Labor and delivery plan

How to Create a Birth Plan

Written by Kathleen Dailey

Medically Reviewed by Neha Pathak, MD on March 19, 2021

The day you give birth is one of the most important of your life. Creating a birth plan ahead of time helps you make decisions about how you want your labor and delivery to be, and lets others know your wishes. So when the big day arrives, you can focus on what's most important -- bringing your new baby into the world.

What Is a Birth Plan?

A birth plan is an outline of your preferences during your labor and delivery. For example, your birth plan may include who you want with you during labor, whether you want pain meds, or if you want the lights dimmed. You can include anything you think will make your labor and birth more comfortable for you.

Keep in mind, though, that a birth plan is not set in stone because you cannot predict everything that may occur that day. You or your doctors may need to make changes to the plan once your labor begins. So try to stay flexible if something unexpected happens.

What Should I Include in a Birth Plan?

Although it's tempting to include many details in a birth plan, try to keep it short so it's easy for everyone to read.

Here are some items your birth plan might cover:

The basics: List your name, your doctor's name and contact information, where you plan to give birth, and who you’re planning to have there with you.

Atmosphere: Think about what will help you feel most comfortable. Would you like the lights dimmed? Do you want your room as quiet as possible or would you prefer soft music? Would you like a support person to take photos or video of your labor or birth?

Labor preferences: Include any preferences you have for your labor. For example, do you want to walk around freely? Do you want to use a birthing stool, ball, or chair? Would you like to take a warm shower or bath?

Pain meds:Pain management during labor is an important consideration. You may not plan to have an epidural, but you could change your mind during labor. Or you may know that you definitely want to have an epidural if possible. As you're defining your birth plan, ask your doctor about your options for pain relief as well as any questions you have about them. These could include breathing or massage.

Delivery preferences: There are many options to consider for your baby's birth. If you're planning on a vaginal birth, would you prefer not to have an episiotomy unless it’s medically necessary? Do you want a mirror to see your baby's birth? Would you like your partner to cut the umbilical cord? Do you want your baby placed on your abdomen right after delivery?

If you need a C-section, who would you like with you in the delivery room?

Feeding and Care in the hospital: Once your baby's born, you’ll need to think about feeding and care. For example, do you want to breastfeed right after delivery? Or are you thinking about bottle feeding or combining bottle feeding with breastfeeding? Would you like your baby in the hospital room with you at all times, or would you prefer your baby stay in the nursery sometimes? Is it OK for the medical staff to offer your baby a pacifier or sugar water? If your baby is a boy, would you like them circumcised at the hospital? (Sugar water may be used at time of circumcision.)

Who Should Review My Birth Plan?

Review your birth plan with your partner and anyone else who will be with you in the delivery room, such as a labor coach or doula. Then ask your doctor to take a look at your birth plan, too. Your doctor, or the hospital or birth center, may have their own delivery policies. Reviewing your birth plan ahead of time gives you time to help resolve any potential conflicts.

Who Needs a Copy of My Birth Plan?

Once your birth plan is set, give a copy to your doctor to keep with your medical records, and take another copy to the hospital or birth center. You'll also want to give copies of your birth plan to anyone who will be with you during labor. It's a good idea to bring a few copies with you to the hospital or birth center when you go into labor, too. Another doctor may wind up delivering your baby if your regular doctor isn't available.

It is not necessary to have a birth plan as all of these preferences can be made while in the hospital, but it is certainly important to think about all the options and discuss them with your partner and doctor.

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Sample Birth Plan | ACOG

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A birth plan is a written outline of what you would like to happen during labor and delivery. This plan lets your obstetrician–gynecologist (ob-gyn) know your wishes for your labor and delivery.

Go over your plan with your ob-gyn well before your due date. But keep in mind that having a birth plan does not guarantee that your labor and delivery will go according to that plan. Unexpected things can happen.

Remember that you and your ob-gyn have a common goal: the safest possible delivery for you and your baby. A birth plan is a great starting point, but you should be prepared for changes as the situation dictates.

Your name:
Name of your ob-gyn:
Name of your baby's doctor:
Type of childbirth preparation:

Labor

Choose as many as you wish:
[ ] I would like to be able to move around as I wish during labor.
[ ] I would like to be able to drink fluids during labor.

I prefer:
[ ] An intravenous (IV) line for fluids and medications
[ ] A heparin or saline lock (this device provides access to a vein but is not hooked up to a fluid bag)
[ ] I don't have a preference

I would like the following people with me during labor (check hospital or birth center policy on the number of people who can be in the room):
_________________________________________
_________________________________________
_________________________________________
_________________________________________
It's OK [ ] /not OK [ ] for people in training (such as medical students or residents) to be present during labor and delivery.

