How to Create a Birth Plan ?

I still remember opening a blank doc titled “How to create a birth plan” and immediately feeling… stuck. Was I supposed to predict every moment of labor? Choose between options I’d never tried? What if I wrote it “wrong”? I’ve been there, friend.

Here’s what I learned the first time and confirmed the second: a birth plan isn’t a script—it’s a conversation starter. It helps you discover your options, share your preferences, and go into birth feeling informed and supported. When things unfolded differently than I imagined (because birth loves a plot twist), the plan still helped. My nurses saw what mattered to me—calm lights, freedom to move, skin-to-skin right away—and they cheered for those things whenever it was safe to do so.

This guide keeps it simple and doable. We’ll cover what to think about before writing, how to structure your plan into one clear page, what to include for labor, delivery, and the first hours with your baby, and a printable-style template you can copy. Most of all, we’ll keep flexibility front and center: you set your preferences, and your team helps adapt them to keep you and baby safe. You’ve got this. 💛

1) Start With the Mindset : Your Plan Is a Guide, Not a Contract

Think of your birth plan as “birth preferences.” It outlines what you hope for, and it makes it easier for nurses, midwives, and doctors to care for you the way you like—while staying medically safe if circumstances change. (Providers love clarity.) The American College of Obstetricians and Gynecologists (ACOG) even shares a sample birth plan and encourages reviewing it with your provider before your due date, so everyone’s on the same page.

Personal note: Writing it with my partner helped us talk through “Who do we text?” “What calms me?” and “What if I change my mind about pain relief?” That conversation mattered as much as the paper.

2) Chat With Your Provider Early (and Ask What’s Available)

Hospitals and birth centers vary. At a routine prenatal visit, ask :

• Do you have a standard birth plan form or preferences sheet?
• What are my options for monitoring (intermittent vs continuous) if I’m low risk?
• Which pain relief options are available here (nitrous oxide, epidural, water, TENS)?
• Can I move freely in labor (birthing ball, shower, tub)?
• What’s your approach to delayed cord clamping, skin-to-skin, and newborn care in the first hour?

Bringing these questions early helps you avoid last-minute surprises and write a plan that actually matches your setting. (More on each topic below.)

3) Take a Class & Research Your Options (Just Enough)

A short birthing class (in person or virtual) gives you a gut-level feel for positions, breathing, partner support, and what different tools feel like. You’ll also hear the lingo you’ll see in your plan—intermittent monitoring, epidural, nitrous, induction, augmentation—and you can decide what sounds right for you now (knowing you might adjust later). I loved practicing positions at home with a yoga ball; it made those choices feel real, not theoretical.

4) Keep It to One Page (Two Max) : Here’s the Simple Structure

Use clear headings + bullets so busy nurses can scan it quickly :

1. The Basics (top of the page)

• Your name, partner/doula names + contacts
• Due date, provider’s name, chosen hospital/birth center
• Allergies/medical conditions/meds
• “What matters most” : one line (e.g., “Calm environment, movement-friendly, skin-to-skin ASAP”)

2. Labor Preferences

• Environment : dim lights, music, photos/video okay or not
• Support people : who you want in the room (and if anyone should not be admitted)
• Movement & comfort : freedom to change positions, shower or tub, birthing ball
• Monitoring : preference for intermittent monitoring if low risk, understanding that continuous may be needed if risks arise (details below)
• Pain relief : comfort measures first, nitrous/epidural if requested, open to change

3. Delivery Preferences

• Positions for pushing : side-lying, hands-and-knees, supported squat, etc.
• Episiotomy : prefer to avoid unless medically indicated
• Assisted delivery : views on vacuum/forceps if needed
• Cesarean “just in case” : clear drape or not; partner present; immediate skin-to-skin if safe

4. Immediate Postpartum & Newborn

• Cord clamping : request delayed clamping (see evidence below)
• Skin-to-skin : immediate and uninterrupted if baby is stable
• Newborn care : timing of vitamin K, eye ointment, hepatitis B; first bath delayed; rooming-in; feeding plan (breast, combo, or formula)

5. Sign-Off

• Your signature + “I understand plans may change for safety.”

This format mirrors what clinical teams see daily and keeps your wishes front and center.

