How to Write a Natural
Birth Plan

Nobody tells you how many decisions you will be asked to make while you are also in the middle of active labour. Do you want an epidural? Who is allowed in the room? Would you like to hold your baby immediately? It is a lot to process in real time. A birth plan is how you think all of that through in advance, calmly, with a cup of tea, so that when things get intense you do not have to find the words.

It is not a contract. Birth is unpredictable and your plan may need to change. But having thought through your preferences in advance means everyone around you knows what matters to you — and that makes a real difference to your experience regardless of how things unfold.

"A birth plan isn't about controlling the uncontrollable. It's about knowing your options, articulating your values, and walking into birth feeling prepared and heard."

Why write a birth plan?

Women who feel heard and informed during birth have better outcomes. Not necessarily easier births — but better emotional experiences, less trauma, and lower rates of postnatal depression. Feeling like you had some agency in the process matters enormously, even when things do not go exactly as planned.

Writing a birth plan also starts important conversations with your midwife or obstetrician before the big day. You will learn what is standard at your birth setting, what flexibility exists, and where you might need to advocate for yourself. That knowledge is genuinely valuable.

Before you start writing

The best birth plans come from actually thinking things through, not just downloading a template and filling in the blanks. A few things worth doing before you put pen to paper:

• Attend a prenatal education class to understand the stages of labour and common interventions
• Read about the evidence base for common birth interventions — the Cochrane Library and Evidence Based Birth are excellent resources
• Have an honest conversation with your midwife or obstetrician about what is standard practice at your birth setting and what flexibility exists
• Consider hiring a doula — their knowledge and advocacy can be enormously valuable in birth

Your support people

Who do you want in that room? Your partner? A close friend? A doula? Your mum? Be specific because people will show up if you do not tell them otherwise. Some mamas want just their partner during active labour and then welcome everyone in after. Completely valid. Write it down so there are no awkward conversations in the middle of contractions.

And if there are people you definitely do not want present at certain stages — write that down too. This is your birth. You get to decide.

Pain management preferences

This is probably the section you have thought about most. Here are all the options worth knowing about before you decide:

• Non-pharmacological options: water (bath or birth pool), TENS machine, massage, heat packs, movement, breathing techniques, hypnobirthing, acupressure
• Pharmacological options: nitrous oxide (gas and air), opioid injections (pethidine, fentanyl), epidural anaesthesia, spinal block

Write your preferences in order so your care team knows where to start and what to offer next. Being upfront that you are open to changing your mind is completely okay and actually makes everyone's job easier. Birth is not the place for rigid plans — it is the place for informed, flexible preferences.

Mobility and positions

Research shows that upright, mobile positions during labour are associated with shorter labours, lower rates of intervention, and lower rates of severe perineal tearing compared to labouring on your back. Note that you'd like to be free to move, walk, use a birth pool if available, or adopt positions that feel instinctively right.

You might write: "I would like to be free to move and change positions throughout labour. Please support me to labour upright and actively unless there is a medical reason to be monitored continuously."

Monitoring preferences

Continuous electronic fetal monitoring (CTG monitoring) is standard practice in many hospitals but is associated with higher rates of caesarean section without improving outcomes in low-risk labours. For low-risk pregnancies, intermittent auscultation (listening to the baby's heartbeat at regular intervals with a handheld device) is an evidence-based alternative.

Note your preference for intermittent monitoring if your pregnancy is low-risk, and ask your care team to discuss with you if continuous monitoring is recommended so you can make an informed decision.

Intervention preferences

Consider your preferences regarding common interventions:

• Augmentation (speeding up labour): "Please discuss all options with me before augmenting my labour."
• Episiotomy: "Please discuss with me before performing an episiotomy. I would prefer to try perineal massage and warm compresses first."
• Assisted delivery (forceps or ventouse): "Please explain why assisted delivery is recommended and what the alternatives are before proceeding."
• Caesarean section: "If a caesarean becomes necessary, I would like skin-to-skin contact with my baby as soon as possible, and for my partner to be present."

Immediately after birth

This section matters enormously for your baby's first minutes and hours of life:

• Delayed cord clamping: Research strongly supports waiting until the cord stops pulsing before cutting. This transfers an additional 80-100ml of blood to your baby, rich in iron and stem cells. Note: "Please practice delayed cord clamping — wait until the cord has stopped pulsing before cutting."
• Skin-to-skin contact: "I would like my baby placed directly on my chest immediately after birth for uninterrupted skin-to-skin contact. Please conduct newborn checks while baby is on my chest wherever possible."
• Who cuts the cord: Note whether you or your partner would like to cut the cord.
• Third stage (delivery of placenta): Note your preference for active management (injection to speed delivery of the placenta) or physiological management (waiting for the placenta to deliver naturally).

Feeding preferences

Note your intention to breastfeed and request support from a lactation consultant or midwife in the early hours. If you would like to attempt breastfeeding before any supplementation is offered, note this clearly: "Please do not offer formula without discussing with me first."

Keeping it simple and flexible

The most effective birth plans are one page maximum. Use bullet points and clear headings. Use collaborative language — "I would prefer," "please discuss with me," and "I understand that circumstances may require changes" — rather than demands or refusals. Include a clear note that you trust your care team and understand that birth is unpredictable.

Share your birth plan with your primary care provider at around 34-36 weeks. Print several copies for your hospital bag. Then, as much as possible, let it go — you've done the thinking, now trust your body and your team.

Writing your plan — practical tips

The most effective birth plans are written in a calm, collaborative tone rather than as a list of demands. Remember that your midwives and doctors want the best possible outcome for you and your baby — they are your allies, not adversaries. A birth plan that acknowledges this collaborative relationship will be received much more warmly than one that reads as adversarial.

Use phrases like "I would prefer," "please discuss with me before," and "if possible, I would like" rather than "I refuse" or "you must not." This keeps the conversation open and acknowledges the reality that birth is unpredictable. The goal of your birth plan is to be heard and respected — not to control every detail of an inherently uncontrollable process.

Format and length

Keep your birth plan to a single A4 page. Midwives and doctors are busy — a long, detailed document is less likely to be read in full than a concise, well-organised one-pager. Use bullet points, clear headings, and short sentences. If you want to include more detail for specific scenarios (such as what you'd like to happen in the case of a caesarean), consider creating a brief "plan B" page separately rather than cluttering your main plan.

After you've written it — what next

Once you've written your birth plan, share it with your primary care provider at around 34-36 weeks. This opens a conversation about what's possible at your birth setting, what's standard practice, and where there's flexibility. This conversation is often more valuable than the document itself — it helps you understand your options and builds a relationship with your care team before the intensity of labour begins.

Print at least three copies to keep in your hospital bag. In the moment of labour, you may not remember every preference you've thought through carefully — having the document accessible means your support people and care team can refer to it even when you're focused entirely on coping with contractions.

Finally, share your birth plan with your birth partner and anyone else who will be supporting you in labour. They need to understand your wishes so they can advocate for you if you're not in a position to speak for yourself. Discuss each preference with them beforehand so they feel confident representing your wishes clearly and calmly.