Pregnancy

Birth Plan Checklist: What to Include and What to Leave Flexible

By Raised Editorial · Published 17 July 2026

A birth plan is a communication tool, not a binding contract. Here is exactly what you should discuss with your midwife, and why the most important part of your plan is flexibility.

Writing a birth plan can feel incredibly empowering. In a process that is largely out of your control, laying out your preferences for dim lighting, a water birth, and delayed cord clamping feels like taking the reins back.

However, birth is profoundly unpredictable. If you treat your birth plan like a rigid itinerary, any deviation can feel like a failure.

The American College of Obstetricians and Gynecologists (ACOG) encourages birth plans, but they emphasize that they are best used as a "roadmap for conversation" rather than a set of demands. Here is a checklist of what to include, and what you must leave flexible.

1. The Environment and Support

This is the section where you outline who will be in the room and how you want the space to feel. This is usually the easiest part of the plan to honor.

• Who is your support team? (e.g., "My partner, Mark, and my doula, Sarah.")
• Atmosphere: (e.g., "I would prefer dim lighting and for people to speak quietly when entering the room.")
• Student presence: Are you comfortable with medical or midwifery students being present for your care?

2. Pain Management Preferences

This is where many people write "unmedicated" or "epidural immediately." It is best to frame these as preferences, knowing that long labours can change your mind.

• Non-pharmacological: (e.g., "I plan to use a TENS machine, hypnobirthing tracks, and the birthing pool.")
• Pain relief: (e.g., "I would like to try gas and air first. I would prefer not to be offered an epidural unless I ask for one.")
• Freedom of movement: (e.g., "I would like to remain mobile for as long as possible rather than being monitored continuously on the bed.")

3. The Actual Birth and Aftercare

How do you want the moment of birth and the immediate aftermath to be handled, assuming the baby is healthy and stable?

• The birth: (e.g., "I would like to catch the baby myself if possible," or "I would like my partner to cut the cord.")
• Delayed cord clamping: This is standard practice in many hospitals now, but it is worth stating: "I would like the cord to finish pulsing before it is clamped."
• Skin-to-skin: (e.g., "I want the baby placed directly on my chest immediately, before they are weighed or measured.")
• Vitamin K: Do you consent to the routine Vitamin K injection for the baby?
• Feeding: (e.g., "I intend to exclusively breastfeed and would like support from a lactation consultant.")

The "Plan B" (What to Leave Flexible)

The most robust birth plans include a "Plan B" for when medical interventions become necessary. Discussing these beforehand ensures you are still part of the decision-making process, even in an emergency.

• If labour needs to be induced or augmented: Do you have a preference for how this is done (e.g., breaking the waters vs. a hormone drip)?
• If an instrumental delivery (forceps/vacuum) is needed: You can request that the doctor explains exactly why they are recommending it and what the alternatives are.
• In the event of an unplanned C-section: (e.g., "I would like the screen lowered so I can see the baby be born," and "I would like skin-to-skin in the recovery room as soon as possible.")

Keep your birth plan to a single, bulleted page. Hand it to your midwife, discuss it, and then remember the golden rule of birth: healthy parent, healthy baby. However they get here is the right way.