Birth plan template with example wording
Updated October 13, 2026 · sources checked October 13, 2026
In short
A good birth plan template fits on one page and has eight sections: your details and support people, your top three priorities, environment, movement and positions, pain relief, the birth itself, after the birth (skin-to-skin, cord, feeding, vitamin K) and what you want if plans change. Fill it in, discuss it with your midwife or OB, then pack printed copies.
How to use this template
Copy the sections below into a document, keep the sentences that fit you, delete the rest. Each section follows the questions in the NHS birth plan checklist. When it is done, read it with your midwife or OB: NICE asks your team to review any written birth plan with you when you arrive in labor, so it helps if they have seen it before.
If you are still deciding what you want, start with our guide on how to write a birth plan.
Printable checklist: decisions to make before you write
Section 1: About me
- Name, due date, hospital or birth centre
- Midwife or OB name
- Birth partner(s): name and phone number
- Anything the team should know straight away: allergies, a previous birth experience, a fear of needles, a language preference
Section 2: My top three priorities
Example wording:
- "I would like to stay mobile and upright for as long as it is safe."
- "Please offer pain relief options but let me ask for them."
- "Immediate skin-to-skin with my baby is the most important thing to me."
Section 3: Environment
- Lights dimmed, quiet voices, my own music
- Trainees and students: welcome / please ask me first / not this time
- Birth pool or bath if available
Section 4: Movement and positions
ACOG supports frequent position changes during labor for comfort, as long as monitoring stays possible, and NICE recommends any position you find comfortable except lying flat on your back.
- "I would like to move freely, use a birth ball and try upright positions."
- "If I need continuous monitoring, I would like to stay as mobile as possible."
- Ideas to list: walking, kneeling, all fours, side-lying, standing, see our labor positions guide.
Section 5: Pain relief
| My preference | Example wording |
|---|---|
| Medication-free if possible | "I plan to use breathing, water and massage. Please do not offer medication unless I ask." |
| Open to options | "I would like to start with water and gas and air and decide on more as labor goes." |
| Epidural planned | "I would like an epidural once I am in established labor." See our epidural guide. |
Section 6: The birth
- Pushing: "I would like to follow my own urge to push" or "please guide me"
- Who will tell me the sex of the baby, if not already known
- Who would like to cut the cord
- Photos or video: yes / no
Section 7: After the birth
The NHS checklist includes three choices most people forget until the moment:
- Skin-to-skin: "Please place my baby on my chest straight away, before the cord is cut, if we are both well."
- Feeding: breastfeeding / formula / combination / undecided
- Vitamin K for my baby: yes / no / I would like to discuss it
Section 8: If plans change
- "If I need forceps or a vacuum, I would like my partner to stay with me."
- "If a caesarean is needed, I would like my partner in theatre, the screen lowered at birth if possible, and skin-to-skin in theatre if we are both well."
- "Please explain what is happening and why, so I can take part in decisions."
For your partner or birth partner
Give your birth partner their own copy and go through it once together. Their role on the day: hand it over on arrival, remind the team of your top three priorities at shift changes, and ask "can we have a few minutes to talk about it?" if a decision comes up. Every choice in Section 5, from no medication to an early epidural, deserves the same support.
Is this normal? When to call
Leaving sections blank because you have not decided yet is fine: "I would like to decide on the day" is a valid answer.
If you are writing this in late pregnancy and your waters break, you bleed, your baby moves less or you have contractions before 37 weeks, call your maternity unit, midwife or OB-GYN straight away. If the baby is coming now, call 911 (US) or 999 (UK); in the UK, NHS 111 if you cannot reach your unit.
Why it is worth the hour it takes
A 2026 meta-analysis of randomised trials linked birth plans with more vaginal births and more early breastfeeding, and described them as a strategy to promote a more respectful childbirth (Martin et al., 2026). The evidence is still limited, but the main benefit is simple: a plan makes sure the conversation happens before you are in the middle of contractions.
The ready-to-fill version
Our kit turns this template into printable, fill-in pages: a one-page birth plan, a caesarean version, the full hospital bag checklist by bag, and the questions to ask at each prenatal visit.
Whatever you write, keep one copy in your notes, one in your hospital bag and one with your birth partner.
Questions parents ask
How long should a birth plan be?
One page is enough. Your team reads it at the start of labor and at shift changes, so short headings and bullet points work far better than paragraphs.
Is there an official birth plan template?
The NHS offers a downloadable birth plan template in Word format on its website, and the March of Dimes offers one in the US. The structure below follows the same NHS checklist.
Should I write a birth plan for a planned caesarean?
Yes. You still have choices to discuss, such as who is with you, music, seeing your baby being born, skin-to-skin in theatre and feeding. Talk them through with your obstetrician and anaesthetist.
Sources
- NHS — What to include in your birth plan (checklist and template) checked October 13, 2026
- NICE NG235 — Intrapartum care, recommendations checked October 13, 2026
- ACOG Committee Opinion 766 — Approaches to Limit Intervention During Labor and Birth checked October 13, 2026
- March of Dimes — Stages of labor (birth plan section) checked October 13, 2026
- Martin GCC et al. The Role of Birth Plan in Shaping Maternal and Neonatal Outcomes. Am J Perinatol 2026 (PMID 41950955, DOI 10.1055/a-2849-7990) checked October 13, 2026
Mamavela explains; it does not replace your midwife, doctor or pediatrician, who know your situation. If something worries you, call them. In an emergency, call 911 (US), 999 (UK) or 112.