What to Include in Your Birth Plan: The Complete Checklist

Basic Information & Contact Details

Start your birth plan with essential information that helps your healthcare team identify you and understand your medical background quickly.

Personal Information to Include:

• ☐ Full name and preferred name/nickname
• ☐ Date of birth and age
• ☐ Expected due date
• ☐ Current pregnancy week
• ☐ Blood type and Rh factor
• ☐ Any allergies (medications, latex, foods)
• ☐ Pre-existing medical conditions
• ☐ Current medications
• ☐ Previous pregnancies and birth experiences
• ☐ Group B Strep status

Healthcare Provider Information:

• ☐ Primary OB/GYN or midwife name
• ☐ Practice name and phone number
• ☐ Preferred hospital or birth center
• ☐ Pediatrician name and contact
• ☐ Doula information (if applicable)

Emergency Contacts:

• ☐ Partner/support person name and phone
• ☐ Alternative emergency contact
• ☐ Childcare arrangements (if applicable)
• ☐ Pet care arrangements

Labor Environment & Atmosphere

Your environment significantly impacts your comfort and ability to cope with labor. Consider these environmental preferences:

Room Atmosphere:

• ☐ Lighting preferences (dim, natural, specific lamps)
• ☐ Music or sounds (playlist, nature sounds, silence)
• ☐ Aromatherapy preferences (specific essential oils)
• ☐ Temperature preferences
• ☐ Personal items to bring (photos, affirmations, comfort objects)
• ☐ Clothing preferences (own gown vs. hospital gown)

Privacy & Documentation:

• ☐ Photography/video recording preferences
• ☐ Student/resident involvement acceptance
• ☐ Number of staff in room preferences
• ☐ Door open or closed
• ☐ Minimal interruptions request

Movement & Positioning:

• ☐ Freedom to walk during labor
• ☐ Use of birthing ball
• ☐ Access to shower or tub
• ☐ Squat bar availability
• ☐ Ability to change positions freely

Support Team & Visitors

Clearly defining who will be present during labor and delivery helps ensure you have the support you need while maintaining your desired level of privacy.

During Labor:

• ☐ Primary support person designation
• ☐ Additional support people allowed
• ☐ Doula presence and role
• ☐ Family member involvement
• ☐ Friend participation
• ☐ Rotating vs. continuous support

During Delivery:

• ☐ Who stays in the room
• ☐ Positioning of support people
• ☐ Who announces baby's sex
• ☐ Who cuts the umbilical cord
• ☐ Photography permissions

Postpartum Visitors:

• ☐ Immediate family only initially
• ☐ Visiting hours preferences
• ☐ Sibling visit timing
• ☐ Extended family and friends
• ☐ No visitors preference

Early Labor Preferences

Your preferences for early labor set the tone for your entire birthing experience. Consider these options:

Admission Preferences:

• ☐ When to come to hospital (specific dilation/contraction pattern)
• ☐ Preference for going home if not progressed
• ☐ Initial exam preferences
• ☐ Gown changing timing

Early Labor Management:

• ☐ Natural labor onset preference
• ☐ Thoughts on membrane sweeping
• ☐ Position on induction if overdue
• ☐ Preferred induction methods if needed
• ☐ Breaking water naturally vs. artificially

Comfort Measures:

• ☐ Walking and movement
• ☐ Shower or bath access
• ☐ Eating and drinking preferences
• ☐ Ice chips vs. clear liquids
• ☐ Position changes

Active Labor Management

Active labor requires more specific preferences as medical involvement typically increases. Address these considerations:

Labor Progress:

• ☐ Frequency of cervical checks
• ☐ Who performs exams
• ☐ Being informed of progress
• ☐ Time limits on labor stages
• ☐ Augmentation preferences (Pitocin)

Hydration & Nutrition:

• ☐ IV fluids vs. heparin lock
• ☐ Eating during labor
• ☐ Types of fluids allowed
• ☐ Energy drinks or honey sticks
• ☐ Electrolyte preferences

Coping Strategies:

• ☐ Breathing techniques
• ☐ Visualization or hypnobirthing
• ☐ Massage preferences
• ☐ Counter-pressure for back labor
• ☐ Hot/cold compresses
• ☐ TENS unit use

Pain Management Options

Pain management is highly personal. Clearly communicate your preferences while remaining open to changes based on your experience.

