What should I include in my birth plan?

One page, not a contract

A birth plan is a one-page list of what matters to you, so your team can see it at a glance. Treat it as a wish list that can bend. Babies don't read birth plans, and your team must be free to change course if your baby or you need help.

The real value of a plan is the conversation it starts. Most of the choices that matter can be settled at a third-trimester visit, weeks before labor, instead of in the delivery room. Write the answers down, and the page does its job even if you never look at it on the day.

Step by step

1. Write the five priority linesCord clamping, skin-to-skin, first feed, who's in the room and pain relief, in that order, on one page.
2. Take the questions to a visitBring the seven questions to a third-trimester appointment and talk them through with your provider.
3. Write down the answersAdd what your hospital can offer, including intact-cord breathing help and skin-to-skin in the operating room.
4. Add your backup planWrite one or two lines each for a cesarean, the NICU and a baby who needs help breathing.
5. Print copiesPut one in your hospital bag and give one to your partner, who will speak for you on the day.

The five lines to write first

1. "For a healthy baby, please wait to clamp and cut the cord until it stops pulsing." That often takes about 3 to 5 minutes. ACOG and the AAP recommend waiting at least 30 to 60 seconds in healthy term babies, and WHO says not earlier than 1 minute. If your baby needs immediate help after birth, that help comes first. See the benefits of delayed cord clamping.
2. "Skin-to-skin right after birth," with the baby on your chest, and on your partner's if you can't. Here's why skin-to-skin matters.
3. "A first feed in the first hour," if the baby and you are well.
4. Who you want in the room, and your partner's job (holding your hand, the camera, the questions).
5. Your pain-relief preferences, with room to change your mind.

Why do the first three lines lead? Because the cord, skin-to-skin and the first feed are decided in the first minutes, while you're busy meeting your baby. Nobody will stop to read paragraph four. Put them at the top, in plain words, and the team will see them in a glance.

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Sample wording you can copy

Plan for the first hour, too

Weighing, measuring and the first bath can usually wait until after the first feed. Two treatments shouldn't be skipped, but can usually be timed around the hour. The vitamin K injection protects against dangerous bleeding, and CDC says it can wait up to 6 hours after birth. US newborns also get erythromycin eye ointment to prevent a gonorrhea infection that can cause blindness. Ask whether both can be given after skin-to-skin and the first feed. The golden hour page walks through the full hour.

If you plan to formula-feed, write that in warmly too. The first bottle can be given skin-to-skin, with your baby held close and looking at your face.

Plan B: when the birth goes differently

A good plan includes a backup, because a changed birth is not a failed birth.

• Cesarean: delayed clamping is often still possible, with the baby held at the level of the incision. Ask about skin-to-skin in the operating room. More on C-sections and the cord.
• Breathing help: some hospitals can start it with the cord intact. If yours can't, the team clamps and helps your baby right away.
• NICU: ask when kangaroo care can start, touch and talk to your baby until then, and ask for help to start expressing milk early if you plan to breastfeed.
• Babies born early, twins and babies with known health problems get a cord plan made with your team.

Questions to settle at a third-trimester visit

1. "If our baby is breathing well, will you wait until the cord stops pulsing and turns white before clamping?"
2. "If our baby needs help breathing, can you start it with the cord intact here?"
3. "If I have a cesarean, how long can you delay clamping? Do you offer skin-to-skin in the operating room, and can my partner do it if I can't?"
4. "Can our baby go straight onto my chest and stay there until the first feed?"
5. "Can weighing, the bath, vitamin K and the eye ointment wait until after the first feed?"
6. "How do you check for jaundice before discharge?"
7. "If we plan to bank or donate cord blood, how does that change the cord plan?"

Policies differ between hospitals, and some answers depend on equipment. Find out before the day, and discuss every line with your birth team.

Give your partner the page

The birthing parent is busy, so the partner runs the plan. Their jobs: hold the page and say the cord line once, calmly; watch the cord and tell the midwife when it looks white and limp; ask "Can that wait until after the first feed?" if someone reaches for the scale; keep the baby's face visible; and take over skin-to-skin if the mother gets sleepy.

Go deeper

Grow a Genius

In the book: Chapter 14: Third Trimester: Getting Ready

Chapter 14 builds your birth plan alongside the car seat, the safe sleep space and a fourth-trimester plan, and the Birth Day Brain Plan guide gives you a printable page with every question already written out.

• The 7 Genius Builders, stage by stage
• 16 printable guides, including the Prenatal Label Decoder
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See the plan