I would like to try the following options if they are available (choose as many as you wish):
[ ] A birthing ball
[ ] A birthing stool
[ ] A birthing chair
[ ] A squat bar
[ ] A warm shower or bath during labor. I understand that a bath would be used only for the first stage of labor, not during delivery.

Anesthesia Options

Choose one:
[ ] I do not want anesthesia offered to me during labor unless I specifically request it.
[ ] I would like anesthesia. Please discuss the options with me.
[ ] I do not know whether I want anesthesia. Please discuss the options with me.

Delivery

I would like the following people with me during delivery (check hospital or birth center policy):
_________________________________________
_________________________________________
_________________________________________
_________________________________________

[ ] I prefer to avoid an episiotomy unless it is necessary.
[ ] I have made prior arrangements for storing umbilical cord blood.

For a vaginal birth, I would like (choose as many as you wish):
[ ] To use a mirror to see the baby's birth
[ ] For my labor partner to help support me during the pushing stage
[ ] For the room to be as quiet as possible
[ ] For one of my support people to cut the umbilical cord
[ ] For the lights to be dimmed
[ ] To be able to have one of my support people take a video or pictures of the birth. (Note: Some hospitals have policies that prohibit videotaping or taking pictures. Also, if it is allowed, the photographer needs to be positioned in a way that does not interfere with medical care.)
[ ] For my baby to be put directly onto my chest immediately after delivery
[ ] To begin breastfeeding my baby as soon as possible after birth

In the event of a cesarean delivery, I would like the following person to be present with me:
_________________________________________

[ ] I would like to see my baby before my baby is given eye drops.
[ ] I would like one of my support people to hold the baby after delivery if I am not able to.
[ ] I would like one of my support people to go with my baby to the nursery.
[ ] I would like my support person to know what shots my newborn will receive.

Baby Care Plan

Feeding the Baby
I would like to (check one):
[ ] Breastfeed exclusively
[ ] Bottle-feed
[ ] Combine breastfeeding and bottle-feeding
It's OK to offer my baby (check as many as you wish):
[ ] A pacifier
[ ] Sugar water
[ ] Formula
[ ] None of the above

Nursery and Rooming-In
If available at my hospital or birth center, I would like my baby to stay (check one):
[ ] In my room with me at all times
[ ] In my room with me except when I am asleep
[ ] In the nursery but be brought to me for feedings
[ ] I don't know yet. I will decide after the birth.

Circumcision
[ ] If my baby is a boy, I would like him circumcised at the hospital or birth center.

HT001

Last updated: August 2022

Last reviewed: January 2021

This information is designed as an educational aid for the public. It offers current information and opinions related to women's health. It is not intended as a statement of the standard of care. It does not explain all of the proper treatments or methods of care. It is not a substitute for the advice of a physician. Read ACOG’s complete disclaimer.

Preparing for breastfeeding when planning a pregnancy

Your pregnancy is going well and it's time to prepare for the birth of your baby. You may want to make a birth plan. If you are going to breastfeed your baby, be sure to include this item on your list.

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Breastfeeding your baby in the first couple of hours after birth maximizes the chances of successful breastfeeding and allows the baby to get the full benefits of colostrum, the very first breast milk, as soon as possible. Include breastfeeding in your birth plan to help you achieve your goal.

What is a birth plan?

The birth plan is a kind of list that will indicate your options and wishes related to labor, the birth of the baby and actions immediately after birth. This may include your preferences for pain relief and positioning during labour, what to do if you have a caesarean section or complications during labor and, of course, items related to breastfeeding.

Ideally, this plan should be made well in advance of your due date so that you can discuss it with the person who will accompany you during the birth and your doctor who will see you.

You are free to plan your birth, but it is best to start with a simple list that you can expand on as more information becomes available. You can ask your labor ward for a sample or template of a birth plan, or look up examples online.

Why is this so important?

Birth plan provides clarity. It will help to dialogue and create trust between you, the person who will accompany you in childbirth, and your doctor. This is especially useful during labor, when unnecessary questions will be completely useless to you! In addition, if there is a change of staff during the birth, such a plan will help new specialists quickly get up to speed.

Preparing to breastfeed

If you are planning to breastfeed your baby, discuss your plans with the birth attendant and your doctor during pregnancy. The midwife will enter your wishes into your medical record and will be able to recommend where you can get support for breastfeeding.

Planning your birth is also a good opportunity to discuss your wishes with the person who will accompany you during the birth, if you have not already done so. Explain that you need his support with breastfeeding. It should help your baby get breastmilk, even if the birth doesn't go according to plan or you can't put your baby to the breast right after the birth. Ask him to make skin-to-skin contact with your baby if you can't do it yourself, as this will help the baby calm down. ¹

What to include in the birth plan?

