Key Takeaways
- A birth plan helps your team understand your labor, birth and baby care wishes.
- Keep the plan short, clear and easy to change during real labor.
- Choose your support person, birth setting and comfort tools before labor starts.
- Ask early about routine checks, movement, food, fluids and fetal monitoring.
- Plan baby care choices before birth, including cord clamping and skin contact.
Birth Plan Basics
Your Main Wishes
A birth plan works best when it tells your care team what you want in clear words. You do not need a long document. One page is often enough. List the choices that affect your labor room, your body, your baby and your first hour after birth.
Write your plan as requests, not demands. Labor can change fast, and your team may need to act if you or your baby needs help. A strong plan gives clear direction while leaving room for safe changes.
ACOG says shared decisions during labor can help limit routine interventions for low risk women when care stays safe (1).
Your plan should name the people allowed in the room. Include your partner, doula, family member or friend. Also state who should speak for you if you feel tired, scared or unable to answer.
Continuous labor support is linked with more vaginal births, shorter labor and fewer negative birth experiences in a large Cochrane review (2).
Care Team Talk
Bring your birth plan to a prenatal visit before labor starts. Ask your doctor, midwife or nurse which requests match the place where you plan to give birth.
Some hospitals have firm rules about food, water, monitors, tubs, photos, support people and baby care steps.
Ask each question in direct words. Can I move around during labor. Can I use water for comfort. Can I eat or drink if labor stays low risk.
Can I have fewer vaginal checks. Can the baby stay on my chest after birth. Clear answers before labor reduce stress later.
Labor Room Choices
Movement & Position
Labor often feels easier when you can move. Walking, standing, leaning, kneeling and side lying can help you work with contractions.
A plan can say you want freedom to change position unless a clear safety issue comes up. Routine bed rest can make labor feel harder for some women.
Ask about wireless monitoring if you want movement but also need fetal heart checks. Continuous electronic fetal monitoring can increase cesarean and assisted birth rates in many low risk labors without clear improvement in several newborn outcomes, so many low risk women ask about intermittent listening instead (3).
Comfort Tools
Your birth plan can list comfort tools you want tried before stronger pain options. Heat, counter pressure, a shower, a tub, slow breathing, low light and quiet voices can help many women stay calmer. These tools do not lock you into one path. They give your team a clear place to start.
Some women want no pain drugs. Some want the option available. Some want to wait and decide during labor. Write the truth. A plan that fits your real view helps nurses support you without guessing.
Routine Interventions
Many birth places use routine steps because they are easy to standardize. Ask which ones you can accept, delay or skip if labor stays low risk.
Common examples include early admission, IV fluids, breaking the water, frequent checks, continuous monitors and directed pushing.
You can also state your wishes for pushing. Many women prefer to push when their body gives the urge. Some want coaching only when needed.
ACOG supports many low intervention choices for appropriate low risk women, including movement, hydration, support and delayed admission when safe (4).
Birth Preferences
Birth Setting
Your birth setting shapes your options. Hospitals offer fast access to surgery, blood, anesthesia and newborn care.
Birth centers and home birth can offer fewer routine interventions for selected low risk pregnancies with skilled care and clear transfer plans. Your plan should match your risk level, your distance from emergency care and the skill of your team.
Planned home birth research is hard to judge because systems differ by country, midwife training, transfer speed and risk screening.
A 2023 Cochrane review found no strong trial evidence favoring planned hospital birth or planned home birth for low risk women, and it stressed the limits of the available trial data (5).
If you plan birth outside a hospital, write the transfer plan clearly. Name the hospital, transport method, warning signs and who rides with you.
A calm transfer plan does not mean you expect trouble. It means you already know the next step if help is needed.
Perineal Care
Ask your team how they handle perineal support during pushing. Some women want warm compresses, slow crowning, oil free support, position changes and no routine cutting.
Routine episiotomy is less favored now because restrictive use gives better or similar outcomes for many women in trials and reviews (6).
Write your request in direct words. I prefer no episiotomy unless there is a clear medical need. Also ask how your team explains the reason before doing one, when time allows. Clear consent language protects your body and keeps trust strong during hard moments.
Cesarean Wishes
A birth plan should include cesarean wishes because surgical birth can happen even when you plan vaginal birth.
You can ask for your support person to stay with you, clear updates during the surgery, calm voices, delayed cord clamping when safe and skin contact as soon as possible.
Ask whether the baby can stay near you during closing if both of you are stable. Ask how feeding starts after surgery. These choices can reduce the feeling that your birth plan ended when surgery began.
Baby Care Plan
Cord & Skin
Many parents want delayed cord clamping. ACOG recommends delaying cord clamping for at least 30 to 60 seconds in vigorous term and preterm babies.
For term babies, delayed clamping increases hemoglobin at birth and improves iron stores during the first months, with a small rise in jaundice needing light treatment (7).
Ask for your baby to go straight to your chest if both of you are stable. Early skin contact can help breastfeeding, warmth and bonding.
A Cochrane review found that immediate skin contact probably improves exclusive breastfeeding at hospital discharge and supports early newborn stability (8).
State whether you want routine baby checks done on your chest when safe. Weight, measuring and bathing can often wait.
