Your Birthing Plan
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3Your birthing plan
Having a birthing plan is an important step in having the kind of birth you are comfortable with. Here, we
guide you through the steps.
Once you have chosen the options you prefer for your birth below, fill in the details in the form provided
and give your birth plan to your midwife or doctor to sign. Keep your birth plan short - it should only be one
single sheet of paper with bullet points.
Remember that everything doesn’t always go according to plan, so it’s important to be flexible.
Consider the following options:
Preferred birthing option:
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Natural birth
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C-section
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Water birth
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No assisted delivery with forceps or a vacuum unless my baby is in distress.
Amenities I’d like in the birthing room:
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Music
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Dim lights
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My own clothes for the labour and delivery
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Take pictures and or video during labour and delivery
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To walk and move around as I choose
I’d like access to, or to be able to bring the following with me:
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Birthing chair / stool
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Birthing ball
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Beanbag chair
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Birthing pool / tub
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Other: ____________________________________________________________________
I’d like to try the following pain-management techniques:
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I would prefer to try to labour without pain medication. I will ask if I want something for the pain.
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Bath/shower
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Breathing exercises
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Massage
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TENS machine
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Epidural
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Other: _____________________________________________________________________
Episiotomy
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I’d prefer to tear naturally and not to have an episiotomy.
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I’d prefer to have an episiotomy if needed.
Post-delivery I’d like to:
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Hold my baby right away, putting off any procedures that aren’t urgent.
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Breastfeed as soon as possible.
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To wait until the umbilical cord stops pulsating before it’s clamped and cut.
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My partner to cut the umbilical cord.
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Bank my baby’s cord blood privately.
If I have a C-section, I’d like:
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My partner present at all times during the operation.
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To hold my baby after birth.
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To breastfeed my baby as soon as possible.
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