What is the birth plan form template?
In the middle of labor, nobody wants to explain from scratch that they'd like the lights low, that their partner hopes to cut the cord, or that they'd rather be asked before baby is given a pacifier. A birth plan puts those wishes on paper in advance, so the midwives and doctors on shift can see them at a glance.
This template walks an expectant parent through three short pages. The first records the basics: due date, where they plan to give birth, their care team, who'll be with them and what kind of birth they're planning. The second covers labor and birth, from the room and movement to pain relief, monitoring, pushing, the cord and the placenta. The third is about the first hours: skin-to-skin, feeding, vitamin K, the first bath, visitors and what should happen if baby needs special care.
Choose planned cesarean and the labor questions step aside. In their place come cesarean preferences: a partner in theater, a lowered screen or clear drape, skin-to-skin if baby is well, music, photos and recovery wishes. The finished plan is saved as a PDF in FileIt, ready to print or bring to an appointment.
- Best for
- Expectant parents, and the midwives, doulas and birth educators who support them
- Filled in by
- The expectant parent, often with their birth partner
- Time to complete
- About 10 minutes
- Includes
- Birth setting and type, room and comfort wishes, pain relief, monitoring, cesarean preferences, newborn care and a sharing consent
Who uses a birth plan form?
- First-time parents putting their wishes in writing before a hospital birth
- Parents planning a home birth or a birth-centre birth
- Parents with a scheduled cesarean who want a gentler theater experience
- Doulas sending a plan template to every client in the third trimester
- Birth educators using it as homework after a preparation class
- Parents planning a vaginal birth after a previous cesarean
Questions on this birth plan form
34 questions over 3 pages · includes conditional questions, multiple pages, consent checkbox.
1 About you
- Your name*
- Due date*
- How you'd like to be addressed
- Where are you planning to give birth?* Hospital labor ward · Birth centre or midwife-led unit · At home
- Midwife, doctor or care team
- Who will be with you?
- Will a doula be with you?
- What kind of birth are you planning?* Vaginal birth · Vaginal birth after a previous cesarean · Planned cesarean · Not decided yet
- Language, interpreter, cultural or religious needs
- The most important thing your care team should know
2 Labor & birth
- The room Lights dimmed · Quiet, with few people coming in and out · My own music · Wearing my own clothes · Photos or video allowed · Happy for students to be present
- Moving and staying comfortable asked only when it applies Free to walk and change position · Birth ball · Bath or birth pool · Light snacks and drinks · Massage or counter-pressure from my partner
- Pain relief I'd like to consider asked only when it applies Try without medication first · Breathing, hypnobirthing or relaxation · TENS machine · Water · Gas and air · An injection of pain-relieving medicine · Epidural · Please don't offer — I'll ask
- Monitoring baby's heartbeat asked only when it applies Checked from time to time if all is well · Continuous monitoring · Whatever the team recommends
- Thoughts on induction, breaking waters or assisted birth asked only when it applies
- Pushing and birth asked only when it applies Follow my body's urges · Coached through each push · Upright positions · A mirror to see the birth · Touch baby's head as it crowns
- During the operation* asked only when it applies Birth partner with me in theater · Talk me through each step · Screen lowered or a clear drape to see baby born · My own music playing · Skin-to-skin in theater if baby is well · Monitor pads placed so baby can lie on my chest · Photos of the birth · A slower, gentle delivery if possible
- Would your partner like to trim the cord afterwards? asked only when it applies
- Anything else about the operation or recovery asked only when it applies
- Cutting the cord Wait until it stops pulsing, if safe · My partner would like to cut it · No preference
- Delivering the placenta asked only when it applies With an injection to speed it up · Naturally, without the injection · Whatever is advised on the day
- Would you like to keep the placenta?
3 After the birth
- Straight after birth Baby placed skin-to-skin on me · Baby dried and wrapped first · Skin-to-skin with my partner if I can't
- Who announces the baby's sex? I'd like to discover it myself · My partner · The team can tell us · We already know
- How do you plan to feed baby?* Breast or chest feeding · Formula · Both · Not sure yet
- Would you like help with the first feed?
