Birth Plan
Free Birth Plan Template (Printable PDF)
Shelbi Kohler, birth doula, 500+ families supported
A birth plan template is a short form for your preferences in labor, pain relief, delivery, and newborn care. Yours fits on one page a nurse can scan in 30 seconds. Below, a filled-in hospital example, the steps, and the download.
The basics
What is a birth plan template?
It's a worksheet for your preferences, covering labor, pain management, delivery, postpartum care, and newborn care. You fill in what you want, and it becomes the document your OB, your nurse, and your doula read before anything happens.
It isn't a contract, or a place to list every preference you've ever had. Nurses meet you for twelve hours, usually during the busiest shift of their week. A one-page plan gets read. A four-page essay gets skimmed. Short wins.
The template flexes by setting. A hospital plan leans on short, scan-friendly sentences, and the hospital birth plan guide goes deep on that. A home birth plan reads like a transfer wish list for your midwife. Not sure what you want yet? Start with the birth plan checklist.
Most hospitals hand you their own form at a prenatal visit or admission, covering their defaults, IV access, continuous monitoring, an epidural offer on schedule. Bring yours anyway. Their form goes in the chart. Yours covers what a form can't ask, like who announces the baby's sex or what the room feels like at 3 a.m. Use both.
Built by Shelbi Kohler, a birth doula with delivery rooms across Texas behind her, around the decisions that actually come up in labor. The birth plan examples make good starting points.
A filled-in example
See exactly what you'll fill in
Excerpts from a hospital birth, filled in. Treat them as calibration, not scripture. Your answers should sound like you.
Labor preferences
- ✓ I'd like to move and change positions freely during labor
- ✓ Intermittent monitoring unless medically necessary
- ✓ Partner and doula present in the room at all times
- ✓ Dim lights and quiet voices please
Pain management
- ✓ Start with breathing, tub/shower, and movement first
- ✓ Please offer an epidural when I ask, not before
- ✓ Open to nitrous oxide if labor is long
Delivery preferences
- ✓ Push in whatever position feels right
- ✓ Delayed cord clamping (at least 60 seconds)
- ✓ Partner announces the sex of the baby
Postpartum care
- ✓ Immediate skin-to-skin
- ✓ Lactation consultant support before discharge
- ✓ Partner stays overnight
Newborn care
- ✓ Baby rooms in with me at all times
- ✓ Vitamin K injection: yes
- ✓ Hepatitis B vaccine: yes, at the 2-month visit
- ✓ No formula or bottles without talking to us first
How to use this template
Five steps from blank page to hospital bag
Download the printable template.
It's free, no email required. Print it and fill it in by hand, or type into the fillable version.
Read it top to bottom with your partner.
Every check box is a conversation worth having in week 30, while nobody is having contractions. Where you disagree, talk it through. That's the template working.
Mark what matters most, and cross out the rest.
You don't need to answer every line. A plan with eight items that all matter beats forty items nobody reads.
Bring it to your next appointment.
Ask your OB or midwife to flag anything your hospital doesn't do, because every hospital handles this differently. The hospital birth plan guide covers the preferences that matter most in that setting.
Pack it in your hospital bag.
Print a few copies. One for your partner, one for your doula, one tucked with your insurance card. When labor starts, you won't be searching for any of it.
Same template, different circumstances
Birth plans for every kind of birth
The five sections stay the same. What goes inside them changes with how you're giving birth.
Hospital birth
The defaults your hospital assumes, and the sentences that rearrange them.
Planned induction
What adjusts when labor starts in a chart instead of your body.
VBAC
A few lines carry extra weight when you're hoping for a vaginal birth after a cesarean.
Home birth
A shorter, quieter plan, plus transfer wishes worth writing down early.
Planned or possible C-section
Surgery has preferences too, from music to who's with you in the OR.
Just the checklist first
If the blank form feels big, start with every choice on one list.
Want personalized support?
Need someone to review your plan with you, line by line?
The free PDF and walkthrough give you the tools. If you want a doula to look at your plan with your hospital in mind, book a Birth Plan Confidence Session, a 60-75 minute video call with Shelbi, real feedback, and advocacy role-play for the conversations you're most worried about. $250 per session. Limited spots.
Learn about the Confidence SessionFree instant download
The one-page birth plan template
Print it, fill it in, bring it to the hospital.
Free, prints on letter paper, no email required
Prefer typing? The full fillable PDF covers the same sections.
Birth Plan Walkthrough
Not sure what to write? Walk through every section with a doula
The template tells you what to decide. The free 5-video walkthrough explains why each choice matters.
About Me & Your Birth Plan
The section that helps your care team see you as a person.
▶ ~5 min
Labor, Delivery & Pain Management
Monitoring, IV, movement, and the pain ladder.
▶ ~8 min
Post-Delivery Preferences
Skin-to-skin, cord clamping, golden hour, feeding.
▶ ~6 min
Free Download
Get the Free Video Walkthrough
Enter your name and email and we'll send you immediate access to all 5 walkthrough videos, a certified doula guiding you through every section of your birth plan. Already have the PDF? The videos work alongside it. No spam, just the guidance you need.
✓ Check your inbox. Your walkthrough access is on its way!
Your free video walkthrough is ready below. Start watching now.
Take your plan to the hospital
The app has your plan, contraction timing, and provider messages in one place.
No spam. Just your birth plan and occasional tips you can actually use.
Prefer to skip the email?
Download PDF directlyAlready have a plan? Book a Birth Plan Confidence Session
Want to understand every choice on it? Watch the free walkthrough
Common questions
Is the birth plan template PDF really free?
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What should I put in a birth plan?
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How you want labor to go, how you'll handle pain, what matters during delivery, the first hours after birth, and newborn care. A one-line flexibility statement at the top tells your team how you want decisions made if something changes.
What makes a good hospital birth plan template?
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One page, short sentences, preferences grouped by the moments your nurse will manage. A plan they can scan in 30 seconds gets followed.
How long should a birth plan be?
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One page. Longer plans get skimmed on a busy shift and the important lines get lost. That's why we made the one-page version. Choose what matters most and leave the rest off.
When should I fill out my birth plan?
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Most families start around 28 to 32 weeks, once prenatal visits get specific. Earlier is fine. Knowing your options early builds real confidence.
Related Resources
- Birth Plan Checklist
- Birth Plan Examples
- Birth Plan Scenarios
- Hospital Birth Plan
- Birth Plan for Induction
- VBAC Birth Plan
- Home Birth Plan