and one for your bag.
Section 1: Your Information and Care Team
Start with the basics so anyone who picks up the document knows exactly who it belongs to.
Include:
- Your name and due date
- Your OB, midwife, or primary provider's name
- Your doula's name and contact number (if applicable)
- Your birth partner's name and their role
- Your baby's pediatrician (if already selected)
- Hospital or birth center name
This section also serves a subtle but important purpose: it signals that you have a prepared, engaged care team. Providers who see a doula listed often approach the birth with a different (and more collaborative) energy.
Section 2: Labor Environment
The environment you labor in shapes how your body responds to contractions. Research consistently links a calm, low-stimulation environment with better pain tolerance and reduced intervention rates. The WHO's 2018 intrapartum care guidelines specifically emphasize that individualized, supportive care — including respecting women's environmental preferences — is a cornerstone of a positive birth experience.
Consider including preferences for:
- Lighting: Dimmed lights vs. bright overhead fluorescents
- Sound: Quiet room, your own music playlist, or white noise
- Temperature: Request extra blankets or a fan
- Visitors: Who is allowed in the room, and when
- Photography/video: What you are and are not comfortable with
- Privacy: Asking staff to knock before entering
Example language: "We would prefer dim lighting and minimal interruptions. Please knock before entering and ask before performing any procedures."
Section 3: Labor Support and Movement
This section is one of the most evidence-backed parts of any birth plan. Continuous support during labor has been shown to significantly improve outcomes — including shorter labors, higher rates of spontaneous vaginal birth, and lower rates of cesarean — with zero identified harms. The landmark Cochrane Review on continuous labor support (27 randomized controlled trials, nearly 16,000 women) found that women with doula-role support were 39% less likely to have a cesarean birth and 15% more likely to have a spontaneous vaginal birth.
Preferences to document:
- Who will provide continuous support (birth partner, doula, or both)
- Freedom to move around during labor — walking, swaying, using the hallway
- Access to a birthing ball, rocking chair, or squat bar
- Use of a tub or shower for pain relief (water immersion has been shown to reduce epidural use; see Cochrane immersion review)
- Upright positioning — the WHO recommends encouraging upright positions for women without and with epidurals alike
Example language: "I would like the freedom to walk, use the tub, and change positions freely during labor. My doula [Name] will be present throughout."
Section 4: Fetal Monitoring Preferences
Routine continuous electronic fetal monitoring (EFM) is standard in many hospitals, but for low-risk pregnancies, evidence does not support it over intermittent auscultation (IA). According to research published in the Journal of Perinatal Education, continuous EFM is associated with higher rates of cesarean and instrumental delivery without providing measurable benefit to the fetus in low-risk pregnancies. ACOG supports intermittent auscultation as appropriate for uncomplicated labors.
Preferences to document:
- Request intermittent monitoring if you are low-risk and not using Pitocin or an epidural
- Telemetry (wireless monitoring) if continuous monitoring is medically necessary
- Preference to discuss your monitoring plan with your provider before labor begins
Note: If you have any risk factors, are induced, or receive an epidural, continuous monitoring is typically recommended. Be sure to discuss your specific situation with your provider.
Section 5: Pain Management Preferences
This is the section most people think of first — and it deserves careful, honest thought. Your preferences can and may change in labor, and that is completely okay.
For those planning unmedicated or minimally medicated birth, consider listing:
- Non-pharmacological methods you want to try first: hydrotherapy, heat/cold, movement, massage, TENS unit, breathing techniques, hypnobirthing scripts
- Request that pain medication not be offered unless you ask for it (this simple preference can be deeply meaningful in active labor)
- Nitrous oxide as a middle-ground option (if available at your facility)
For those open to or planning an epidural, include:
- At what point you would like to discuss it
- Any specific concerns or questions about timing
For everyone:
- Preference to exhaust non-pharmacological options before medication is offered
- Right to ask for and receive medication at any time, without judgment
Example language: "I am planning an unmedicated birth and would prefer not to be offered pain medication. I will ask for it if I want it. I would like to have access to the tub, a birthing ball, and a TENS unit."
Section 6: Labor Interventions — Your Preferences
Understanding your preferences around common interventions is one of the most empowering things you can do before your birth.
IV access:
- IV line vs. a saline/heparin lock (a lock allows IV access without being tethered to a bag)
Fluids and eating:
- The WHO recommends allowing oral fluid and food intake during labor for low-risk women — include your preference to eat and drink lightly if your facility permits it
Vaginal exams:
- Request to limit the frequency of vaginal exams
- Ask to be told your progress without unsolicited opinions about "how quickly" you should be dilating
Amniotomy (artificial rupture of membranes):
- Preference to allow membranes to rupture on their own unless medically necessary
Pitocin/Oxytocin augmentation:
- Preference to avoid routine augmentation, especially before 5 cm dilation (WHO guidelines do not recommend augmentation before this threshold)
Episiotomy:
- Request no routine episiotomy. The 2017 Cochrane Review found that selective (not routine) episiotomy results in significantly fewer severe perineal tears. ACOG Practice Bulletin 165 also recommends against routine use.
