How to Create a Birth Plan: A Step-by-Step Guide
Jun 25, 2025
Co-written by Deja Ramos, a Certified Doula (DONA), ICCE, and Co-Founder of The Birth Companions and the team at Mila Support
Creating your Birth Plan is about understanding your options, knowing what matters most to you, and being prepared for different scenarios. Birth is unpredictable, but having a plan gives you a place to start and a way to clearly communicate your preferences.
Click here to create your birth plan today through Mila Support.
Step 1: Know the Hospital “Default” vs. What Requires Advocacy
Hospitals have standard practices, but you can ask for something different. Understanding what's automatic means you know where your preferences differ and can help you decide what to include on your plan.
✅ What’s Standard in Most Hospitals?
IV fluids upon admission.
Continuous fetal monitoring (may limit movement).
Epidurals available but may require waiting.
Immediate cord clamping and cutting.
Routine newborn exams right after birth.
⚠️ What Might Require Discussion or Advocacy?
Eating and drinking during labor.
Moving freely and using different labor positions.
Alternative pain relief options before an epidural.
Delayed cord clamping.
Immediate skin-to-skin contact before newborn procedures.
Step 2: Figure Out What’s Important to YOU
What’s Standard in Most Hospitals? | What you can ask for instead: |
IV fluids upon admission. | Delay the IV, or ask for a saline lock so you’re not connected to anything |
Continuous fetal monitoring | Intermittent fetal monitoring, or wireless monitors |
Laboring in bed, delivering lying down | Mobility during labor and an upright position for birth |
Immediate cutting of the umbilical cord | Delayed cord clamping and cutting, but be specific because “delayed” means something different to everyone. |
💡 Rather than listing every detail, focus on what truly matters to you
What kind of pain management do I want? (Try natural methods first, or get an epidural ASAP?)
How do I want to cope with my labor in the hospital? (Support people, moving around, eating and drinking)
What’s most important for my baby right after birth? (Immediate skin-to-skin? Common medications after birth? Delayed cord clamping?)
How do I feel about the tools used in medicalized birth? (Am I open to augmentation with pitocin , or do I want to let labor unfold at its own pace?)
Step 3: Understand How Your Choices May Impact Each Other
Here is an example of the trade offs of choosing an epidural:
Birth Plan Preference | What Happens with an Epidural |
Freedom to walk or move | Supported position changes in bed only |
Eating and drinking freely | Clear liquids only (hospital policy) |
No IV or minimal interventions | IV fluids required for epidural safety |
Intermittent fetal monitoring | Continuous fetal monitoring |
Avoid catheterization | A urinary catheter is typically placed |
✅ Choices Not Affected by an Epidural
Setting the environment: low lights, music, calming space
Immediate skin-to-skin with baby
Delivering in alternative positions (with support)
Cervical exams only by request
💬 You are making a choice that impacts the plan you had previously laid out. Stay flexible, understand how one choice impacts others. But, the Epidural doesn't take away your ability to make choices about your care.
Parting words
Discuss & Stay Flexible:
✔ Review your birth plan with your provider so you know what’s realistic at your hospital.
✔ Share your birth plan with your support people.
✔ Print 2 copies of your birth plan to give one to the nurse who admits you and post up the second in your delivery room.
✔ Stay flexible—birth is unpredictable, and your preferences can adapt to the situation, it is your values that stay consistent.
💡 Remember birth isn’t about following a checklist—it’s about making informed choices and feeling supported.
That’s why our Birth Planning Tool makes this process easy—answer a few questions to get started, then use our library of information to inform all your preferences, and walk away with a plan that reflects what matters most to YOU. The process of creating a birth plan and choosing your birth preferences will help you prepare for different scenarios and feel confident no matter how birth unfolds.