The first hour is a major change for the baby. Warm skin, a quiet room and steady breathing near your body help that first change feel less abrupt.
Feeding Start
Write your feeding plan before birth. If you want breastfeeding, ask for help with the first latch and request no bottles or pacifiers unless needed. If you plan another feeding route, state who should feed the baby and what support you want.
Baby feeding can feel emotional right after birth. Clear words help staff avoid wrong assumptions. Ask what the hospital does if the baby has low blood sugar, trouble latching, sleepiness or a tongue movement concern. You want help that protects the baby while keeping your goal in view.
First Procedures
Newborn care often includes eye ointment, vitamin K, weighing, measuring, blood sugar checks, hearing screening, pulse oxygen screening and vaccines.
These practices vary by country and birth setting. Your plan can say you want each item explained before it happens.
Some procedures are time sensitive, and some can wait. Ask during pregnancy so you know which choices are routine, optional, delayed or required by local rules. Write your decisions in plain words. Keep copies for your bag, your support person and your nurse.
For any health concerns or questions about a medical condition, get guidance from a physician or another appropriately trained clinician. Before changing your diet, supplements or health routine, talk with a licensed healthcare professional.
Research
American College of Obstetricians and Gynecologists 2019, Approaches to Limit Intervention During Labor and Birth, Obstetrics & Gynecology, DOI 10.1097/AOG.0000000000003074, PMID 30575638.
Bohren, M.A. et al. 2017, Continuous support for women during childbirth, Cochrane Database of Systematic Reviews, DOI 10.1002/14651858.CD003766.pub6, PMID 28681500.
Alfirevic, Z. et al. 2017, Continuous cardiotocography as a form of electronic fetal monitoring for fetal assessment during labour, Cochrane Database of Systematic Reviews, DOI 10.1002/14651858.CD006066.pub3, PMID 28157275.
Olsen, O. and Clausen, J.A. 2023, Planned hospital birth compared with planned home birth for pregnant women at low risk of complications, Cochrane Database of Systematic Reviews, DOI 10.1002/14651858.CD000352.pub3, PMID 36884026.
Carroli, G. and Mignini, L. 2009, Episiotomy for vaginal birth, Cochrane Database of Systematic Reviews, DOI 10.1002/14651858.CD000081.pub2, PMID 19160176.
American College of Obstetricians and Gynecologists 2020, Delayed Umbilical Cord Clamping After Birth, Obstetrics & Gynecology, DOI 10.1097/AOG.0000000000004168, PMID 33214530.
Moore, E.R. et al. 2025, Immediate or early skin to skin contact for mothers and their healthy newborn infants, Cochrane Database of Systematic Reviews, DOI 10.1002/14651858.CD003519.pub5, PMID 41093772.
Devane, D. et al. 2017, Cardiotocography versus intermittent auscultation of fetal heart on admission to labour ward for assessment of fetal wellbeing, Cochrane Database of Systematic Reviews, DOI 10.1002/14651858.CD005122.pub5, PMID 28125772.
Sandall, J. et al. 2016, Midwife led continuity models versus other models of care for childbearing women, Cochrane Database of Systematic Reviews, DOI 10.1002/14651858.CD004667.pub5, PMID 27121907.
Lawrence, A. et al. 2013, Maternal positions and mobility during first stage labour, Cochrane Database of Systematic Reviews, DOI 10.1002/14651858.CD003934.pub4, PMID 23450540.
Gupta, J.K. et al. 2017, Position in the second stage of labour for women without epidural anaesthesia, Cochrane Database of Systematic Reviews, DOI 10.1002/14651858.CD002006.pub4, PMID 28539008.
Cluett, E.R. et al. 2018, Immersion in water during labour and birth, Cochrane Database of Systematic Reviews, DOI 10.1002/14651858.CD000111.pub4, PMID 29768662.
Dowswell, T. et al. 2013, Transcutaneous electrical nerve stimulation for pain management in labour, Cochrane Database of Systematic Reviews, DOI 10.1002/14651858.CD007214.pub2, PMID 23450572.
Singata, M. et al. 2013, Restricting oral fluid and food intake during labour, Cochrane Database of Systematic Reviews, DOI 10.1002/14651858.CD003930.pub3, PMID 23450543.
Rossi, A.C. and Prefumo, F. 2018, Planned home versus planned hospital births in women at low risk pregnancy, Journal of Maternal Fetal & Neonatal Medicine, DOI 10.1080/14767058.2018.1441270, PMID 29408739.
World Health Organization 2018, WHO recommendations intrapartum care for a positive childbirth experience, World Health Organization.
American College of Obstetricians and Gynecologists 2017, Planned Home Birth, Obstetrics & Gynecology, DOI 10.1097/AOG.0000000000002024, PMID 28383379.
Hofmeyr, G.J. et al. 2015, Fundal pressure during the second stage of labour, Cochrane Database of Systematic Reviews, DOI 10.1002/14651858.CD006067.pub3, PMID 26094403.
Dekker, R.L. et al. 2017, Women’s experiences of labour and birth when having a termination of pregnancy for fetal abnormality in the second trimester of pregnancy, Midwifery, DOI 10.1016/j.midw.2017.01.007, PMID 28161140.