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Sample Birth Plan
This is the very simple birth plan I wrote for my last birth, in January 2001. To some of you who didn't know there
are actually options for you, this might seem a bit much. To others who've done extensive research, this is a rather simple birth
plan. I knew that some preferences would not be accommodated so I chose to include only those things that were most
important to me. There was one other thing I wish I'd included in my plan, and that I suggest you discuss with your doctor: "After
the birth of my baby, please allow the placenta to expel naturally." When you read my birth story, you'll understand why I would
want to add this.
I plan to labor at home until contractions are regular, coming 5 minutes apart.
I will eat and drink throughout labor to keep my energy level high.
I wish to labor in whatever position is most comfortable for me.
I will make use of a special birthing room if one is available.
We would like to take pictures during labor and after the baby is born.
I would not like an enema.
I would not like my pubic area shaved.
If I feel I need pain medication, I will ask for it.
I will not have internal fetal monitoring. I would prefer intermittent or portable monitoring for comfort.
I do not want any drugs to stimulate contractions.
I would like to avoid an episiotomy, if possible.
I would prefer not to have forceps or a vacuum cap used, unless the baby is in distress. Please let my baby come out when she is ready.
Cesarean ONLY if baby is in danger.
Please allow my husband to cut the cord after it stops pulsating.
I would like to hold and nurse my baby immediately after birth.
Please do not administer eye drops until after baby and I have spent time together.
I will keep the baby in my room to nurse on demand. I would like a private room if one is available.
I will breastfeed only. Please don’t give my baby any water or formula in a bottle.
If our baby is a boy, my husband and I wish to be present at the circumcision, and for the baby to have anesthetic.
THANK YOU for helping to make our birth a special one!
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