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Birth Plan Word Template - How To Write A Birth Plan

Updated on October 6, 2010

Every pregnant woman needs to create a birth plan. They're a great tool for effective communication – and  will allow you to convey your needs and wishes to the medical team that will be with you during the birth and labor process. They will be aware of your expectations prior to your arrival and can refer to it should the need arise.

It is also something that should be done between you and your partner, if you have one. It can be a great way of bringing you together and allows both to feel equally involved. Expectant dads often feel left out and this is a great pregnancy exercise that you can do in partnership.

Birth Plan

Before you start, you need to know how to write your birth plan, what to include within in it and who will need to have a copy. Ultimately, your needs/wishes will be observed as much as possible. For example you can and should expect that you don't have to avail yourself of pain relief – if you'd prefer to opt for a natural birth. However, you will also have to accept and understand that sometimes, extenuating circumstances may cause your 'ideal birth' to be set aside.

I diligently wrote one out for every one of my pregnancies. Unfortunately, with my second baby, every single thing that I’d written down was thrown out of the window – simply because my son was born with a great deal of haste. His arrival was hasty to the point it was almost ridiculous. The midwife barely had the time to ask me my name, let alone take the time to find out what I did - or didn't - want!

Write Your Birth Plan

In plenty of time.
In plenty of time.

Of course you need to know how to write a birth plan. What to include – what to leave out, what may need highlighting, what may be flexible. You will need to keep it concise - that goes without saying. And you’ll also need to be clear and direct. You’re not aiming for an essay – simply a means of conveying your wishes to those that need to know.

One of the easiest ways to start is to find out all that you can about the establishment that you’ll be giving birth in. Check out the facilities, what’s available, what’s not. Discuss your thoughts and ideas with your midwife, partner or friends/family if you’re alone. Once you’ve got a clear understanding of how your needs can fit into the birthing facility, or vice versa, you can begin to create your 'ideal' birth on paper.

Things To Consider

Some of your considerations should include the following:

  • Deciding who your birth partner will be
  • Your personal comfort – music, clothing etc
  • Your thoughts regarding pain relief – do you want a 100% natural birth or not
  • How do you feel about having an episiotomy – should the need arise
  • What birthing positions you may wish to adopt
  • Your thoughts regarding breast or bottle feeding
  • What you want regarding an emergency situation – they can and do happen and it’s best to consider the possibility – though don’t focus on it as this will only cause unnecessary anxiety
  • Think about the possibility of your baby’s well being – if he needs to be monitored, what method would you prefer, if you had the choice
  • What relaxation methods you may want – e.g. massages or bathing
  • How you’d like to be kept hydrated – water, ice cubes
  • What you’d like to have post-birth – time alone with baby and partner or whether your other children (if you have any) can be brought into the room

These are just some suggestions regarding your birth plan – after talking with others, you may discover further aspects, alternative ideas that are personal to you. You can be as specific as you like – after all, it is your labor and delivery and your needs are paramount, especially regarding your comfort levels, which will be an important part of the labor and deliver process.

Create Your Birth Plan

Easy to do, easy to save and adjust later and can be printed out when you need it.
Easy to do, easy to save and adjust later and can be printed out when you need it.

Now that you’ve considered your options, you need to create your birth plan. As previously mention, keep it simple. You can look around the web and find a myriad of plans but many are rather complicated and overstate the obvious. Your midwife may not have met you prior to your labor and what she will need is a document that covers the basics, at a glance.

She will be more than capable of reading between the lines, so it’s really not helpful to write an essay, detailing every last thing, needle to thread. She needs to concentrate on you and your baby, not find a quite corner whereby she can digest what amounts to a short story.

I have created and included a Birth Plan Template, which lists the basic preferences that will be useful for your midwife. It can be copy and pasted straight onto a word.doc or simply used as a guide.

Birth Plan Template

Birth Plan

Name:___________________________ D.O.B.___________


Partner/Birth Partner’s Nane:_____________________________

Comfort During Labor

I Would Prefer:

___To bring my own music

___To be massaged

___To make use of aromatherapy

___To use self-hypnosis

___To wear my own (suitable) clothing

___To remain as mobile as possible

___To take a warm bath

Pain Relief Alternatives

I would prefer:

___Bathing or Shower





Labor Induction

I Would Prefer

___To try to avoid unless necessary

___Membrane rupture

___ Prostaglandin gel

___ Pitocin

In The Event Of A Caesarean Section

I Would Prefer:

___To remain awake if possible - epidural

___To have an anaesthetic

___To give my partner the option of being present

Pain Control During Labor

I Would Prefer:


___Mobile Epidural

___Normal Epidural


___Narcotic Pain relief


I Would Prefer:

___Continuous monitoring

___Intermittent Monitoring

___Only If Necessary

During The Delivery

I Would Prefer:

___To lay on my side

___Use a birthing stool

___To be able to squat

___Use a birthing pool

___To have leg support

___To adapt my position according to how I feel

Post Delivery

I Would Prefer:

___My baby delivered onto my stomach

___To allow my partner to cut the cord

___Breast feed

___Bottle feed

Additional Information:

I understand that the above are guidelines regarding my preferences during my labor and delivery. I am fully aware that variations can and do occur and in the event of such an occurrence, I am willing to be guided regarding the health and wellbeing of both myself and my baby.


To Finish

Now that you have the tools, you can go on to tailor your birth plan to suit your preferences. Make sure that you print several copies and ensure that one is placed into your hospital bag. Present your birth plan on your arrival at the delivery suite, if you know that you don't have a pre-assigned midwife.

Rest assured that your needs and wishes are always taken into consideration by the medical staff and that they will adhere to your choices where possible.


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