A Midwife’s Guide to Creating a Birth Plan

Creating a birth plan is a helpful way to prepare for one of the most important days of your life. It gives you the opportunity to think about your preferences, learn about your options and share what matters most to you with your birth team.

But a birth plan is not a script. Labor and delivery can be unpredictable, and the safest path for you and your baby may sometimes look different than what you originally imagined.

The goal of a birth plan is not to control every moment of birth. It is to help you feel informed, supported and confident as you make decisions with your care team.

What Is a Birth Plan?

A birth plan is a written summary of your preferences for labor, delivery, newborn care and the first hours after birth.

It helps communicate your wishes to your healthcare team and support person so everyone understands what is most important to you.

A birth plan may include your preferences for:

• Who you would like with you during labor and delivery
• Pain management options
• Your labor environment
• Delivery preferences
• Newborn care after birth
• Feeding plans and postpartum support

A birth plan can also be a source of education. When creating one that’s specific to you, it’s an opportunity to learn new things and have deeper conversations with your provider.

Do You Need a Birth Plan?

The short answer: no. You can have a safe and positive birth experience without writing a birth plan.

However, many expecting parents find that creating a plan is helpful because it encourages you to:

• Learn about your options before labor begins
• Discuss your preferences with your healthcare team
• Identify what matters most to you
• Prepare your support person to advocate for you

Your birth plan is also a helpful conversation starter. It gives you and your care team a chance to talk through your goals and answer questions before the day arrives.

Why Flexibility Matters in Your Birth Plan

One of the most important things to remember is that birth does not always follow a plan — and that’s completely normal. That’s why many midwives call these “birth preferences” or “birth wishes” rather than a birth plan.

Your labor experience may change based on your health, your baby’s health, how labor progresses or other circumstances that arise.

For example, you may need:

• An induction to help start labor
• Additional monitoring during labor
• Assistance with delivery using tools such as forceps or a vacuum
• A Cesarean birth (C-section) if it’s the safest option for you or your baby

These changes do not mean your birth experience was unsuccessful. They mean your care team is responding to what you and your baby need.

A helpful birth plan focuses on your preferences while leaving room for flexibility. Think of it as a guide for your care team — not a set of rules.

What Should You Include in a Birth Plan?

You do not need to have an opinion about every possible decision. Start by thinking about what matters most to you.

Many parents find it helpful to divide preferences into three categories:

• Strong preferences: Things that are especially important to you
• Open to discussion: Things you would like but are flexible about
• Only if medically needed: Things you would prefer to avoid unless recommended for safety

Here are some common areas to consider:

1. Labor Environment and Support

Think about what would help you feel comfortable and supported during labor.

You may want to include:

• Who you would like present, such as a partner, family member, friend or doula
• Whether you would like to move around, use a birthing ball or change positions during labor
• Comfort preferences, such as music, lighting or a quieter environment
• How you would like your care team to communicate with you when decisions need to be made

You can also ask about options for monitoring your baby’s heart rate and what is typically available at your birth location.

2. Pain Management and Delivery Preferences

There is no single “right” way to experience labor. Your pain management choices should reflect what feels right for you.

Options may include:

• Breathing techniques, movement, massage, water therapy and position changes
• Epidural anesthesia
• Other medications available during labor

You may also want to discuss:

• When you would like pain relief options discussed
• Your preferences for pushing positions
• Your thoughts about induction if it becomes recommended
• Your preferences if a C-section becomes necessary

3. Newborn Care and Your First Days as a Family

Your birth plan can also include preferences for your baby’s first moments and the days after delivery.

Consider including:

• Who you would like to visit after your baby is born and when you would prefer visitors. Some parents want family and friends to visit right away, while others prefer quiet time to rest, recover and bond with their newborn.
• Whether you would like uninterrupted time for bonding with your baby when possible.
• How you would like your support people involved during those first hours and days.

Other preferences to consider include:

• Skin-to-skin contact: Holding your baby against your chest after birth when medically appropriate
• Delayed cord clamping: Waiting before clamping the umbilical cord when appropriate
• Feeding preferences: Breastfeeding, formula feeding or a combination of both
• Postpartum recovery: Support you may need with feeding, rest, healing and adjusting to life with a newborn

Talk with your healthcare provider about these choices ahead of time so you understand what is recommended and why.

