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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.

Birth Plan

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


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.


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.

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


Last updated: August 2022

Last reviewed: January 2021

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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.