Creating Your Birth Plan
A Printable Checklist
By Liza Barnes, Health Educator
There are many good reasons to create a birth plan. Besides
communicating your desires about your baby's birth to your health care provider, writing a birth
plan helps you (and your partner) to mentally prepare for the birth. It also may help facilitate
discussions with your health care providers about details that you may have overlooked. Think
through each and every choice you list on your birth plan.
First Stage (Labor)
Whom will you invite to attend/witness the birth?
What are your environmental preferences (lighting, noise level, music, etc.)?
What are your film/video preferences (check one)?
Yes, I want to record the event with video
No just cameras
No recording devices of any kind
What are your clothing preferences (check one)?
A hospital gown
My own clothing
What are your fetal monitoring preferences (check one)?
Internal fetal monitor
External fetal monitor