4. Supporting Your Mental Health After Birth

Preparing for a baby involves more than planning for labor and delivery. Your emotional health is an important part of your birth and postpartum plan.

During pregnancy, talk with your care team about your mental health history, any concerns you have and what support is available after your baby arrives.

Postpartum emotions can vary widely, and many new parents experience changes in mood, anxiety or feelings of being overwhelmed. Knowing where to turn for support can make a big difference during this transition.

5. Choosing Your Baby’s Pediatrician Before Birth

Your birth plan focuses on labor and delivery, but preparing for your baby’s care after birth is another important step during pregnancy.

Many parents choose their baby’s pediatrician before delivery so they know who will care for their newborn from the very beginning.

When choosing a pediatrician, consider:

• Whether you feel comfortable with the physician and care team
• How the practice handles urgent questions
• Whether the practice accepts your insurance
• The office location and hours

Your midwife or obstetrician can be a great resource when choosing a pediatrician. They can recommend trusted providers who align with your family’s needs and approach to care.

When Should You Make a Birth Plan?

Many parents begin thinking about their birth preferences during the second trimester or early in the third trimester. Starting around 20 to 28 weeks of pregnancy gives you plenty of time to learn about your options, discuss questions with your care team and adjust your plan as your pregnancy progresses.

Starting early also means less pressure. You can explore different options, take a childbirth class, tour your birth location and return to your plan as your preferences become clearer.

By the third trimester, many parents create a shorter version of their birth plan to bring with them to the hospital or birthing center. A one-page summary is usually easiest for your care team to review quickly.

How Should You Discuss Your Birth Plan With Your Care Team?

Your prenatal appointments are the perfect time to review your birth plan and talk through your preferences with your midwife or obstetrician.

Ask your provider:

• What options are available at my hospital or birth location?
• Which preferences may depend on how labor progresses?
• How can my care team best support my goals?
• When should I call or come to the hospital once labor begins?
• How long is it generally safe to labor at home before coming in, based on my pregnancy and individual circumstances?

Every pregnancy and labor experience is different, so it’s important to have this conversation ahead of time. Knowing what to expect can help you feel more confident when labor begins and reduce uncertainty during those first important hours.

Simple Birth Plan Example

Your birth plan doesn’t need to be long or complicated. A clear, one-page outline is often the easiest for your care team to review. Here’s a simple framework you can personalize:

Labor

• Support person(s):
• Comfort measures I’d like to try:
• Movement or labor position preferences:
• Pain management preferences:
• Labor environment preferences (lighting, music, etc.):

Delivery

• Pushing positions I’d like to try:
• Preferences if interventions become necessary:
• If a C-section is needed, what would help me feel supported:

Newborn Care

• Skin-to-skin contact:
• Delayed cord clamping:
• Feeding plan:
• Newborn medications and procedures:

Recovery and the First Days

• Visitor preferences:
• Recovery and bonding preferences:
• Emotional support or mental health considerations:

What Should You Avoid Putting in a Birth Plan?

A birth plan works best when it focuses on your priorities and allows room for medical guidance.

Try to avoid:

• Long lists of rules or demands
• Detailed medical instructions for your care team
• Information copied from the internet that does not reflect your personal wishes

Your healthcare team respects your preferences, while also making decisions based on your safety and your baby’s well-being.

The Bottom Line

A birth plan is not about creating the perfect birth experience. It’s about understanding your options, identifying what matters most to you and building a relationship with the team caring for you.

Start the conversation early, ask questions and remember that flexibility is part of the process.

However your birth unfolds, being informed and prepared can help you feel more confident as you welcome your baby.

If you have questions about creating a birth plan or your options for labor and delivery, talk with your midwife or obstetrician at your next prenatal visit. We are here to support you.

For more information on maternity care options at Stony Brook University Hospital, including midwifery services, visit Stony Brook Women’s Center. The Division of Midwifery at Stony Brook University Hospital has been serving women and families since 1996. At Stony Brook, all midwives are faculty members in the Department of OB/GYN. Our philosophy is to place the needs and desires of women first while maintaining a safe and supportive environment.