Birth Plan Review Checklist

Use this list to make sure you have covered everything you feel is important in your birth plan. You do not need to have something written for all these areas, this is only a list of areas you may have strong preferences about.

Introductions
  • Names of parents
  • Others who will be with you
  • Specific concerns or unique circumstances
  • Health issues for mom or baby
  • Current medications
 Pain Management Preferences
  • First Stage
  • Second Stage
  • Postpartum
 Medical Decision Making Preferences
  • For inducing or speeding up labor
  • For pain management
  • For monitoring
  • After baby is born
Pushing
  • Positions you are able/wishing to try or avoid
  • Style of pushing
  • Who will be with mom
Preferences in case of unexpected events
  • Who contributes to decision making team
  • How soon to begin medical interventions
Preferences in case of cesarean
  • Who should remain with mother/baby
  • How soon to hold/feed baby
  • How soon to receive visitors
Postpartum care of baby
  • Cord cutting
  • Timing of routine assessments
  • Breast or bottle feeding
  • Rooming in or nursery
  • First bath
  • Circumcision or intact
Other Important Items
  • Photos and videos
  • Privacy needs
  • Environmental issues (lighting, music)
  • When to discharge
  • Educational needs (anything you want to be sure to learn about baby care before you leave)

Review Your Work

  • What additional information do you need to include in a birth plan?
  • Have you discussed all the preferences on your birth plan with your midwife?
  • Did you identify items that can be removed from your birth plan?
  • Is there disagreement between you and your birth team about any of the items on your birth plan? How will you resolve these differences?