When you get to the point about breastfeeding, simply state your intention to breastfeed exclusively. Explain that you would like the doctors to do everything possible so that you can breastfeed your newborn baby, and if this proves impossible, feed him expressed breast milk so that you can still start producing milk.

Here are a few examples of things you can include in your birth plan to clearly express your desire to breastfeed and start breastfeeding successfully:

I would like to have my baby placed on my breast for skin-to-skin contact immediately after birth, before being weighed and washed, unless there is a medical reason for doing so.
If I can't take the baby right away, please give it to the birth attendant so they can attach it to themselves, skin to skin.
I would like to be allowed to breastfeed my baby in the first hour after birth, if possible.
I would like my baby to be allowed to latch on or gently assisted in doing so.
If my baby becomes unwell or we need to be apart for a while, I would like to express colostrum so that the baby can be fed by syringe or cup.
If for some reason my baby is not able to breastfeed in the first few hours after birth, or if he does not do well, I would like to be given the opportunity to double pump in the first three hours and give the baby expressed milk.
If I need to continue pumping, I would like to pump 8 times a day to get my milk production going.
Please do not give formula to my baby without my consent or the consent of the birth attendant, and once consented, only if medically indicated.
Please do not bottle feed or pacify my baby without my consent or the consent of the birth attendant.
I would like help with breastfeeding from a qualified lactation specialist or consultant if possible.

What if the birth did not go according to plan?

Even with the most carefully thought out plan, it is impossible to predict how the birth will go. Therefore, it is important to be ready for change.

Be aware that some medications and medical interventions during labor can affect a baby's ability to breastfeed at first. It is worth asking your doctor about the side effects of various pain medications and birth surgeries on you and your baby, as well as any possible consequences for breastfeeding, so that you or your birth attendant can make informed decisions.

Do not lose heart, even if you fail to breastfeed your baby in the very first hour after birth. Many moms are great at establishing and continuing breastfeeding despite not having the best start. Try to get as much help as possible from the professionals around you and, if necessary, contact a lactation consultant in order to establish breastfeeding as soon as possible.

Literature

1 Erlandsson K et al. Skin-to-skin care with the father after cesarean birth and its effect on newborn crying and prefeeding behavior . Birth . 2007;34(2):105-114. - Erlandsson, K. et al., "Paternal skin-to-skin maneuver for caesarean section babies and its effect on infant crying and pre-feeding behavior." Bers. 2007;34(2):105-114.

Birth plan | Articles by EMC doctors about diseases, diagnosis and treatment

Soon you will have to draw up a detailed plan for childbirth with your doctor.

Unfortunately, not always the expectant mother can participate in the planning of childbirth. As a rule, in most clinics, the sole decision is made by the obstetrician-gynecologist and all objections and wishes are rarely taken into account.

However, choosing the clinic where your baby will be born and the doctor who will help him to be born, you, of course, are already planning your ideal birth. It is our deep conviction that in order for the birth to go the way you want, even with the amendments and adjustments that life can make, first of all, we must hear the expectant mother and her wishes.

What do we mean by the birth plan and how it happens, - says the head of the EMC Perinatal Center prof. Natalia Kan.

What should be in the plan of childbirth?

The first thing that the doctor evaluates is the possibility of having a baby through the natural birth canal. The size of the fetus, its location, the characteristics of the pelvis, and whether there are any aggravated factors in the form of somatic or obstetric pathology are taken into account. For us, the most important thing is the health of the mother and her unborn baby, even minimal risks must be taken into account. If a woman in labor has strict indications for a planned caesarean section, the doctor will discuss in detail all the risks that may be if you choose a different method, tell you why operative delivery is required. For example, with complete placenta previa, the doctor adds measures to prevent possible risks to the plan.

Most cases involve vaginal delivery or elective caesarean section. Then we provide all the possibilities for the imagination of future parents: do they want to be together in the birth unit, do they need to dim the lights, what music should be played, perhaps the woman wants to call her doula for childbirth or ease the contractions in the water, will the husband be present in the operating room and take the child first.

When drawing up a birth plan, the doctor and the patient discuss the possibility of inducing labor, the use of anesthesia, pain relief after cesarean, the ability to cut the umbilical cord and much more.

When is the best time to schedule a birth?

As a rule, at 36 weeks, so that the obstetrician-gynecologist has the most complete clinical picture based on the history of the course of pregnancy and the collected examination data.

What to do if things don't go according to plan?

Of course it could be. For example, during EP, situations may arise that cannot always be predicted in advance: acute fetal hypoxia, discoordination of labor, etc.