- Should staff ask you before giving formula or a pacifier? asked only when it applies
- Vitamin K for baby Injection · By mouth · I'd like to discuss it first
- Baby's first bath Delay it — we'll do it ourselves · Happy for staff to bath baby · No preference
- Other wishes for newborn care
- If baby needs special care
- Visitors after the birth
- Sharing*
- Date*
The birth plan form, page by page
1 About you
Your name, due date, and Where are you planning to give birth? are required, along with What kind of birth are you planning? The answers are vaginal birth, vaginal birth after a previous cesarean, planned cesarean or not decided yet. Optional questions cover how you'd like to be addressed, your midwife or care team, who will be with you, whether a doula is coming, language or cultural needs, and the most important thing your care team should know.
2 Labor & birth
The room asks about dim lights, quiet, music, your own clothes, photos and whether students may be present. Unless a planned cesarean was chosen, you then see Moving and staying comfortable, Pain relief I'd like to consider (from trying without medication to an epidural, or Please don't offer — I'll ask), monitoring baby's heartbeat, your thoughts on induction or assisted birth, pushing preferences and how the placenta is delivered.
For a planned cesarean, a Cesarean preferences heading appears with During the operation (at least one choice required), whether your partner would like to trim the cord, and notes on the operation and recovery. Everyone answers the questions about cutting the cord and keeping the placenta.
3 After the birth
Choose what happens straight after birth, who announces baby's sex, and How do you plan to feed baby? (required). Parents planning to breast or chest feed are asked whether staff should check before giving formula or a pacifier. Vitamin K, the first bath, other newborn wishes, plans if baby needs special care and visitors follow. A short note explains that plans can change, then you agree to share the plan with your care team and date it.
Make the template yours
- Edit the options to match what your hospital or birth centre actually offers
- Add a question about a birth pool booking or water birth if you're a home-birth midwife
- Remove questions your clients rarely use to keep the plan to a page or two
- Add your practice's contact details and when to call to the cover text
- Add a file question so parents can attach a previous birth summary
- Send it as an emailed request to each client around 32 to 36 weeks
Tips for a better birth plan form
- Talk the plan through with your midwife or doctor; they can tell you what's possible where you're giving birth
- Keep answers short; the team will read it quickly during labor
- Print two copies, one for your hospital bag and one for your birth partner
- Think about a second-choice plan in case things change on the day
- Revisit the plan if your birth type changes, for example to a planned cesarean
- A birth plan records preferences; it isn't medical advice, and your care team will guide decisions on the day
Every response becomes a PDF in your vault
The plan is filed as a PDF in the vault folder you choose, laid out page by page with every option shown and your choices ticked. The person who set up the form is notified, and you can be emailed a copy to print.
If you change your mind, fill it in again and a new PDF is filed alongside the first, so you always have the latest version.
- Start from this template. It opens in the FileIt Forms designer — change any question, add pages, set the rules for when questions appear.
- Share it. Turn on a public link, or send it to people by email, each with their own link. They don’t need a FileIt account.
- Get the answers as PDFs. Each response is saved as a PDF in the vault folder you choose, with uploaded files attached — and listed in a Responses table you can export to CSV.
Birth plan form: frequently asked questions
Is this birth plan template free?
Yes. It's included with the Forms app on every FileIt account, including the free plan.
Do I need an account to fill in a birth plan someone sent me?
No. Your midwife or doula sends a link or request, and you answer without creating an account.
What changes if I'm having a planned cesarean?
The labor questions on movement, pain relief, monitoring, pushing and the placenta are hidden, and cesarean preferences appear instead.
Will the hospital follow my birth plan?
It helps your team understand your wishes, but decisions on the day depend on your health and baby's. Discuss the plan with your care team before your due date.
Can I use it as a midwife or doula for all my clients?
Yes. Create the form once, adjust the options to your setting, and send it to each client. Every plan arrives as its own PDF.
Can I print it?
Yes. Open the filed PDF from your vault or the copy in your email and print it, then pack it in your hospital bag.