Section 7: Pushing and Second-Stage Preferences
The pushing phase is another area where your preferences can make a real difference.
Include:
- Freedom to push in the position that feels right — squatting, hands and knees, side-lying, or supported standing. The WHO recommends encouraging women to follow their own urge to push rather than directed (coached) pushing
- Request to "labor down" (wait for spontaneous urge to push) rather than begin coached pushing immediately upon reaching 10 cm
- Perineal support preferences: warm compresses, perineal massage, or hands-off approach
- Preference for a slow, controlled delivery to reduce tearing
- Who you want to announce the sex (if you do not already know)
- Who you would like to catch the baby or cut the cord (if desired)
Section 8: Immediately After Birth
The first hour after birth — often called the "golden hour" — has profound implications for breastfeeding, bonding, and your baby's physiological transition to the outside world. Being specific here pays off.
Skin-to-skin contact:
- Immediate uninterrupted skin-to-skin contact after birth. Research in Acta Paediatrica confirms robust evidence for multiple maternal and infant benefits, including breastfeeding support, temperature regulation, and reduced maternal stress. The WHO/UNICEF Baby-Friendly guidelines also support this practice
Delayed cord clamping:
- ACOG recommends delayed cord clamping for at least 30–60 seconds for all vigorous term infants. It increases hemoglobin levels and improves iron stores in the first months of life. Specify whether you want to wait until the cord stops pulsing, or have your partner cut it
Who cuts the cord:
- Partner, family member, or provider
Placenta:
- If you want to see or keep the placenta, note that here (check your facility's policy in advance)
Newborn procedures timing:
- Request that non-urgent procedures (vitamin K, eye ointment, first bath, measurements, hearing screen) be delayed until after the golden hour and your initial breastfeeding session
- Specify preference for no separation unless medically necessary
Example language: "Please place baby directly on my chest immediately after birth for uninterrupted skin-to-skin. We would like delayed cord clamping until the cord stops pulsing. Please delay all non-urgent newborn procedures until after our first breastfeeding session."
Section 9: Infant Feeding
Even if your feeding intentions seem obvious to you, put them in writing. Hospitals vary widely in their default practices.
Include:
- Exclusive breastfeeding — no formula supplementation without your explicit consent
- No pacifiers or artificial nipples unless medically indicated and you consent
- Request to see a lactation consultant within the first 24 hours
- Or, if you are formula feeding: specify your preferred formula brand and request that staff support — not question — your choice
- Preference for rooming-in (baby stays in your room around the clock) to support feeding on demand
Section 10: Newborn Care Preferences
Routine newborn care options to address:
- Vitamin K injection: Standard and strongly recommended — protects against rare but serious vitamin K deficiency bleeding
- Erythromycin eye ointment: Standard in most US states; discuss with your provider if you have questions
- Hepatitis B vaccine: First dose typically given in hospital — note your preference (consent or delay)
- Newborn screening (PKU): Mandatory in all US states; typically a heel stick at 24–48 hours
- First bath timing: Many families now request to delay the first bath 12–24 hours to preserve the vernix, which has antimicrobial and moisturizing properties
- Circumcision: If applicable, note your decision and preferences
Section 11: Cesarean Birth Preferences
Even if you are planning a vaginal birth, including a C-section section shows your care team that you have thought through every scenario — and it gives you voice in the room if a cesarean becomes necessary.
Consider including:
- Request for a "gentle cesarean" or "family-centered cesarean" if available at your facility: lower drape at delivery, delayed cord clamping, immediate skin-to-skin in the OR or recovery
- Who you want present in the OR
- Music or audio preferences
- Request for a clear drape or to lower the curtain at the moment of birth
- Skin-to-skin with partner if you are unable to hold baby immediately
- Preference to breastfeed in recovery as soon as possible
Section 12: Postpartum Recovery Preferences
Birth does not end when baby arrives. Your recovery matters too.
Include:
- Preference for minimal interruptions during the first night (cluster newborn checks if possible)
- Request for privacy during breastfeeding
- Support for any mental health monitoring or postpartum depression screening
- Requests regarding your own medications or pain management
How to Use This Checklist
- Work through each section during pregnancy — ideally between 28 and 36 weeks
- Talk through your plan with your provider at a prenatal visit. Use it as a discussion guide, not a declaration
- Be flexible. A good birth plan reflects your values, not a rigid script. Things change in labor, and adapting is not failure
- Keep it readable. Use bullet points, bold key preferences, and keep total length to one or two pages
- Bring five copies to the hospital: chart copy, nurse copy, doula copy, partner copy, and one for your bag
A well-made birth plan is one of the simplest, most effective tools you have for a positive birth experience — regardless of how your labor unfolds.
Build Your Birth Plan in Minutes with Eden
The Eden app makes this process easy. Our built-in birth plan builder guides you through every section from the comfort of your phone — with evidence-based explanations for each preference so you can make truly informed choices. You can customize, share with your provider, and update as your preferences evolve.
Download Eden and start building your birth plan today. Your voice in the birth room starts here.