Here's a sample birth plan that's super easy to read and follow. This is the format I always use to write birth plans for my clients. There's no wrong way to write a birth plan, but I like to keep them simple and easy to skim over.
This birth plan is an actual plan I wrote for one of my clients. I changed her name to protect privacy.
Jan Smith's Birth Plan
Estimated Due Date: 1/12/14
OB: Dr. Hurst
Doula: Stephanie Mitchell
-I would like to wear my own clothing
-Please keep low lighting
-No students please
-I plan to eat and drink as needed/desired
-Please no routine electronic monitoring- I prefer intermittent monitoring via Doppler (this has been discussed and approved by Dr. Hurst).
-I do not want routine vaginal exams if my labor appears to be progressing normally.
-I plan to avoid Pitocin if at all possible- please do not suggest or offer unless absolutely necessary.
- I plan to allow cervical dilation to occur naturally without time expectations.
-I plan to use natural pain relief methods.
-Please do not offer any pain medication or epidural- I will ask if it becomes necessary.
-I wish to push in whatever position is most comfortable- I do not plan to push lying down unless I choose to do so.
-Please allow me to push only at my urge.
-NO episiotomy- I prefer to tear.
-I would like cord clamping delayed.
-Exclusive breastfeeding on-demand.
-Please do not give my baby any pacifiers or bottles.
-I do not want my baby to have eye ointment.
-Please do not bathe my baby.
-No Hep B vaccine.
-Please do give our baby a vitamin K shot.
-I would like all procedures- measurements included- to be delayed until after mom-baby bonding time.
Other: If deviation from this plan becomes necessary, please give us time alone to discuss and consider all of our options without pressure.
We appreciate your support in our desire to have a natural birth, as hands-off as possible. Thank you!