How to Write a Birth Plan: What to Include, What to Skip, and When to Share It

Somewhere around the third trimester, someone will ask if you have a birth plan. If your honest answer is "a plan for what, exactly?" you are in good company. The phrase makes it sound like a legal document, and the templates online can run to six pages of checkboxes about lighting and playlists.

The real thing is simpler and more useful than that. A birth plan is a one-page way of telling the people caring for you what matters to you, so nobody has to guess in the middle of a contraction. Here is what the major medical sources say belongs on it, what can safely be left off, and when to hand it over, with nothing invented in between.

01What a birth plan actually is

MedlinePlus, the National Library of Medicine's consumer health site, puts it plainly: "Birth plans are guides that parents-to-be make to help their health care providers best support them during labor and delivery." March of Dimes calls it "a set of instructions you make about your baby's birth," and adds a line worth remembering if you feel behind: "You don't have to have a birth plan. But having one is a great idea!"

The Cleveland Clinic describes it as a written summary of your preferences for labor, delivery, and postpartum care. Certified nurse midwife Claire Hamp, quoted in that article, frames it as guidelines for your care team, a way to make sure everyone understands your wishes. The Clinic's own summary is the best one we found: think of it as "a roadmap, not a script." Labor does not read your document. The point of writing one is to have already thought through your choices, so that when the day arrives you are deciding from a calm place instead of a surprised one.

02When to write it

There is no official week, but the sources agree on the shape of the timing. The Cleveland Clinic says to create your plan during pregnancy and bring it to prenatal visits to review with your provider. MedlinePlus says that once it is done, "be sure to share it with your provider well before your delivery date." The NIH's child health institute says the same about pain relief: "A woman should discuss the many aspects of labor with her health care provider well before labor begins."

In practice, the middle of the third trimester works well: close enough that the questions feel real, far enough away that you still have prenatal visits left. One choice has a firm deadline. If you want to donate cord blood, the American Academy of Pediatrics says the donation "should be arranged by the 34th week of pregnancy," because a collection kit has to be sent to you first. Our third trimester checklist puts that and the other late-pregnancy tasks in order, and our free week-by-week planner places "draft the birth plan" on your own calendar based on your due date.

03What to include, section by section

Both MedlinePlus and the Cleveland Clinic organize a birth plan into roughly the same sections. Here they are, with the actual questions those sources suggest you answer.

The basics at the top

The Cleveland Clinic suggests opening with your name and how you like to be addressed, your partner or labor support person's name, your due date, and your provider's name. A nurse coming on shift at 3 a.m. reads this first.

Who is in the room, and what it looks like

MedlinePlus asks: "Who do you want to be with you during labor? During delivery?" and, just as usefully, "Is there anyone you want kept out of the room?" It also asks whether you want a doula present. If there is a relative you would rather see after the baby arrives than during, this is the polite, official place to say so. Then the low-stakes items: "Do you want music? Lights? Pillows? Photos?" The Cleveland Clinic adds movement during labor, access to a birthing ball or water therapy, and preferred positions. One line each, not a page.

Labor and delivery

This is the section your care team reads most closely. MedlinePlus lists the questions: "Do you want to stand up, lie down, use a shower, or walk around during labor?" "Do you want continuous monitoring?" "Do you want treatments to move labor along faster?" "What are your feelings about episiotomy?" and "Do you have strong feelings about assisted delivery (the use of forceps or vacuum extraction)?" If some of those are new to you, that is what the next prenatal visit is for: ask what each one means and how often it comes up at your hospital, then write down where you land.

If a C-section becomes necessary

Even if you are planning a vaginal birth, put a line in about a cesarean. MedlinePlus asks: "If you need to have a cesarean delivery (C-section), do you want your coach or partner to be with you?" The Cleveland Clinic suggests naming who you want present, if circumstances allow, and whether you would like skin-to-skin care in the operating room if it is safe. Deciding this while it is hypothetical is far easier than deciding in the moment. Our C-section recovery guide covers the weeks after one.

04The pain relief section

This is the part most people picture when they hear "birth plan." MedlinePlus boils it down to a few questions: "Do you want to try to give birth without pain medicine, or do you want medicine for pain relief?" "Would you like to have an epidural for pain relief during labor?" "Would you prefer only IV pain medicine?" and "Would you like to be able to labor in a tub or shower, if allowed, at the hospital?"

