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Birth Plan Organizer

Birth by Bloom knows firsthand how overwhelming it can be when you read and learn about birth. There are so many options and opinions. Where do you start?

... Delayed Cord Clamping, cesarean births, inductions, breastfeeding, bottle feeding, unmedicated, medicated ... how will you decide?

 Birth Plan Vancouver

What is the right answer? There seem to be two sides to every story? The internet is filled with so many options, most of which are for birthing your baby in the USA. We have outlined everything that will routinely come up during your birth with local Vancouver and Lower Mainland care providers.

You might say that you can’t plan birth, so why make a birth plan? This is true. You can not plan your birth, but you can look into things that may come up during your birth and think them through. When someone has had time to think about the possible interventions in birth, before they happen, they have an easier time having productive conversations with their medical team. This helps birthing people have a more positive feeling about their birth.

Your medical team will always offer you the most up-to-date information they have about the unique situations that come up during your birth. Just because you write something in your birth plan does not mean they will not offer you a medical intervention if needed. Everyone wants a healthy baby and a healthy birther.

Our birth plan takes out all the fluff. It is more of a medical directive for your medical care providers.

Use this as a guide to plan your own document. You can delete elements that are not important to you and add anything you feel you need your birth team to know. You can change the wording to make it your own.

It is important to keep your birth plan short and to the point. Be clear in your statements. Less is more. Only write statements that are important for your medical team to know in the first part. You can add your comfort requests to the last section.

Saying simple statements like ‘I do not consent’ or ‘I want.’ Giving reasons for points that are important to you can help your team understand your wishes. This document is a place to make sure you have recorded your wishes. If you would like routine procedures, you do not have to include them in your birth plan.

Please print off two copies. One for your birth bag and one to give to the birth team on the day of your birth. You can also share your birth plan with your medical team so they can go over it with you and let you know their medical perspective on your wishes.


My name / Partner's name

40-week date

Address (If having a home birth)

Write a sentence or two on what is the most important for you at your birth. This is an introduction to your birth team about who you are and what you want and expect from your birth. Everyone wants to have a healthy outcome for the birther and the baby, so something more specific than a healthy baby.

Examples might be “I need to be told I am doing a good job, please remind me.” “I like quiet, please keep noise to a minimum.” “I have always dreamed about catching my baby with my partner. I would like this to happen.

List any allergies and/or fears you have. Any important medical information your team might need to know. If you don't have any, skip this part.

Examples might be “I have a fear of needles. Please get the most experienced person to administer an IV.” “I need to take my thyroid medication at 8 am. Please remind me.”


Pain medication preference:

Examples “Please do not offer me pain medication."Please have medication ready for me as soon as possible,” or “I have a code word for medication if I decide I want it.” “I am open to an epidural but not other pain medication. I would like to get the epidural as late as possible.”

Please keep the number of people present in the room to a minimum.

Please speak to me first if a resident or student might provide any care.

Progress: “I am hoping for a more holistic approach to assessing my progress (i.e.

Incorporating other signs of the intensity of labour, approach of transition, readiness to push, etc.)” or “I am very interested in my progress. Please make sure you inform me of how things are progressing.”

I like to be well informed. Please give me lots of information about my care.” or “I do not want to be talked to very much during my birth. Please give my partner the medical information.”

I would like to have access to a tub for my labour.

I would like to eat and drink during my labour and birth.


“I would prefer a water birth.” or “I would like to birth my baby in the water.”

Pushing: “It is important to me to push instinctively.” or “I am very nervous about pushing. Please give me lots of space and time to get comfortable with it.”

I would like to touch my baby's head as it emerges, please remind me” or “I do not want to touch or see my baby as it is emerging.”

“I would like to catch my baby with my partner” or “.I don’t want my partner seeing the birth. Please make sure I am well covered for the birth.”

I would like to have my birth photographed.

Please do not rub the baby down at birth. I would like to keep the vernix on the baby.

Please do not disclose the sex of the baby, we would like to find out ourselves.

I would prefer physiological management of placenta” or “I would like active management of the placenta.

Please delay cord clamping until after I birth the placenta and ask my partner to cut the cord,” or “please do 5 minutes of delayed cord clamping.” “I would like to cut the cord" or "please cut the cord right away.”

Newborn Procedures

I would like at least 30 mins of limited distractions with my baby after it is born” or “I would like you to clean up and get all the baby checks out of the way before you give me my baby.”

No antibiotic eye treatment” or “Yes to antibiotic eye treatment

Please give the vitamin K shot while breastfeeding” or “I will use oral vitamin K. Do not give my baby a shot of vitamin K.”

I would like to do baby-led breastfeeding. I will ask for help if I need it” or “Please help me with breastfeeding as soon as the baby seems interested.” "Please delay the newborn exam until we have had bonding time, and the baby has breastfed."

We are keeping the placenta.” Or “we do not want to keep the placenta but we would like to see it.”


I prefer to breastfeed and/or have skin-to-skin immediately in the OR.

I would like my doula with us in the OR to support us.

Please do not disclose the sex of the baby, we would like to find out ourselves.

I would like pictures of the birth.

I would like a vaginal swab taken for inoculating the infant.

I would like delayed cord clamping.

All relevant statements in previous sections apply in the event of caesarean birth.

Optional: Include a nice sentence talking about how excited you are to meet your baby.

How to support me during my birth

I would like the lights dimmed.

I would like my playlist on Spotify called birth party.

Please tell me I am doing a good job and remind me I can do it.

I would like to use movement and the birth ball.

I want to use the TENS machine.

If you have questions please leave a comment or get in touch with us. We always love feedback. If you are interested in our childbirth classes, check out our upcoming classes.

** Collaborative post with Martha, Doula and Birth Photographer, with


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