Medical Information
The information on this page is for educational and informational purposes only. It is not medical advice and should not be used to diagnose or treat any medical condition. Always consult your healthcare provider (doctor, midwife, or nurse) before making any decisions about your pregnancy or your baby's health.
labor-deliveryHow to Write a Birth Plan: Template, Tips, and What to Include
A section-by-section birth plan guide covering pain relief, delayed cord clamping, skin-to-skin, feeding, and how to write preferences your midwife will actually find useful.
A birth plan is one of the most misunderstood documents in maternity care. Many people approach it as a contract — a list of demands that must be honoured. In practice, the most useful birth plans work the other way around: they show your care team that you understand labour is unpredictable, that you have thought about multiple scenarios, and that you know what matters most to you when circumstances change.
This guide takes you through every section a birth plan might cover, explains what the current evidence and NHS guidance says about each option, and gives you a practical template to adapt.
Fact-Checked & Transparent: This article is fact-checked against current CDC, WHO, ACOG, and NHS guidelines. All health information is based on authoritative medical sources. Last verified: June 2026.
⚠️ MEDICAL DISCLAIMER
This article is educational information only. It is NOT a substitute for professional medical advice, diagnosis, or treatment.
Always consult your pediatrician or healthcare provider before making any medical decisions for your baby or child. Every baby is unique, and professional medical guidance is essential.
In case of emergency, call 911 or your local emergency number.
What a Birth Plan Is — and What It Is Not
A birth plan is a written record of your preferences for labour, birth, and the immediate postnatal period. It is not a guarantee of outcome. Labour can change direction quickly. A baby who is coping well at 8 cm might show signs of distress that make continuous monitoring essential. A person who planned a water birth might find that an epidural is the right choice once labour establishes.
The NHS describes birth plans as a way to think through your choices and communicate your wishes to the midwife looking after you. Midwives and obstetricians read birth plans as a sign of how engaged and informed a person is — and a plan that acknowledges uncertainty is far more reassuring to read than one that refuses standard safety procedures without clinical discussion.
The most useful birth plans are also short. One to two pages, clearly organised, easy to scan in the middle of a busy shift. Bullet points and short sentences work better than paragraphs.
When to Write Your Birth Plan
Most people write their birth plan during the third trimester, between 28 and 36 weeks. This gives you time to:
- Attend antenatal classes where birth options are discussed
- Ask your community midwife about what your specific birth setting offers (not every unit has a pool, for example)
- Read the relevant sections of your maternity notes
- Talk to your birth partner about what role they want to play
Your 34–36 week antenatal appointment is a natural moment to go through your birth plan with your midwife. If you have a specific obstetric history — previous caesarean, pregnancy complications, Group B Strep — this conversation becomes especially important.
What to Include: A Section-by-Section Guide
Birth Setting Preferences
If you have a choice of birth setting, state it clearly. In the UK, options typically include a consultant-led labour ward, a midwife-led unit, and home birth. Each has different facilities, staffing levels, and intervention rates. The NHS supports informed choice for low-risk pregnancies across all three settings.
If you are planning a home birth or midwife-led unit birth, your plan might include a note about transfer preferences if a complication arises — for example, expressing that you understand transfer might be needed and that you want it to happen promptly if recommended.
Who You Want Present
List your birth partner or partners. Some units allow two support people; others restrict to one in certain areas (such as theatre). Check your unit's current policy and state your preference clearly. If you have a doula, note this — some units will accommodate a doula as an additional person.
Mobility in Labour
Research consistently shows that upright positions and freedom to move help labour progress and reduce the perception of pain. The Royal College of Midwives supports active labour. If staying mobile matters to you, say so — and ask in advance whether your unit has birthing balls, mats, and pool facilities available.
