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Free birth plan template: fill it in and print it

Check the options you want, add your details, and print it or save it as a PDF. The template lists common choices without recommending any.

Covers labor, pain relief, a C-section, after the birth and feeding

  • Saves in your browser only
  • Print or save as PDF
  • Lists options, not advice

What it's for

A birth plan is a written outline of what you'd like to happen during labor and delivery. ACOG suggests going over it with your doctor or midwife well before your due date, and being ready for changes.

Fill in your birth plan

About me
Where I plan to give birth
During labor
The room
Moving and comfort
Monitoring and procedures
Pushing
Pain relief

Options vary by hospital and birth center, so ask what yours offers.

How to offer it
Options I'm open to
If I need a C-section

Write this down even if you don't expect one, so your wishes are on paper if plans change.

If it's possible
After the birth
The first hour
Newborn care (vitamin K, eye ointment, hepatitis B vaccine, screening and hearing test)
In the hospital or birth center
If my baby is a boy, circumcision
Feeding
I plan to feed my baby
Help I'd like
Notes
See your plan

Your answers save in this browser only. Nothing is sent to us.

My birth plan

Due date, and where I plan to give birth

These are my preferences. I know plans can change; if they need to, please tell me what's happening and what my options are.

About me

Hospital or birth center name:

My doctor or midwife:

Support people with me:

My doula (name and phone):

Baby's doctor:

What my care team should know

During labor

The room

  • Dim lights
  • A quiet room
  • My own music
  • My own clothes
  • Only my support people in the room
  • Photos or video, where allowed

Moving and comfort

  • Walk and change positions
  • Use a birth ball, shower or tub if available
  • Eat or drink if my care team says it's OK

Monitoring and procedures

  • Explain options before any procedure
  • Ask me before breaking my water or giving medicine to speed up labor
  • Intermittent monitoring, if it's an option for me
  • A saline lock instead of a continuous IV, if it's an option for me
  • Fewer cervical checks

Pushing

  • Push in the position that feels right
  • Coaching on when to push
  • A mirror to see the birth

Pain relief

How to offer it

  • Offer me options as labor goes
  • Wait for me to ask
  • I'll decide during labor

Options I'm open to

  • Breathing and relaxation
  • Massage or counter-pressure
  • Warm shower or tub
  • TENS unit
  • Nitrous oxide
  • IV pain medicine
  • Epidural

If I need a C-section

If it's possible

  • My support person with me
  • Tell me what's happening as it happens
  • Lower the drape or use a clear drape so I can see the birth
  • Skin-to-skin in the operating room
  • Keep one arm free to touch my baby
  • Baby stays with my support person if I can't hold them
  • Photos, where allowed

After the birth

The first hour

  • Skin-to-skin right away
  • Wait before clamping the cord
  • My support person cuts the cord
  • Do routine checks with baby on my chest when possible

Newborn care (vitamin K, eye ointment, hepatitis B vaccine, screening and hearing test)

  • Explain each one before it's done
  • Do them while I hold my baby, when possible
  • Do them after the first feeding, when possible

In the hospital or birth center

  • Baby stays in my room
  • Wait on baby's first bath
  • Limit visitors at first
  • Cord blood banking or donation (arranged ahead)

If my baby is a boy, circumcision

  • Yes
  • No
  • Not sure yet

Feeding

I plan to feed my baby

  • Breast milk, at the breast or chest
  • Pumped breast milk
  • Formula
  • Not sure yet

Help I'd like

  • A visit from a lactation consultant
  • No pacifier or bottle unless I ask
  • Help pumping if my baby needs special care
  • Donor milk if it's needed and available

Notes

Anything else

Made with the free birth plan template at themomsite.com/tools/birth-plan/

How to use your birth plan

  1. Fill it in with your support people

    Your partner, a family member or your doula can help you think through each choice.

  2. Go over it with your doctor or midwife

    Do it well before your due date, and ask which options your hospital or birth center offers, such as tubs, nitrous oxide or rooming in.

  3. Print a few copies

    Keep one in your bag and give one to your support person. Bring it when you go in to give birth.

Find your care team

A rose-pink birth ball and a folded woven rebozo scarf on a pink backdropDoulasSupport before, during and after the birth.A wooden Pinard fetoscope, a measuring tape and a notebook on a teal backdropMidwivesPrenatal care and births at home, centers and hospitals.A newborn ID bracelet, a striped knit baby hat and a receiving blanket on a sky-blue backdropHospitalsWhere most babies are born, by state and city.Folded lavender towels, a white water pitcher and a glass on a lilac backdropBirth centersMidwife-led births outside a hospital.

Questions about birth plans

What should a birth plan include?

Who you are and where you plan to give birth, who's supporting you, what you'd like during labor and for pain relief, what you'd want if you need a C-section, the first hours after birth, and how you plan to feed your baby. This template covers each one and prints only what you pick.

When should I write my birth plan?

Early enough to go over it with your doctor or midwife well before your due date, as ACOG suggests. That gives you time to ask what your hospital or birth center offers.

What if my birth doesn't go to plan?

ACOG notes that a birth plan doesn't guarantee labor and delivery will go that way, and that you should be ready for changes. The plan tells your team what matters to you, so they can explain your options if things change.

Is my birth plan saved?

Only in this browser, on this device. Nothing is sent to us. Clearing your browser data deletes it, so print it or save a PDF to keep a copy.

Can I print a blank birth plan?

Yes. Print before you fill anything in and you get the full checklist, with empty boxes and lines to complete by hand.

Sources

  1. 1.Sample Birth Plan ACOG. Accessed October 9, 2026.

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