# Birth Plan > A calm, comprehensive birth plan template covering labor preferences, pain management, delivery wishes, newborn care, and C-section preferences. Pre-filled with a realistic example for first-time parents. Source: https://buildpdfs.com/templates/birth-plan Category: Life Events A calm, comprehensive birth plan template covering labor preferences, pain management, delivery wishes, newborn care, and C-section preferences. Pre-filled with a realistic example for first-time parents. ## What's included - Labor environment and support team preference section - Pain management options with checkbox layout - Delivery wishes: cord clamping, skin-to-skin, cord cutting - Newborn care and breastfeeding preferences - C-section preferences section for emergencies ## Sample content A Personal Document Birth Plan Emma & James Callahan Due Date: April 12, 2025 Riverside Medical Center Attending Physician: Dr. Sarah Okonkwo Our preferences for labor, delivery, and postpartum care. This birth plan reflects our wishes. We understand that medical circumstances may require adjustments and trust our care team's judgment. Labor Preferences Emma & James Callahan · Due April 12, 2025 Environment * ☑ Dim lighting throughout labor * ☑ Own music playlist (calm / nature sounds) * ☑ Minimal interruptions during contractions * ☐ Aromatherapy diffuser (if permitted) * ☑ Freedom to move around freely Support Team * ☑ Partner James present throughout all stages * ☑ Doula — Sarah Miles (555-0147) present * ☐ Mother present during labor * ☑ No additional observers without our permission Labor Interventions * ☐ IV line preferred — hep-lock only (no continuous IV unless medically required) * ☑ Freedom to eat and drink lightly during early labor * ☐ Continuous electronic fetal monitoring * ☑ Intermittent monitoring preferred when possible * ☐ Amniotomy (artificial rupture of membranes) — prefer to avoid unless medically necessary Comfort & Mobility Requests * ☑ Access to a birthing ball * ☑ Access to shower or tub for hydrotherapy * ☑ Freedom to walk hallways between checks * ☑ Ability to choose labor positions freely Emma & James Callahan — Birth Plan Page 2 of 4 Pain Management & Delivery Emma & James Callahan · Due April 12, 2025 Pain Management * ☑ Prefer to try natural coping first: walking, position changes, birthing ball, shower / tub * ☑ Open to epidural if I decide I need it * ☐ Nitrous oxide (laughing gas), if available * ☑ Please ask before suggesting pain medication * ☑ No medication administered without my consent Pushing & Delivery * ☑ Coached pushing (directed by care team) * ☐ Uncoached / breathe-down pushing * ☑ Mirror available to view delivery * ☐ Episiotomy — prefer natural tearing over incision * ☑ Partner James to announce baby's sex if possible * ☑ Partner James to cut the umbilical cord Immediately After Birth * ☑ Immediate skin-to-skin contact with Emma * ☑ Delayed cord clamping — minimum 60 seconds * ☑ Photos and video are welcome throughout * ☐ Cord blood banking (collection kit provided) * ☑ Routine newborn assessments done at Emma's side if possible * ☑ Baby placed on chest before any cleaning / weighing Placenta * ☑ Physiologic (natural) delivery of placenta preferred * ☐ Pitocin to manage third stage (only if necessary) * ☐ We would like to keep the placenta Emma & James Callahan — Birth Plan Page 3 of 4 Postpartum & C-Section Preferences Emma & James Callahan · Due April 12, 2025 Newborn Care * ☑ Begin breastfeeding as soon as possible after birth * ☑ Rooming-in — baby stays with us at all times * ☐ Pacifier — prefer to delay introduction * ☑ Vitamin K injection (standard) * ☑ Erythromycin eye ointment (standard) * ☑ Newborn hearing screen Visitors * ☐ No visitors for first 2 hours — bonding time only * ☑ Immediate family only on the first day * ☑ Please contact James to arrange all visits If C-Section Is Necessary * ☑ Partner James present in the OR * ☑ Drape lowered (or clear drape) to see birth moment * ☑ Immediate skin-to-skin in OR if mother and baby are stable * ☑ James carries and stays with baby if Emma is unable * ☑ All postpartum preferences above still apply * ☑ Please narrate what is happening throughout procedure Notes to Our Care Team "Thank you for supporting us through this experience. We are open to discussing any deviations from this plan and fully trust your medical expertise. Please explain all procedures before performing them — we want to be active, informed participants in our care. Your kindness means the world to us." Emergency Contact **James Callahan** (Partner) 555-0198 Doula **Sarah Miles** 555-0147 Physician **Dr. Sarah Okonkwo** Riverside Medical Center Emma & James Callahan — Birth Plan Page 4 of 4 ## Frequently asked questions ### What is a birth plan? A birth plan is a document you share with your care team that outlines your preferences for labor, delivery, and postpartum care. It ensures your wishes are clearly communicated even during the intensity of childbirth. ### What should a birth plan include? A complete birth plan covers: your support team, environment preferences (lighting, music), labor intervention preferences, pain management options, delivery preferences (cord clamping, skin-to-skin), newborn care wishes, and C-section preferences. ### When should I write my birth plan? Write your birth plan during the third trimester — around 32–36 weeks — so you have time to review it with your OB or midwife before labor begins. ### How long should a birth plan be? Keep it to 1–2 pages. Longer birth plans are less likely to be read in full during labor. Use checkboxes and bullets rather than paragraphs — exactly how this template is structured. ### Is this birth plan template free? Yes — free to use and customize. Describe your preferences to the AI and it will update the checkboxes and notes to match your wishes. ## Related reading - [What to include in a birth plan (and what to skip)](https://buildpdfs.com/guides/what-to-include-in-a-birth-plan) [Use this template](https://buildpdfs.com/signup?templateId=birth-plan) — free, no credit card required.