Pain Relief Preferences
This is often the longest section of a birth plan. A realistic plan lists preferences in order rather than excluding options entirely:
- Non-pharmacological first: movement, water, TENS machine, massage
- Entonox (gas and air) if needed
- Epidural if the above are not providing enough relief
If you feel strongly about avoiding an epidural, it is more useful to write "I would like to try all non-pharmacological options before considering an epidural" than to write "no epidural under any circumstances." The first leaves you open to changing your mind — which is completely valid — while the second can feel dismissive to a midwife who can see you are in significant pain.
Monitoring Preferences
Continuous cardiotocography (CTG) monitoring is standard when there are risk factors, after an epidural, or if concerns arise during labour. For low-risk labours, intermittent auscultation — where the midwife listens to the baby's heartbeat every 15 minutes in first stage and after every contraction in second stage — is the NICE-recommended approach.
If you prefer intermittent monitoring, say so, and note that you understand continuous monitoring may be needed if the situation changes.
Delayed Cord Clamping
The NHS now recommends delayed cord clamping as the default for all births. The cord should not be clamped for at least one minute after birth, and ideally three to five minutes, unless there is a clinical reason to clamp earlier (such as the need for immediate resuscitation). This allows the baby to receive additional blood volume and iron stores, which the WHO supports for improved outcomes.
You do not need to specifically request delayed cord clamping in most NHS trusts — it is now standard practice. However, you can note it in your plan if it is important to you, and also note who you would like to cut the cord.
Skin-to-Skin Immediately After Birth
Skin-to-skin contact immediately after birth supports temperature regulation, feeding initiation, and early bonding. The NHS and UNICEF Baby Friendly Initiative both recommend immediate, uninterrupted skin-to-skin for at least an hour after birth. Note in your plan that you would like skin-to-skin before any non-urgent newborn checks, and that you would like your birth partner to provide skin-to-skin if you are unable to.
Third Stage: Physiological or Managed
The third stage is the delivery of the placenta. There are two approaches:
- Managed third stage: You are given an injection of oxytocin (syntocinon) after birth, which causes the uterus to contract and the placenta to deliver more quickly, usually within 30 minutes. This is the NHS default recommendation and reduces the risk of postpartum haemorrhage.
- Physiological third stage: No injection is given; the placenta delivers naturally, which can take up to an hour and requires the cord to remain unclamped.
The NHS recommends managed third stage for most people. If you would prefer physiological third stage, this is worth discussing with your midwife in advance so the clinical implications are clear.
Vernix
Vernix caseosa — the white, waxy coating on a newborn's skin — is a natural moisturiser and has antimicrobial properties. You can note in your plan that you would like vernix to be left on the baby rather than wiped off immediately.
Birth Plan for a Planned Caesarean
A caesarean birth plan is just as valid and just as useful as one for a vaginal birth. Many hospitals now offer what is sometimes called a gentle caesarean or family-centred caesarean, which may include:
- The drape being lowered or made transparent at the moment of birth so you can see your baby being born
- Delayed cord clamping, which is now increasingly offered in theatre
- Immediate skin-to-skin in theatre, with the baby placed on your chest while the surgical team closes the incision
- Your choice of music during the procedure
- Your birth partner being present from the start of the procedure
- Noting who you would like to cut the cord if delayed clamping is possible
Ask your consultant or midwife what your specific hospital offers — not all trusts have adopted all of these options.
Birth Plan for VBAC
If you are planning a vaginal birth after caesarean (VBAC), your birth plan should acknowledge the monitoring requirements. Continuous CTG is recommended throughout VBAC labour because uterine scar rupture, though rare, requires prompt detection. Noting in your plan that you understand and accept continuous monitoring — while also stating your other preferences — shows that you are well informed and helps your care team see you as a collaborative partner.
The Postnatal Section
Many birth plans end at delivery, but the postnatal section is just as important:
Feeding Intentions
State clearly whether you intend to breastfeed, formula feed, or combination feed. This helps the midwifery team offer appropriate support from the start. If you plan to breastfeed, you can note that you would like help with positioning and attachment within the first hour, and that you do not want formula offered unless you request it.