Natural Pain Management:

• ☐ Breathing and relaxation techniques
• ☐ Position changes and movement
• ☐ Hydrotherapy (shower/tub)
• ☐ Massage and touch
• ☐ Heat and cold application
• ☐ Acupressure or acupuncture
• ☐ Hypnobirthing techniques
• ☐ Aromatherapy
• ☐ Music therapy
• ☐ Birth ball use

Medical Pain Relief:

• ☐ Preference order for pain medications
• ☐ Nitrous oxide (if available)
• ☐ Narcotic medications (types and timing)
• ☐ Epidural preferences and timing
• ☐ Walking epidural if available
• ☐ Patient-controlled epidural
• ☐ Spinal block for C-section

Communication About Pain:

• ☐ Don't offer medication (I'll ask)
• ☐ Offer options at regular intervals
• ☐ Code word for epidural request
• ☐ Partner's role in pain management decisions

Monitoring & Medical Interventions

Understanding monitoring options helps you balance mobility with medical safety requirements.

Fetal Monitoring:

• ☐ Continuous vs. intermittent monitoring
• ☐ Wireless/telemetry monitoring
• ☐ Internal vs. external monitoring
• ☐ Frequency of monitoring checks
• ☐ Movement with monitoring

Medical Procedures:

• ☐ IV or heparin lock preferences
• ☐ Catheter use and timing
• ☐ Artificial rupture of membranes
• ☐ Internal exams frequency
• ☐ Scalp electrode use
• ☐ Intrauterine pressure catheter

Labor Augmentation:

• ☐ Natural methods first
• ☐ Nipple stimulation
• ☐ Walking and position changes
• ☐ Pitocin as last resort
• ☐ Lowest effective dose preference

Pushing & Delivery Preferences

The pushing stage and moment of delivery are pivotal. Consider these preferences:

Pushing Stage:

• ☐ Spontaneous vs. directed pushing
• ☐ Pushing positions (side-lying, squatting, hands and knees)
• ☐ Use of mirror to see progress
• ☐ Squat bar or stirrups
• ☐ Time limits on pushing
• ☐ Episiotomy avoidance
• ☐ Perineal massage/support
• ☐ Warm compresses

Moment of Delivery:

• ☐ Who catches the baby
• ☐ Partner involvement in delivery
• ☐ Immediate skin-to-skin placement
• ☐ Discovering baby's sex ourselves
• ☐ Quiet or celebratory atmosphere
• ☐ Photography/video preferences

Cord Management:

• ☐ Delayed cord clamping duration
• ☐ Who cuts the cord
• ☐ Cord blood banking
• ☐ Lotus birth consideration
• ☐ Saving cord for keepsake

Placenta Delivery:

• ☐ Natural vs. managed third stage
• ☐ Pitocin for placenta delivery
• ☐ Cord traction preferences
• ☐ Viewing the placenta
• ☐ Placenta encapsulation
• ☐ Taking placenta home

Immediate Postpartum Care

The first hours after birth are crucial for bonding and recovery. Plan for this golden hour:

First Hour:

• ☐ Uninterrupted skin-to-skin time
• ☐ Delay routine procedures
• ☐ First breastfeeding attempt
• ☐ Partner skin-to-skin if needed
• ☐ Quiet bonding time
• ☐ Limited visitors

Mother's Care:

• ☐ Repair preferences (sutures)
• ☐ Pain management after delivery
• ☐ Fundal massage preferences
• ☐ Showering/bathing timing
• ☐ Food and drink requests
• ☐ Room temperature adjustment

Initial Assessments:

• ☐ APGAR scoring location
• ☐ Weighing and measuring timing
• ☐ All procedures at bedside
• ☐ Parent present for all care

Newborn Care Decisions

Your preferences for newborn procedures and care should be clearly stated:

Medical Procedures:

• ☐ Vitamin K injection (timing and location)
• ☐ Eye ointment (erythromycin)
• ☐ Hepatitis B vaccine timing
• ☐ PKU/newborn screening timing
• ☐ Hearing test preferences
• ☐ Circumcision decision and timing
• ☐ Blood sugar monitoring if needed
• ☐ Jaundice screening

Newborn Care Practices:

• ☐ First bath timing (delay 6-24 hours)
• ☐ Who gives first bath
• ☐ Diapering preferences
• ☐ Swaddling vs. skin-to-skin
• ☐ Pacifier use
• ☐ Room temperature for baby
• ☐ Clothing choices

