A birth plan is a short written record of your preferences for labour, birth and the first hours with your baby. It is not a contract and it cannot guarantee a particular kind of birth, but it is a valuable tool. Writing one encourages you to learn about your options, helps you think through what matters to you and gives your midwives and doctors a quick snapshot of your wishes, especially if staff change shifts while you are in labour.
The NHS describes a birth plan as a way of letting your care team know what you would like during labour, and it recommends talking it through with your midwife as you write it. This guide walks you through each section and finishes with a template you can copy and adapt.
When to Start
Many people begin thinking about their birth plan in the second trimester and finalise it in the third, often around 32 to 36 weeks. That leaves time to attend antenatal classes, visit or read about your birth unit and ask questions at your appointments. Your preferences may change as you learn more, and that is perfectly normal.
Principles of a Good Birth Plan
- Keep it short. One page, or two at most, is easier for busy staff to read.
- Use bullet points and clear headings.
- Phrase things as preferences, for example “I would prefer…” or “If possible…”.
- Include plans for different scenarios, such as an assisted birth or caesarean.
- Make several copies: one in your notes, one in your hospital bag and one for your birth partner.
Section 1: About You
Start with the basics so anyone reading the plan understands your situation at a glance. Include your name, your expected due date, your birth partner’s name and relationship to you, and any important health information or previous birth experiences. If you have had a difficult birth before, a brief note can help staff support you sensitively. If there are words or topics you find distressing, you can mention that too.
Section 2: Place of Birth and Environment
Depending on your health and local services, you may be able to choose between giving birth at home, in a midwife-led unit or in a hospital labour ward. Your midwife can explain which options are suitable for you. Within each setting, you can express preferences about the environment.
- Lighting: dimmed lights or natural light where possible.
- Sound: your own music or a quiet room.
- Equipment: birthing ball, mats, beanbags or a birth pool, if available.
- Comfort: your own pillow, clothes or comfort objects.
Section 3: Support and Company
Note who you would like with you during labour and birth, and whether you would like them to stay if you need an assisted birth with forceps or ventouse, or a caesarean birth. You can also say whether you are comfortable with students or trainee staff being present. Most units are happy to accommodate these preferences where they can.
Section 4: Movement and Positions
Many people find that moving around and changing position helps them cope with contractions. You might prefer to stay upright and active for as long as possible, use a birthing ball, or try kneeling, all-fours or side-lying positions. If you need continuous monitoring, ask whether wireless monitoring is available so you can keep moving. Your midwife can suggest positions that suit your circumstances.
Section 5: Pain Relief
Pain relief preferences are personal, and it is wise to stay open-minded because labour is unpredictable. Learn about the full range of options available at your unit so you can make informed choices on the day. Common options include:
- Self-help techniques such as breathing, massage, hypnobirthing and warm water.
- TENS machines, used in early labour.
- Gas and air (Entonox) in many countries.
- Injected pain relief such as opioids.
- Epidural anaesthesia.
You can write something like “I would like to try breathing techniques and the birth pool first, and I’m open to an epidural if I ask for it.” Avoid making promises to yourself that make it hard to change your mind. Wanting more pain relief than you planned is never a failure.
Section 6: Monitoring and Interventions
Some labours need closer monitoring or medical help. It is useful to think in advance about how you would like decisions to be explained to you. Many people include a line such as “Please explain the reasons, benefits, risks and alternatives before any intervention, unless it is an emergency.” You might also include preferences about induction if your pregnancy goes beyond your due date, about vaginal examinations, and about how long you would like to try different positions in the second stage of labour before assistance is considered.
Section 7: If You Need a Caesarean Birth
Even if you are hoping for a vaginal birth, it is worth writing a short caesarean section. Preferences might include having your birth partner present, having the screen lowered to see your baby being born, immediate skin-to-skin contact in theatre if you and your baby are well, music in the operating room and delayed cord clamping where possible. Discuss these with your care team, as what is possible can vary.
Section 8: Third Stage of Labour
The third stage is the delivery of the placenta. You can usually choose between an actively managed third stage, which involves an injection to help the uterus contract, or a physiological third stage, which happens without medication. Your midwife can explain the benefits and risks of each for your situation. You can also note preferences about delayed cord clamping and whether your birth partner would like to cut the cord.
Section 9: Your Baby After the Birth
- Skin-to-skin contact immediately after birth, if you and your baby are well.
- Feeding plans: breastfeeding, formula feeding or combination feeding, and whether you would like support with the first feed.
- Vitamin K: newborns are routinely offered vitamin K to prevent a rare but serious bleeding disorder. You can ask your midwife about the injection or oral options available where you live.
- Who will announce the baby’s sex, if you do not already know.
- Preferences if your baby needs neonatal care, such as your partner going with the baby.
Section 10: Postnatal Preferences
Add any wishes for the hours and days after birth: visitors, cultural or religious practices, dietary needs, help with feeding and when you would like to go home if all is well. If you have experienced anxiety or depression, mention it here so staff can offer support.
A Template You Can Copy
- About me: name, due date, birth partner, key health notes.
- Environment: lighting, music, equipment, comfort items.
- Support: who is with me, including for assisted or caesarean birth; students yes/no.
- Movement: staying active, preferred positions, monitoring preferences.
- Pain relief: options I would like to try first, options I am open to.
- Interventions: how I would like decisions explained; induction and examination preferences.
- Caesarean preferences: partner present, skin-to-skin, screen, music.
- Third stage: active or physiological, cord clamping, who cuts the cord.
- Baby: skin-to-skin, feeding, vitamin K, neonatal care plans.
- After the birth: visitors, cultural needs, feeding support, emotional support.
Staying Flexible
The NHS reminds parents that birth does not always go to plan and that last-minute changes may be needed for the safety of you or your baby. A birth plan works best as a conversation starter rather than a rulebook. If things change, your preferences can still guide how you are cared for, for example keeping the room calm or ensuring your partner stays with you. Afterwards, if you have questions about why things happened as they did, you can ask to talk through your birth with a midwife or doctor.
Bring your draft to an antenatal appointment and ask your midwife to look over it. They can tell you which options are available at your unit and whether any preferences need adjusting for your health. That conversation is often the most valuable part of the whole process.
Sources
- NHS – How to make a birth plan
- NHS – Pack your bag for labour
- NICHD (NIH) – Options for pain relief during labor and delivery
Featured image: Petr Kratochvil (https://publicdomainpictures.net/en/browse-author.php?a=1) / Wikimedia Commons, CC0