Expecting
A birth plan that actually gets read
Tick what matters to you and this builds a one-page summary you can print or hand over. Every choice says what it means, and — the part most templates leave out — whether it is genuinely yours to decide, something the hospital varies on, or a clinical call that is not a preference at all.
A birth plan is a way of being understood, not a contract. Births change course for reasons nobody chooses, and none of that is a failure of the plan or of you. That is exactly why the last section — what you want if things change — is the one most worth filling in.
During labor
Most of this is genuinely yours to choose, and most of it costs the hospital nothing. It is worth writing down precisely because in labor you may not want to be explaining yourself.
- Freedom to move and change positionYours to choose
Walking, leaning, birth ball, hands and knees. Continuous monitoring can restrict this — ask whether intermittent monitoring is an option for you.
- Intermittent rather than continuous monitoringAsk your hospital — it varies
How often the baby's heartbeat is checked. ACOG supports intermittent auscultation for low-risk labor where the parent wants it, and notes continuous monitoring has not reduced deaths or cerebral palsy in low-risk pregnancies while raising caesarean rates. An epidural or oxytocin augmentation means continuous monitoring.
ACOG Committee Opinion 766 (2019, reaffirmed 2021) - Low lighting and few interruptionsYours to choose
Fewer people in the room, voices down, door closed. Easy to honor and easy to forget in a busy unit.
- My own music or playlistYours to choose
Bring a speaker. Nobody minds, and it is one of the few things entirely within your control.
- Eating and drinking as I want toAsk your hospital — it varies
ACOG supports moderate amounts of clear liquids in uncomplicated labor, and says solid food should be avoided. Individual hospital policy still varies.
ACOG Committee Opinion 766 (2019, reaffirmed 2021) - Access to a shower or tubAsk your hospital — it varies
For labor, for pain relief — separate from whether the hospital supports actually giving birth in water, which fewer do.
- Who I want in the roomAsk your hospital — it varies
Partner, doula, family member. ACOG notes continuous one-to-one support such as a doula is associated with improved outcomes. Hospitals cap numbers and the cap changes — confirm the current one, not the website's.
ACOG Committee Opinion 766 (2019, reaffirmed 2021)
Pain relief
There is no right answer here and no prize for any particular choice. Saying what you would prefer to start with is useful; so is saying how you want to be asked about it later.
- I plan to have an epiduralYours to choose
Knowing in advance helps the team plan. It usually means continuous monitoring and limited mobility.
- I would like to try without one firstYours to choose
You can change your mind at any point, and doing so is not a failure of the plan. There can be a wait for the anesthesiologist, so it is worth asking how long that typically is.
- Please do not offer it — I will askYours to choose
Some people find repeated offers undermine their resolve. Others want to be asked. Either is fine; the staff cannot guess which you are.
- Nitrous oxide, if availableAsk your hospital — it varies
Self-administered gas and air. Common in some countries and only in some US hospitals — worth checking rather than assuming.
- Non-medical methods firstYours to choose
Breathing, movement, counter-pressure, heat, water. ACOG supports non-pharmacologic pain relief as part of individualised labor management. Often what a doula or a birth class is chiefly teaching.
ACOG Committee Opinion 766 (2019, reaffirmed 2021)
The birth itself
Less of this section is yours to decide, and that is worth knowing in advance rather than in the moment.
- Push in a position that feels rightYours to choose
Upright, side-lying, hands and knees. An epidural narrows the options; a clinical concern may narrow them further.
- A mirror, or to touch the head as it crownsYours to choose
Some people find it powerful and some find it the opposite. Say either.
- Perineal support, and no routine episiotomyYours to choose
ACOG recommends restrictive rather than routine episiotomy — it is performed for specific indications, not by default. Warm compresses and guided pushing may reduce tearing.
ACOG Practice Bulletin 198 (2018) - Delayed cord clampingYours to choose
ACOG recommends waiting at least 30-60 seconds in vigorous term and preterm infants. It raises haemoglobin at birth and improves iron stores for months, with a small rise in jaundice needing phototherapy. Not possible if the baby needs immediate help.
ACOG Committee Opinion 814 (2020) - My partner cuts the cordYours to choose
Almost always accommodated when asked.
- Talk me through it before any forceps or vacuumA clinical decision, not a preference
Whether an assisted delivery is needed is a clinical call. Being told what is happening and why is still yours to ask for.
Straight after
The first hour. Much of this is now standard practice, but standard is not the same as guaranteed, and asking costs nothing.
- Immediate skin-to-skinYours to choose
Baby straight onto your chest, weighing and measuring deferred. WHO recommends it immediately and uninterrupted for at least an hour; it improves temperature regulation and blood glucose and supports breastfeeding. Possible after a caesarean in many hospitals — ask.
WHO / UNICEF Baby-Friendly Hospital Initiative - Delay the first bathYours to choose
Leaving the vernix for some hours is common practice now. Say if you want it.
- If I cannot, my partner does skin-to-skinYours to choose
Worth writing down precisely because it applies when you are not in a position to ask.
- Vitamin K and eye ointment — discuss timingAsk your hospital — it varies
Both are routine newborn care. The AAP recommends a single intramuscular dose of vitamin K for every newborn to prevent vitamin K deficiency bleeding, and notes oral dosing is less effective. Timing can often shift to after the first feed.
American Academy of Pediatrics - Baby stays in the roomYours to choose
Rooming-in is standard in most units now. Say if you would rather have the option of the nursery, which is equally legitimate and less often written down.
