Free birth plan template

How to fill it in

Work through it with your partner, then take it to a prenatal visit so your provider can tell you what is and is not possible where you are giving birth. That conversation is the real point of the exercise.

• Start with the header: your name, due date, provider, birth place, and any medical notes the team needs, like your blood type and Group B strep result.
• For each section, cross out what does not apply and fill the brackets with what you want. Leave the rest to your team.
• Mark the two or three things you feel strongest about so they stand out. A team can honor a short, clear list far more easily than three pages of detail.
• Use plain preferences, not ultimatums. 'I would like intermittent monitoring if it is safe' reads better to a nurse than a demand.
• Ask your provider what their default practice is for the things you care about, so there are no surprises in the room.
• Print a few copies to bring with you, and give one to your partner or doula to keep handy.

Keep it to one page

This is the mistake that undoes an otherwise good birth plan. A labor and delivery team is moving fast, and a long document gets skimmed or set aside. Lamaze International recommends keeping a birth plan to a single page, bulleted, with only the essentials. So write the full template out, then cut it. Drop anything that is already the standard practice at your hospital, since you do not need to ask for what they do by default. Keep the items where your preference differs from the routine, or where you want a choice, like pain relief or delayed cord clamping. The goal is a page a nurse can scan in thirty seconds and act on.

A birth plan is not a contract or a consent form

This is worth being clear about. A birth plan records what you want, but it does not bind the hospital or your provider, and it is not the same as informed consent. Lamaze puts it plainly: a birth plan is not a contract, and neither your provider nor the hospital has to comply with it. Consent still happens at the point of care, in the moment, for each procedure. Your team will use clinical judgment, and if your health or your baby's health is at risk they may recommend or carry out steps that are not in your plan. That is not the plan failing; that is how care works. Because it is a communication tool and not a legal instrument like a contract or an advance directive, a birth plan does not need to be signed in any formal way, witnessed, or notarized. Its power is that it gets your wishes in front of the people caring for you, and gets the conversation started early.

Newborn procedures you should discuss, not just decline

A few newborn steps are routine, and some are required by state law, so treat these as things to understand and talk through rather than boxes to simply tick off. The American Academy of Pediatrics recommends a vitamin K injection at birth to prevent vitamin K deficiency bleeding, a rare but serious problem; babies who do not get it are far more likely to develop the late-onset form. Antibiotic eye ointment to prevent a newborn eye infection is recommended for all newborns and is required by law in many states, though the specifics vary by state. The hepatitis B vaccine is recommended by the AAP in the first day of life. And newborn screening, which is the heel-stick blood test plus a hearing screen and a heart screen using a pulse oximeter, runs in every US state, although states differ on exactly what they screen for and on whether and how a parent can opt out. If you have questions or concerns about any of these, raise them with your provider before your due date so you understand the reasons and the rules where you are delivering.

• Vitamin K injection: AAP-recommended at birth to prevent vitamin K deficiency bleeding.
• Eye ointment: recommended for all newborns and required by law in many states.
• Hepatitis B vaccine: AAP recommends the first dose within the first day of life.
• Newborn screening: a heel-stick blood test, hearing screen, and heart screen in every state; conditions and opt-out rules vary by state.

Preferences for the first minutes after birth

Some of the most-requested items on a birth plan happen right after delivery, and they are worth spelling out because the room is busy. Immediate skin-to-skin contact, if you and the baby are stable, is a common request and most hospitals support it. Delayed cord clamping is another: ACOG recommends waiting at least 30 to 60 seconds before clamping the cord for vigorous term and preterm infants, which lets more blood reach the baby and improves iron stores, with a small increase in jaundice to be aware of in term babies. You can also note who you want to cut the cord, what you want done with cord blood, whether you want the baby to stay in your room, and whether to delay the first bath. None of these should get in the way of care if something is wrong, so frame them as what you want when things are going normally.

If you need a cesarean

About one in three US births is a cesarean, and plenty happen without being planned, so it is worth having a few preferences ready even if you are hoping for a vaginal birth. Many hospitals now support what is often called a gentle or family-centered cesarean. On your plan you can ask for your support person to be with you in the operating room, a clear drape or the screen lowered so you can see your baby being born if it is safe, your hands kept free, and skin-to-skin contact in the operating room or recovery as soon as it is safe. You can also ask the team to talk you through what is happening as they go. These are the kinds of requests Cleveland Clinic and other hospital systems list on their own birth-preference worksheets. Not every facility can do all of them, so this is another thing to raise with your provider ahead of time.