The NIH's child health institute lays out the actual options. Analgesics reduce pain without a total loss of feeling. Some are given through the whole body, while regional analgesia, which includes epidurals and spinal blocks, numbs one region and is "the most common way to relieve pain during labor" in the United States. Anesthetics block all feeling; "General anesthesia causes the patient to go to sleep," and is not the norm for a routine delivery. For people who want to go without medication, the same page lists what they lean on instead: continuous support from others "who offer reassurance, advice, or other help," breathing and music, movement and position changes, massage, yoga, bathing, hypnosis, acupuncture and acupressure, and aromatherapy. Many of those work alongside medication too, so "unmedicated" and "epidural" are not the only two boxes.

05Right after the baby arrives

The first hour after birth comes with its own short list of choices, and they go by fast if nobody has written them down. MedlinePlus asks: "Who do you want to cut the umbilical cord?" "Do you want delayed cord clamping?" "Do you want to save or donate the cord blood?" and "Do you want skin to skin contact for immediate bonding with baby after birth?"

Skin-to-skin. The Cleveland Clinic describes the standard version: "Your baby is placed belly-down, directly on your chest, right after birth." It notes that the American Academy of Pediatrics recommends all breastfeeding babies spend time skin-to-skin right after birth, that it "helps your baby start and continue breastfeeding," and that "Your care team will try to help you do skin-to-skin after a vaginal delivery or a C-section. If you need surgery or aren't feeling well enough to do skin-to-skin, your partner or another support person can step in." Our skin-to-skin guide covers how to keep doing it at home.

Cord blood. The AAP says "Donating cord blood is safe for the baby and doesn't interfere with labor and delivery," and it favors public donation over private storage: "Thirty times more publicly banked cord blood units are used for transplants compared to privately banked cord blood." Public banking is free; private banks charge an upfront fee plus a yearly one. The AAP suggests raising it with your obstetrician or pediatrician at the first prenatal visit, and arranging a donation by the 34th week.

06Feeding and newborn care in the hospital

The last section covers the day or two before you go home. MedlinePlus asks whether you are planning to breastfeed, whether you want help from the hospital with breastfeeding, whether you would like to avoid pacifiers or supplements unless your baby's provider orders them, and whether you want a boy circumcised. The Cleveland Clinic adds who gives the baby their first bath, and March of Dimes suggests noting any "special religious or cultural practices you want to have happen once your baby is born." None of these have to be locked in on paper. "Undecided on circumcision, please ask us" is a perfectly good entry; if you do decide on it, our circumcision care guide covers the healing days after.

07What to leave off

March of Dimes's first tip is to keep it simple, and every source we read points the same direction. A few things that bloat a plan without helping anyone:

• Anything the hospital already does by default. Ask at your hospital tour or a prenatal visit what is standard there, and note those items in one word rather than a paragraph.
• Wishes the hospital cannot grant. MedlinePlus notes that "The hospital may not be able to provide you with some of the options you may want," and that "Your health insurance coverage may not cover every wish in your birth plan." A water birth in a hospital with no tubs is a conversation to have now.
• A script for every scenario. One or two lines about what matters most to you if things change does more work than three pages of contingencies.
• The packing list. That belongs in the bag, not the plan. Our hospital bag checklist has it.

08Who to share it with, and when

A birth plan nobody has read is a diary. MedlinePlus gives the sequence: "Talk to your partner as you make your birth plan. Also talk with your provider about your birth plan." Then share it with your provider well before your delivery date and "leave a copy with the hospital or birthing center where your delivery will occur." March of Dimes widens the circle to the nurses at the hospital or birthing center, and to your family and other support people too.

09The one thing every source agrees on

Flexibility. MedlinePlus says it directly: "It's important to stay flexible. Keep in mind that some of the things you want may not be possible," and "Your provider may feel that certain steps are needed for your health or your baby's health, even though they are not what you wanted." The Cleveland Clinic's midwife puts the same idea more warmly: "If things change, your provider will work with you to make the best decisions to keep you and your baby safe."

So write the plan, and then hold it loosely. Its job is to make sure that whatever the day brings, the people in the room know what you care about, and you have already had the conversations that let you decide with a clear head. Once the baby is here, our first twelve weeks guide picks up where this one leaves off.

Questions parents actually ask

Newborn Weeks is planning help, not medical advice — always follow your own doctor, midwife, or pediatrician.