Feeding
Whatever you plan, saying it in advance stops you having the conversation repeatedly with different staff on no sleep.
- I plan to breastfeedYours to choose
Ask whether a lactation consultant sees every parent or only on request — it varies, and the first 48 hours are when it matters most.
- I plan to formula feedYours to choose
A legitimate choice that does not need justifying. Writing it down reduces how often you are asked.
- Both, or deciding laterYours to choose
Also fine, and more common than the two tidy options suggest. Saying so up front stops the question being reopened by each new shift.
- No formula unless medically needed — ask me firstYours to choose
For parents who want to protect early breastfeeding. There are medical situations where supplementing is necessary, and the team will explain if so.
- No pacifierYours to choose
Often requested alongside establishing breastfeeding.
If things change
The most useful part of a birth plan, and the part most often left out. Births change course for reasons nobody chose. Saying what matters to you WHEN that happens is not pessimism — it is the bit that still works when the rest of the plan does not.
- Explain what is happening and why, as it happensYours to choose
Even when there is no time to decide, there is usually time to be told.
- If a caesarean, my partner stays with meAsk your hospital — it varies
Standard for a planned or unplanned caesarean under regional anesthetic. Under general anesthetic it is usually not possible.
- If a caesarean, skin-to-skin in theatreAsk your hospital — it varies
Increasingly offered, sometimes called a gentle or family-centerd caesarean. Ask whether your hospital does it.
- If baby goes to NICU, my partner goes tooYours to choose
So the baby is not alone and somebody can tell you what is happening.
- Talk to me, not only to my partnerYours to choose
Worth stating. It happens more than it should.
Turn this into your one-page plan
Everything above stays free to read. The builder ticks these off into a single page you can print or hand to a midwife, flags the choices that contradict each other, and exports a PDF. Nothing you tick is ever saved or sent — not even to us.
What you get
- A birth plan that gets read. Tick what matters and it builds a one-page summary you can print or hand over — with what each choice means, whether it is genuinely yours to decide, and the guidance behind every clinical one. Nothing you tick is saved or sent anywhere.
- The Texas licensing lookup. Every licensed childcare operation near you, by address or ZIP, with its inspection history and what each finding actually was — and enforcement action called out separately from a routine finding.
- Find a doctor. 31 specialties a family actually gets referred to — pediatric cardiology, ENT, orthopedics, maternal-fetal medicine — searchable by ZIP, with Texas licenses checked against the state medical board's own file.
- Where to give birth. 2,263 hospitals carrying the federal birthing-friendly designation, with Medicare's own rating and what discharged patients reported.
- Birth classes near you. 635 childbirth educators, birth centers and hospital programs across 99 cities in five states, 613 with a phone number. Nobody keeps a register of these — no license, no federal file — so we went and found them.
- 8 childcare guides. Built on state inspection data and AAP guidance — what to look at on a tour, how to read a licensing record, what it costs, and what hiring a nanny commits you to.
- The advisor. Ask about a specific place or a specific worry and get a real answer back — a named doctor, hospital or daycare near you, not just a link to go search yourself.
- The weekly note. Timed to your child, one email a week, no account.
Three things never need an email: 14,935 free Head Start places, 19,003 clinics that must see you whatever you can pay — both searchable by ZIP — and what childcare costs in all 57 states and territories.
Finding a birth class
There is no public register of birth classes — no license, no federal file. We went and found them anyway, one state at a time, and we will say plainly which states and when they were checked rather than implying a completeness we do not have. Search 635 providers across five states. Everywhere else, and as a check anywhere, these are the routes that work.
- The hospital where you plan to deliver. This is the main answer. Most run their own classes, and theirs will describe how that unit does things, which no general class can. We hold 2,263 hospitals with the federal birthing-friendly designation, each with a phone number — find yours and ring the maternity unit. Ask what they run, when it books up, and whether it is free. We checked whether that designation predicts a better birth, and it does not narrow the choice as much as it looks.
- A community health center. Federally funded centers do prenatal care and often free classes, on a sliding scale by income — low-cost clinics near you.
- A doula, who often teaches too. Many run private classes or one-to-one sessions — doulas near you.
- The national programs. Lamaze, ICEA and the Bradley Method each run their own instructor directories. We link rather than copy — their listings are theirs, and ours would go stale.
Whichever you pick, book earlier than feels necessary. Classes commonly fill six to eight weeks ahead, and the useful time to take one is the third trimester.
Where the clinical notes come from
Every option above marked as a clinical matter links to the guidance it rests on. Those documents are:
- ACOG Committee Opinion 814 (2020) — Delayed Umbilical Cord Clamping After Birth. Preterm guidance updated by an ACOG Clinical Practice Update in 2025.
- ACOG Committee Opinion 766 (2019, reaffirmed 2021) — Approaches to Limit Intervention During Labor and Birth.
- ACOG Practice Bulletin 198 (2018) — Prevention and Management of Obstetric Lacerations at Vaginal Delivery.
- American Academy of Pediatrics — Vitamin K prophylaxis for newborns.
- WHO / UNICEF Baby-Friendly Hospital Initiative — Early skin-to-skin contact for mothers and their healthy newborn infants.
Nothing on this page is medical advice or a recommendation to choose any particular option — it describes what each choice involves so you can discuss it with your own midwife or doctor. How we handle sources.