Birth Plan Examples: 5 Sample Birth Plans to Copy
Last reviewed on October 1, 2026
It's much easier to write a birth plan when you can see a finished one. Below are five filled-in sample birth plans for the most common situations. Copy the one closest to yours, delete what doesn't fit, and add your own details. Each example has a matching free printable template.
What a Good Birth Plan Looks Like
- One page, two at most, with headings and short bullet points
- A one-line note to the team that shows you understand plans can change
- Your top three priorities at the top, so a busy nurse or midwife sees them first
- Flexible wording: "I'd prefer…", "If possible…", "Please ask me before…"
- A backup section for a cesarean or a change of plan
Example 1: Hospital Birth With an Epidural
This is the most common type of birth plan in the US. The focus is on timing the epidural, staying comfortable and mobile where possible, and protecting the first hour with the baby. For a printable version, use the epidural birth plan template.
Birth Plan for Jordan Smith
Due date: March 14 | Partner: Alex | OB: Dr. Patel | Hospital: St. Mary's | GBS: negative | Allergies: none
Thank you for caring for us. These are our preferences if all goes well. If anything changes, please explain our options so we can decide together.
Our top 3 priorities
- An epidural once I'm in active labor
- Immediate skin-to-skin and delayed cord clamping
- Alex stays with me the whole time, including in the OR
Labor
- I'd like to labor at home until contractions are regular and strong
- Dim lights and our own music
- Please offer a peanut ball and help me change position after the epidural
- If labor slows, please talk to us before starting Pitocin
Pain relief
- I plan to have an epidural; please let anesthesia know when I'm admitted
- Until then: shower, birth ball, and nitrous oxide if available
Pushing and birth
- If baby is doing well, I'd like to rest and let my body bring baby down before I start pushing
- Please coach me when to push if I can't feel the urge
- Warm compresses; no episiotomy unless it's needed
After birth
- Baby straight onto my chest; delayed cord clamping; Alex cuts the cord
- Weighing and measuring after the first feed
Newborn care and feeding
- Yes to vitamin K, eye ointment and hepatitis B vaccine
- Delay the first bath until at least 24 hours
- I plan to breastfeed; please send a lactation consultant on day one
If I need a cesarean
- Alex with me throughout; skin-to-skin in the OR if baby is well
Start from: free birth plan template (PDF) or the Word version.
Example 2: Unmedicated (Natural) Hospital Birth
For an unmedicated birth, the most useful thing a plan can do is tell staff how to support you, especially how you want pain relief to be offered (or not offered).
Birth Plan for Maria Lopez
Due date: June 2 | Partner: Sam | Doula: Kim | Midwife: Lisa (CNM) | Allergies: penicillin
I'm hoping for an unmedicated birth. I trust you to tell me if baby or I need more help.
Our top 3 priorities
- Please don't offer pain medication. I'll ask if I want it
- Freedom to move, use the tub and choose my pushing position
- Uninterrupted skin-to-skin for the first hour
Labor
- Intermittent monitoring if baby and I are low risk
- Saline lock instead of a continuous IV, if one is needed
- I'd like to drink and eat light snacks
- Keep vaginal exams to a minimum and ask me first
- Let my waters break on their own
Comfort measures
- Tub or shower, birth ball, counter-pressure from Sam and Kim
- If I ask for medication, please remind me of my goal once, then respect what I decide
Birth
- Push when I feel the urge, in the position I choose
- Help me slow down as baby crowns; warm compresses
After birth
- Delayed cord clamping until the cord stops pulsing, if baby is well
- Newborn checks on my chest; vitamin K given while I hold baby
- Breastfeeding; no pacifier or formula without asking us first
If plans change
- If I need an epidural or a cesarean, I'd still like skin-to-skin as soon as possible
Start from: natural birth plan template (PDF). More on preparing: natural birth plan guide and natural pain relief methods.
Example 3: Scheduled C-Section
A planned cesarean still involves choices. Most of them are about the OR environment, seeing your baby born, and the first hour.
Cesarean Birth Plan for Priya Shah
Surgery date: September 9 | Reason: breech | Partner: Dev | OB: Dr. Moore
We're excited to meet our baby. When it's safe, these small things would make a big difference to us.
Our top 3 priorities
- Dev with me from the moment the spinal is placed
- A clear or lowered drape so we can see baby born
- Skin-to-skin in the OR if baby is well
In the operating room
- Please talk me through each step
- ECG leads placed on my back or side so my chest is free
- One arm free to hold baby, if possible
- Our own playlist, quietly
Baby's birth
- Delayed cord clamping if baby is well
- Dev announces the sex
- If baby needs checks, Dev goes with baby and does skin-to-skin
Recovery
- Baby stays with me in recovery; help with the first breastfeed
- Explain my pain relief plan and when I can eat and get up
- Visitors only after we say we're ready
Start from: C-section birth plan template (PDF). Full checklist: C-section birth plan guide.
