Example Birth Plan

Our Birth Plan

Emily (Mama's Name)

Due date: 

Primary caregiver: Doctor/Midwife's Name

To deliver at: Perfect Hospital/Birth Center

My support person will be: Ben, husband (this is also where you would put the name of your doula)

We realize that our birth plan is neither a contract or guarantee of an uncomplicated labor. We have prepared this Birth Plan to help you understand our philosophy and the kind of care we hope to have for the birth of our child. We have done everything we can to prepare for a healthy and uncomplicated birth. We have chosen our obstetrician/midwife because she shares our desire for a low-intervention birth and respects our need for good communication. We wish for as natural a birth as possible, avoiding unnecessary procedures and medications. However, if medications or procedures become necessary, we ask that you discuss them with us in advance so that we can participate in the decision making. Thank you so much for taking the time to read this, please let us know if you have any questions or concerns. 

Labor: 

It is important to us that we remain together at all times during the labor and delivery (vaginal or cesarean). 

I would prefer to wear my own nightgown during labor and delivery. 

We’d like to have the option of music and dimming the lights.

I would like the opportunity to walk and move freely during labor.

As long as things are progressing well, I prefer intermittent monitoring with an external fetal monitor.

I have tested positive for Group B Strep & would like a heparin lock when not receiving antibiotics. I would prefer to drink fluids and/or munch on ice chips for hydration. 

As long as baby and I are doing fine, I’d like to progress free of time limits and to avoid artificial induction (pitocin). 

When it’s time to push I’d like to do so instinctively. I’d also like to avoid an episiotomy, and would rather tear (though, I’m not hoping for that!). 

I’d like to try different pushing positions if one is not effective or comfortable (suggestions are welcome).

Pain Relief:

I’d like to use emotional support from my husband, and the the staff; as well as relaxation exercises, position changes, the shower/tub, breathing techniques, a birthing ball, hot/cold compresses, massage and comfort methods to relieve pain.

Please do not offer pain medication; if I want something, I will request an epidural. 

Postpartum:

I’d like to hold my baby right away, putting off any procedures that aren’t urgent.

My husband would like to cut the cord. 

I’d like to breastfeed as soon as possible and do baby’s eye care after initial feeding.

I will be breastfeeding exclusively. 

We’d like the baby to stay in our room for her bath, weighing etc. 

We will not be giving our baby any immunizations at this time. 

We’d like all newborn exams to be done in our presence or in the presence of my husband. 

Again thank you for taking the time to read this. We are so excited to share our birth experience with you and the other staff. Please know we appreciate your kindness and consideration during this special time. 


(You can read Gwen's birth story here: Part 1 & Part 2)