How To Design Your Birth Plan

What is a birth plan?

A birth plan is a list of your preferences and desires for your birth and postpartum care. It can include your feelings about
pain medications, common medical interventions, labor and delivery positions and movement, natural comfort measures,
people present at your birth, and the birth environment you desire. It also includes your wishes for your baby’s care
such as internal fetal monitoring, rooming in, breast or bottle feeding, eye drops, and circumcision. A birth plan is a goal
for you and your doctor to work toward. As unexpected events occur, your birth plan may have to be modified in order
to provide the best care for you and your baby.

Why is a birth plan helpful?

A birth plan gives your care provider a clear picture of the type of birth you want. It also gives you a platform to talk through
your desires with your care provider. In addition, a birth plan helps you clarify what is really important to you. As you think through your options and write down your preferences, the areas that are most important to you will become clear.
A well written birth plan enables you to think through your options and clearly state your desires in writing before you
are in the middle of labor.

Who should see your birth plan?

Your doctor or midwife, and any colleagues that might be on call at the time of your birth should review your birth plan.
After discussing your birth plan with your care provider, both of you should sign it. You might deliver the final copy
of your birth plan with a basket of goodies for the hospital/birth center staff.

How to write a birth plan:

l Avoid using strong language in your birth plan. Instead, use words like “prefer,” “request,” and “unless medically necessary.”
You are trying to secure the staff’s cooperation in carrying out your wishes. The attitude you present in person, and in writing, will make a big difference in the staff’s desire to serve you.

l The opening paragraph of your birth plan should state why you chose to give birth at this facility, some praise for the staff,
your birth philosophy, and any concerns or fears you have for this birth.

l You may wish to include your personal preferences on things like lighting, whether or not you like to be touched and talked
to or left alone, whether you prefer quiet or do not mind some noise, the number of people you wish to be present in the room, and if you wish to use a video camera or camera.

l You will want to state your wishes on such things as pain medication, common interventions (such as continuous or intermittent fetal monitoring, episiotomies, IV’s, spontaneous or artificial rupture of membranes, pitocin, and forceps
or vacuum extraction), eating and drinking during labor, the freedom to move around or change positions or take a bath,
playing music, and anything else that is important to you.

l You should include your desires for the care of your baby. You may want to include your wishes on who cuts the cord, antibiotic eye ointment and vitamin K shots, when and where the newborn exam is performed, how the baby is to be fed
(bottle or breast), and whether you would like the baby to room in with you or have nursery care.

l You may also want to include a section that covers your wishes for an emergency situation such as a c-section.

l A birth plan is a very personal thing. It should include whatever is important to you in the process of labor and delivery.
If a birth plan clearly and politely states your wishes, then you have succeeded.

Sources
Murkoff, H., Eisenberg, A., & Hathaway, S. (2002) What To Expect When You’re Expecting. New: Workman Publishing Korte, D. & Scaer, R. (1992) A Good Birth, A Safe Birth. Massachusetts:
The Harvard Common Press
Sears, W. & Sears, M. (1994) The Birth Book. New York: Little Brown and Company


Sample Birth Plan

We chose to give birth at Anytown Regional Hospital because of the progressive facilities and the wonderful experiences
Mary has had there over the years as a doula. The staff shows excellent care, concern, and attention to a couple’s wishes.
We are very happy to have Dr. Brown assisting us in this exciting journey. We wish for this birth to be as happy and memorable as possible. In order to facilitate this we have listed our preferences below. These decisions are the product of much time, research, and thought. We would greatly appreciate your help in carrying these decisions out. Should unforeseen
complications arise, we will be happy to modify our plan after discussing our options with our doctor, and having
some time for us to confer privately.

l Mary would prefer to walk into the hospital. We would also like the freedom to return home if she is less than 5 cm dilated.

l We would like the freedom to have John (Mary’s husband), her mother, sister and a doula present at all times. Other family members may be waiting outside of the room.

l We prefer to bring our own pillows, birth ball, and music to the birth.

l We would rather not have a time limit on how long labor can go on, providing mother and baby are handling labor well.

l We desire this to be an all-natural birth therefore instead of pain medications we will seek to use freedom of movement, position changes, showers, massage, touch and other methods to relieve pain naturally.

l We would prefer not to have continuous fetal monitoring, AROM, pitocin, or frequent vaginal exams unless medically necessary.

l We would like the freedom to use various positions during the second stage to better facilitate pushing.

l We prefer to use mother-directed pushing, and to take the crowning stage slowly to avoid perineal tears. We also wish
to avoid an episiotomy and would instead like to use perineal support and massage during pushing to further prevent tearing.

l We request for the baby to be allowed to adjust to his new environment for a few minutes before the cord is cut.
We also wish for dad to cut the cord.

l We would prefer that the placenta be allowed to deliver naturally.

l We would prefer the baby to be placed on the mother’s chest immediately after birth. We also would like the freedom
to begin breastfeeding right away. In order to better facilitate breastfeeding we ask that our baby have no supplements
other than the breast. We also request full rooming in with our baby.

l We would like to be informed in advance of all procedures regarding our baby. We do not wish our baby to have antibiotic eye ointment and have already signed the appropriate forms. We also ask that the newborn exam be performed in our room
and if possible be delayed for a while to facilitate bonding.　




_____________________________________                              ________________________________________
Physicians Signature                                             John Doe

________________________________                      ___________________________________
Co-Physician’s Signature                                       Mary Doe