5) Choose Your Comfort Toolkit: Pain Relief Options (You Can Mix & Match)

There’s no “right” way to manage sensations in labor—only what supports you. Common options include :

• Non-medication strategies : movement, counter-pressure, water therapy, heat packs, breathing, visualization, TENS. These can be used anywhere and pair well with everything else.
• Nitrous oxide (“gas & air”) : a 50/50 oxygen–nitrous blend you self-inhale through a mask as a contraction starts. It acts quickly, can be used at any stage, and you control when you breathe it. It may cause lightheadedness or nausea and doesn’t remove all pain, but many find it helpful for calm and coping. (Some hospitals offer it; ask yours.)
• IV/IM opioids: short-acting medications that can take the edge off; may cause drowsiness or nausea for you and temporary sleepiness in baby—timing matters.
• Epidural anesthesia: highly effective pain relief placed by anesthesia; you’ll have monitoring and IV access and less freedom to walk, but many parents love the rest and focus it allows.

Safety note : ACOG advises not to use nitrous oxide at the same time as systemic opioids or sedative-hypnotics. If you’re switching methods, your team will guide timing.

Personal note : With my first, I planned to “see how it goes.” I started with movement and water, then tried nitrous, and eventually chose an epidural. With my second, I stuck with nitrous and counter-pressure. Both births were positive—because I felt supported in choosing what I needed in the moment.

6) Monitoring : Intermittent vs Continuous (and When It Changes)

Monitoring keeps tabs on how baby handles labor. If you’re low risk, your plan can request intermittent auscultation (periodic listening) instead of continuous electronic fetal monitoring—this often allows more movement and may be associated with fewer operative births. If risk factors show up (fever, concerning heart rate patterns, labor complications), your team may switch to continuous monitoring for safety. ACOG’s patient guidance explains both methods; recent clinical guidance notes that intermittent monitoring can be appropriate for low-risk labors but should transition to continuous if concerns arise.

How to write it :
“Monitoring : If low risk, I prefer intermittent monitoring. I understand continuous monitoring may be needed if risks develop or baby needs closer watch.”

7) Delivery Details : Positions, Pushing, and “Gentle Cesarean”

• Positions : Many people push more effectively in side-lying, hands-and-knees, or a supported squat. Write the ones you want to try.
• Episiotomy : You can say, “Please avoid unless medically indicated.”
• Assisted delivery : If vacuum/forceps become necessary, ask for a quick explanation and consent in the moment.
• Cesarean preferences : Even if you hope to avoid one, add a short “just in case” section: partner present if possible, music/low voices, immediate skin-to-skin and delayed cord clamping if safe, and early breastfeeding support.

Personal note : I added “talk me through what you’re seeing” to my plan. Hearing my team say, “Baby’s doing great, you’re making progress” was magic for my mindset.

8) Immediate Postpartum & Newborn Care : Small Choices, Big Meaning

These are the first moments you’ll remember forever. Common preferences include:

• Delayed cord clamping : Waiting at least 30–60 seconds (longer when feasible) increases baby’s iron stores and hemoglobin in early months. ACOG recommends delaying clamping in vigorous term and preterm infants when possible.
• Skin-to-skin contact : Placing baby directly on your chest immediately after birth (vaginal or cesarean) helps regulate baby’s temperature, stabilizes breathing, supports bonding, and can boost breastfeeding initiation. WHO and other experts encourage immediate, uninterrupted skin-to-skin whenever mother and baby are stable.
• Vitamin K, eye ointment, hepatitis B : In the U.S., the vitamin K shot shortly after birth prevents dangerous bleeding; CDC notes AAP has recommended it for decades. If you want that first uninterrupted hour, you can request it within the recommended window (up to about 6 hours). Eye ointment and the first hepatitis B vaccine are routine in many hospitals—ask about timing.
• First bath : Many families delay the first bath to protect baby’s vernix and temperature; write your preference.
• Rooming-in & feeding : If you plan to breastfeed, ask for lactation support and baby to room-in with you. If you plan to formula-feed or combo-feed, write that too—great care meets families where they are.

How to write it :
“Postpartum : Delay cord clamping 60+ seconds if safe. Immediate skin-to-skin with me (or partner if I’m unavailable). Vitamin K within the first few hours; please delay non-urgent procedures until after the first feed.”

9) Write It So Nurses Can Scan It (Fast)

• Bullet points, not paragraphs.
• Headings + bold keywords (MONITORING, PAIN RELIEF, NEWBORN).
• One page (front). If you truly need more, use two-sided.
• Put your top 3 priorities in a mini box at the top.
• Friendly tone. (“Thank you for caring for us!” goes a long way.)