Rooming Arrangements:

• ☐ 24/7 rooming-in
• ☐ Nursery for specific procedures only
• ☐ Nursery at night preference
• ☐ Partner staying overnight
• ☐ Security preferences

Feeding Preferences

Clear feeding preferences help establish your chosen method from the start:

Breastfeeding:

• ☐ Exclusive breastfeeding intention
• ☐ First feeding timing
• ☐ Lactation consultant visit
• ☐ No formula supplementation
• ☐ No pacifiers or artificial nipples
• ☐ Pumping if separation needed
• ☐ Donor milk preference if needed
• ☐ Night feeding support

Formula Feeding:

• ☐ Formula brand preference
• ☐ Ready-to-feed vs. powder
• ☐ Feeding schedule preference
• ☐ Who can feed baby
• ☐ Bottle type preferences

Combination Feeding:

• ☐ Primary method preference
• ☐ When to introduce bottles
• ☐ Pumping schedule
• ☐ Formula timing

C-Section Preferences (If Needed)

Even if planning a vaginal birth, including C-section preferences ensures your wishes are known if plans change:

Before Surgery:

• ☐ Partner present for preparation
• ☐ Anesthesia preferences (spinal vs. epidural)
• ☐ Anti-nausea medication
• ☐ Catheter insertion timing
• ☐ Music in OR

During Surgery:

• ☐ Partner at head of bed
• ☐ Clear drape or dropped drape
• ☐ Narration of procedure
• ☐ Gentle cesarean techniques
• ☐ Immediate skin-to-skin if stable
• ☐ Partner announces sex
• ☐ Delayed cord clamping if possible
• ☐ Photography permissions

Recovery:

• ☐ Baby stays with parents
• ☐ Breastfeeding in recovery
• ☐ Pain management plan
• ☐ Visitor limitations
• ☐ Mobility goals
• ☐ Incision care preferences

Special Circumstances

Address any unique situations that might apply to your pregnancy:

Multiple Births:

• ☐ Delivery room vs. OR preference
• ☐ Order of skin-to-skin contact
• ☐ Individual vs. together photos
• ☐ NICU preparation preferences
• ☐ Feeding order/schedule

High-Risk Considerations:

• ☐ Specialized team preferences
• ☐ NICU tour and preparation
• ☐ Extended monitoring acceptance
• ☐ Visitor restrictions understanding

Previous Trauma or Loss:

• ☐ Extra emotional support needs
• ☐ Specific triggers to avoid
• ☐ Memorial preferences if applicable
• ☐ Rainbow baby celebrations
• ☐ Counseling support

VBAC Attempt:

• ☐ Continuous monitoring acceptance
• ☐ IV access requirements
• ☐ OR readiness understanding
• ☐ Success celebration plans
• ☐ Repeat cesarean acceptance

Cultural & Religious Considerations

Honor your cultural and spiritual traditions during this sacred time:

Religious Practices:

• ☐ Prayer or blessing timing
• ☐ Religious items in room
• ☐ Clergy visits
• ☐ Specific rituals at birth
• ☐ Naming ceremonies
• ☐ Baptism preferences

Cultural Traditions:

• ☐ Placenta burial traditions
• ☐ First visitor protocols
• ☐ Gender announcement customs
• ☐ Specific foods after birth
• ☐ Traditional clothing for baby
• ☐ Postpartum confinement practices

Language & Communication:

• ☐ Interpreter needs
• ☐ Written materials in preferred language
• ☐ Cultural liaison request
• ☐ Family spokesperson designation

Postpartum Recovery Preferences

Your postpartum stay sets the foundation for recovery. Consider these preferences:

Hospital Stay:

• ☐ Length of stay preference
• ☐ Early discharge if eligible
• ☐ Private room request
• ☐ Partner accommodation needs
• ☐ Quiet hours enforcement

Recovery Support:

• ☐ Lactation support frequency
• ☐ Physical therapy if C-section
• ☐ Mental health check-ins
• ☐ Postpartum doula visits
• ☐ Meal preferences/restrictions

Discharge Planning:

• ☐ Car seat inspection
• ☐ Home visit scheduling
• ☐ Follow-up appointments
• ☐ Prescription needs
• ☐ Support group information
• ☐ Emergency contact numbers