Example 4: VBAC (Vaginal Birth After Cesarean)
A VBAC plan has two halves: how you'd like your labor to go, and what you'd want if a repeat cesarean becomes the safer choice.
VBAC Birth Plan for Hannah Cole
Due date: January 20 | Previous birth: cesarean for fetal distress (2024), low transverse incision | Partner: Chris | OB: Dr. Nguyen
We've talked with Dr. Nguyen and are planning a trial of labor. We know continuous monitoring is recommended and we're comfortable with it.
Our top 3 priorities
- Spontaneous labor if possible; let's discuss options together if I go past my due date
- Wireless monitoring so I can stay upright and move
- If we need a repeat cesarean, an explanation and a few minutes to talk it over when it's not an emergency
Labor
- Continuous wireless monitoring; IV access is fine
- Epidural is fine when I ask for it
- Discuss any induction or Pitocin with us first
Birth
- Immediate skin-to-skin; delayed cord clamping; Chris cuts the cord
If a repeat cesarean is needed
- Chris stays with me; lowered drape; skin-to-skin in the OR if baby is well
- Baby stays with me in recovery
Start from: VBAC birth plan template (PDF). Background: what is a VBAC?
Example 5: Short One-Page Birth Plan
If you only want the essentials (or you're "going with the flow"), this is all you need. It fits on half a page and takes 10 minutes.
Birth Preferences: Taylor Brooks
Due: April 30 | Partner: Jamie | Allergies: latex
- Pain relief: open to anything; I'll ask when I want it
- Labor: I'd like to move around and choose my positions
- Birth: push when I feel the urge; avoid an episiotomy if possible
- After birth: skin-to-skin straight away, delayed cord clamping
- Baby: all standard newborn procedures, done in the room with us
- Feeding: combination feeding; happy to have help
- If I need a cesarean: Jamie with me and skin-to-skin in the OR
Start from: one-page birth plan (PDF) or Word. In the UK? See the UK birth preferences template, which uses NHS terms like gas and air and labour ward.
Birth Plan Wording That Works
How you phrase a preference changes how it lands. Staff respond best to requests that are specific, polite and leave room for safety.
| Instead of… | Try… |
|---|---|
| "No interventions." | "Please discuss any intervention with us first, unless it's an emergency." |
| "Absolutely no epidural." | "Please don't offer pain medication. I'll ask if I want it." |
| "Natural birth only." | "I'm hoping for an unmedicated birth and would like support with movement, water and massage." |
| "Do not take the baby away." | "If baby is well, please do newborn checks on my chest or in the room." |
| "No students." | "Please ask me before a student examines me or joins the room." |
| "No visitors." | "No visitors in labor. After the birth, visitors only once we say we're ready." |
How to Turn an Example Into Your Own Plan
- Pick the closest example above and copy it into a document, or download the matching template.
- Choose your top three priorities. If you only get three things, which matter most?
- Cut anything that's already routine at your hospital. Ask on your hospital tour or at a prenatal visit.
- Add a backup plan for a cesarean or a change of mind about pain relief.
- Review it with your provider around 32–36 weeks, then print three or four copies for your hospital bag.
Prefer not to write from scratch? The birth plan generator asks simple questions and writes the plan for you. For a full list of options to consider, see what to include in a birth plan.
Frequently Asked Questions
What is a good example of a birth plan?
A good birth plan fits on one or two pages, opens with a short note to the care team, lists your top three priorities, then uses short bullet points under headings such as labor, pain relief, birth, after birth, newborn care, feeding and "if I need a cesarean." It uses flexible wording like "I'd prefer" and includes a backup plan.
How long should a birth plan be?
One page is ideal and two pages is the practical maximum. Nurses and midwives read birth plans quickly, often at a shift change, so short bullet points and a clear top-three list are more likely to be read and followed than a long narrative.
Can I copy a sample birth plan?
Yes. The examples on this page are free to copy and adapt. Delete anything that doesn't apply, add your own details, and review the finished plan with your doctor or midwife so you know which preferences your hospital can support.
What should I not put in a birth plan?
Leave out long explanations, demands such as "under no circumstances," things that are already routine at your hospital, and preferences you haven't checked with your provider. Avoid listing every possible option. When everything is ticked, it's harder for staff to see what really matters to you.
Make Your Own Birth Plan
Download a free printable template that matches one of these examples, or let the generator write a personalized plan for you.
Use the Birth Plan Generator See All Templates