Personal note : A nurse once told me, “Your one-pager was perfect—I knew exactly what mattered to you in 10 seconds.”

10) Share, Print, Pack (and Save on Your Phone)

• Review with your provider at a regular visit. Ask, “Do these preferences fit our hospital’s policies?” Adjust together.
• Print 3–5 copies. Put one in your hospital bag, one in your chart if allowed, and keep a digital copy on your phone.
• Give your partner a copy. They’re your advocate when you’re busy doing the brave work of birthing.
• Bring a pen. You might initial small changes together (for example, if monitoring needs to change).

11) Sample One-Page Birth Plan (Copy, Paste, Customize)

Name(s) : Taylor & Jordan Rivera | Due Date : 02/14/2026
Provider : Dr. Kim | Place of Birth: Riverside Women’s Center
Allergies/Notes : None. First baby.
What matters most : Calm environment, freedom to move, immediate skin-to-skin.

Environment & Support

• Dim lights, soft music; photos okay (no video of procedures).
• Present in room: Jordan (partner) + Doula (Ari). Please limit other visitors.

Labor Preferences

• Freedom to move, shower/tub, birthing ball.
• Monitoring : Prefer intermittent if low risk; okay to switch to continuous if concerns arise.
• Pain relief : Start with movement, water, counter-pressure; nitrous if available; epidural if I request.

Pushing & Birth

• Positions to try : side-lying, hands-and-knees, supported squat.
• Episiotomy : avoid unless medically indicated.
• If assisted delivery is recommended, please explain options briefly first.
• Cesarean (if needed) : partner present; low voices/music; clear drape optional; immediate skin-to-skin if safe.

Postpartum & Newborn

• Cord clamping : delay 60+ seconds if safe.
• Skin-to-skin : Immediate and uninterrupted, then breastfeeding support.
• Newborn care : Vitamin K within first hours; delay eye ointment/hep B until after first feed if safe.
• Bath : Delay first bath; Rooming-in preferred.

Thank you for caring for us. We understand plans may change for safety.

12) Quick Troubleshooting (Because Birth Is Dynamic)

• “Plans changed and I feel overwhelmed.” Ask your nurse to translate what’s happening and how your preferences still fit. Even in twists, you can often keep your top values (calm, skin-to-skin, partner involvement).
• “I changed my mind about pain relief.” Totally okay. Your plan is a living document.
• “I’m getting conflicting advice.” Ask, “What are the benefits, risks, alternatives, and timing?” A 60-second huddle can bring clarity.
• “I want to advocate, but I’m tired.” This is your partner/doula’s moment. Point them to the three top priorities at the top of your plan.

13) Tiny Evidence Bites (Trust-Builders You Can Share)

• Birth plans help communication. ACOG provides a sample birth plan and encourages reviewing it with your obstetric provider before your due date—because clear, shared expectations help everyone.
• Monitoring choices depend on risk. Intermittent listening can be appropriate in low-risk labors; if risk factors show up, teams transition to continuous monitoring for safety.
• Delayed cord clamping (30–60+ seconds) improves newborn iron stores and hemoglobin; ACOG recommends it for vigorous term and preterm infants when feasible.
• Immediate skin-to-skin supports temperature, breathing, bonding, and early feeding; WHO encourages immediate, uninterrupted skin-to-skin when mother and baby are stable.
• Vitamin K shot soon after birth prevents dangerous bleeding; CDC notes AAP has recommended it for decades, and timing can accommodate early bonding.
• Pain relief options: ACOG’s patient guidance covers nitrous oxide, IV meds, and epidurals—use what fits you, and change course if needed.

Wrapping Up with Love & Support

Mama, if writing a plan feels big, that’s normal. You’re making space for a brand-new person and a brand-new version of you. Keep it simple, keep it kind, and keep it flexible. A one-page plan and a supportive team go a long way. No matter how your baby’s birthday unfolds, you’re making thoughtful choices with so much love—and that’s what your little one will feel from the first moment.

You’ve got this. 💛

What’s one preference you’re including in your birth plan—lighting, movement, skin-to-skin, something else? Share it in the comments! And if you’d like a printable, one-page Birth Plan Template (the exact layout I use), drop “BIRTH PLAN” below or join my email list and I’ll send it right to your inbox.