Sample Birth Plan

Things To Consider

This sample birth plan page should help you, as your pregnancy progresses, to start thinking about the birth, and how you would like it to go so that you can let your midwife know ideally what you would like to happen.

Remember, a birth plan is a guide for them because circumstances may dictate that some of the notes in your birth plan cannot be followed.

It is definitely worth looking at a sample birth plan and then doing one of your own because this will ensure that, wherever possible, your labour and delivery will proceed how you would like it to because the professionals caring for you are aware of your wishes.

So what do you need to consider for your birth plan? Here are some ideas:

1. Do you want to be up and about during labour, lying on a bed or in a pool?

2. Who would you like in the labour room with you, ie husband, mother?

3. Are you prepared to accept pain relief? Which kinds?

4. Would you prefer to keep internal examinations to a minimum?

5. Do you want the placenta injection to aid the delivery of the placenta?

6. Do you want your baby to have the Vitamin K injection?

7. Who do you want to cut the cord?

8. Do you want your baby to be given to you straight away?

9. Do want to check the sex of your baby or to be told?

10. Do you want your baby to be put to your breast straight away?

Don’t assume that your midwife or doctor will ask you what you want before they take action or that they will automatically know what you want. If you have not indicated what you want, they may go ahead with what they think. It really is worth having a plan, even if it’s just for a few things you feel strongly about.

Usually, included in your maternity notes is a couple of pages where you can draft your birth plan. Alternatively, you could write your own one and make sure you include it in your maternity notes. Have a look at the sample birth plan below to give you an idea of what to write.


Sample Birth Plan

Birthing Partner/s

My husband and my mother or sister, depending on who is available to come.


Home, but if there are complications then hospital.

Pain relief

Ideally just gas and air. Do not want pethidine. Epidural if absolutely necessary.

Labour and birth positions

Standing and walking for labour with partner to lean on. Standing for delivery with support of partner, or birthing stool if available.


Regular monitoring of baby.

Interventions (forceps, ventouse, episiotomy)

Avoid forceps, ventouse and episiotomy unless vital. Avoid caesarean unless vital.

Injections (Syntometrine for speeding up delivery of placenta and Vitamin K for baby)

Would like injection to speed up the delivery of the placenta and also vitamin K for baby.

When baby is delivered

Want baby to be put onto my tummy straight away if possible and then put on my breast to feed.

Umbilical cord

Husband to cut the cord.

Any other preferences

I would like to have relaxing music playing during the labour and delivery if possible. I would like for any interventions to be discussed with me and my husband first if there is time. I would like internal examinations to be kept to a minimum. When my baby is born I would like me and my husband to be able to look for ourselves to find out if it’s a boy or a girl.

So this is just a sample birth plan to give you an idea of how to structure yours. Some people prefer to write theirs more like a story of how they would like it to go rather than having headings and short sentences.

Just try to think of how you want it to all happen and then record what you would like. But have a flexible view and don’t worry too much if circumstances prevent you from having everything you wanted.

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