Vitamin K
Vitamin K is offered to all newborns to prevent vitamin K deficiency bleeding (VKDB), a rare but serious condition. It can be given as a single intramuscular injection or as a series of oral doses. The NHS recommends the injection as the most reliable method. Note your preference in the birth plan and discuss the differences with your midwife beforehand.
Newborn Checks and Procedures
State any preferences about timing of routine newborn checks, heel prick test, and any other procedures. Most parents are happy for checks to be done after the initial skin-to-skin period, rather than immediately after birth.
Talking to Your Midwife About Your Birth Plan
Bring your draft plan to your antenatal appointments and ask your midwife to read it. Specifically:
- Ask whether any of your preferences are not available at your birth setting
- Ask what would change if you needed to transfer from a midwife-led unit to the labour ward
- Ask what the trust's standard approach is to anything you have listed, so you understand what you are asking for versus what already happens routinely
Being open about what matters most — and why — helps your midwife advocate for you. "I had a previous traumatic birth and being able to move freely is very important to me" is more useful than a list of demands without context.
Frequently Asked Questions
Can I change my mind about pain relief during labour?
Yes, and this is completely normal. Many people plan a non-medicated labour and find that an epidural is the right choice once active labour begins. Your birth plan represents your preferences at one point in time — your decision-making in the room takes priority.
How long should a birth plan be?
One to two pages is ideal. Midwives are reading dozens of birth plans and caring for multiple patients. A clear, concise plan that can be scanned quickly is far more likely to be read and followed than a lengthy document.
Does a birth plan guarantee my preferences will be followed?
No. A birth plan communicates your wishes, but clinical decisions must always be made in the context of what is safe for you and your baby. If a recommendation is made that differs from your plan, your midwife or doctor should explain why and get your informed consent.
Do I need a birth plan for a planned caesarean?
Yes. A caesarean birth plan allows you to express preferences about skin-to-skin, music, who cuts the cord, delayed cord clamping, and the immediate postnatal period. Many people feel these preferences matter just as much for a surgical birth.
What should I leave out of a birth plan?
Avoid absolute refusals of standard safety procedures without clinical discussion. Avoid lengthy contingency planning for every possible scenario — this can make a plan difficult to use. And avoid language that positions you adversarially against your care team.
When should I give my birth plan to the hospital?
Bring it to your 36-week appointment so your midwife can review it and add relevant notes to your records. Also bring a printed copy to your birth — do not rely on it being in your notes when you arrive.
Key Takeaways
- A birth plan is a preference document, not a contract — the most useful ones show you understand labour may not go to plan.
- Include your preferences for pain relief, monitoring, delayed cord clamping, skin-to-skin, third stage, and feeding.
- The NHS recommends delayed cord clamping of at least one minute as standard for all births.
- A planned caesarean deserves a birth plan too — gentle caesarean options including skin-to-skin in theatre are available in many trusts.
- Discuss your plan with your midwife at 34–36 weeks so any preferences that need clinical discussion can be addressed in advance.
- Keep it to one or two pages, use bullet points, and bring printed copies to your birth.
📋 SOURCES & FACT-CHECKING
This article is compiled and verified against these authoritative sources: - CDC (Centers for Disease Control & Prevention) - WHO (World Health Organization) - ACOG (American College of Obstetricians and Gynecologists) - NHS (National Health Service) - AAP (American Academy of Pediatrics)
Last verified: June 2026
Educational content only. Always consult your pediatrician for medical decisions.
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PregnancySprout Editorial Team
Our editorial team researches every article against primary medical sources — NHS, WHO, NICE, and RCOG guidelines. We are health writers and parents, not doctors; content is reviewed for accuracy but does not constitute medical advice.
✓ Fact-checked against NHS, WHO, and NICE guidelines
