How to Write a Birth Plan: A Practical Australian Guide

A birth plan goes by several names in Australian maternity care, including birth preferences, birth wishes, and birth notes. The terminology matters because it reflects the right framing. A birth plan is not a script that your labour will follow. It is a document that communicates your preferences to the people caring for you, so that when decisions need to be made quickly, your care team already knows what matters to you.

The value of a birth plan is not in controlling outcomes. Birth is inherently unpredictable and the best-laid plans frequently change on the day. The value is in having thought through your preferences in advance, discussed them with your care team, and created a reference document that means you don't have to communicate everything from scratch while you're in active labour.

Written well, a birth plan is one of the most useful things you can bring to hospital. Written poorly, whether too long, too rigid, or covering things that aren't actually within your choice to decide, it becomes something the care team quietly sets aside. This guide helps you write one that works.

When to write your birth plan

The ideal window is between 32 and 36 weeks. Early enough that you have time to discuss it with your midwife or obstetrician at an antenatal appointment before you reach full term, late enough that you have a realistic sense of how your pregnancy is progressing and what options are actually available to you.

Writing it earlier than 32 weeks is fine for thinking through your preferences, but worth revisiting closer to the date when you have more information about your baby's position, your health, and any complications that may affect your options.

Have it completed and in your hospital bag by 36 weeks. You want it ready before you need it.

What a birth plan should and shouldn't include

Should include: Your preferences in areas where genuine choice exists. Pain relief preferences, positions you'd like to try during labour, who you want present, your preferences around interventions if offered, skin-to-skin and cord clamping, and what you'd like to happen if a caesarean becomes necessary.

Should not include: Demands for specific outcomes that can't be guaranteed, detailed medical instructions for emergency scenarios that your care team is better positioned to manage, or preferences about things that are standard practice and not variable, such as requesting that staff wash their hands.

Length: One page is the gold standard. Two pages at most. A five-page birth plan will not be read carefully during a busy labour ward shift. A single clear page that covers the essentials will be.

What to cover: section by section

Your support people

Who will be with you during labour and birth? In Australian public hospitals, most facilities allow one to two support people for vaginal births and one support person in theatre for caesareans, though this varies by facility. If you have a doula, note this here so the team knows to include them.

Pain relief preferences

This is one of the most important sections and worth being specific about. Options available in most Australian hospitals include gas and air (nitrous oxide), TENS machine in early labour, heat packs, water including shower and bath where available, epidural, and opioid pain relief including pethidine and morphine.

You don't need to commit to a specific plan. Many women find that what they want in labour is different from what they expected. What's more useful is noting your general preference — for example, whether you'd like to explore non-pharmacological options first, or whether you're open to an epidural and would like it offered at a certain point. You can also note anything you specifically want to avoid if relevant.

Labour positions and mobility

If you want to be able to move freely during labour rather than being confined to the bed, note this. If you'd like access to a shower, bath, or birth pool if available at your facility, include it. Mobility during labour is associated with shorter labours and reduced pain, and most midwives actively support it, but having it in your plan means it doesn't need to be negotiated in the moment.

Monitoring preferences

Continuous electronic fetal monitoring is standard for certain situations including induction and epidural use. For lower-risk labours, intermittent monitoring with a handheld Doppler is often available. If you have a preference, note it, though be aware that your care team may recommend continuous monitoring based on how your labour progresses and that this recommendation takes precedence over preference.

Intervention preferences

This covers your preferences around interventions that may be offered or become necessary during labour. Areas worth considering include your feelings about artificial rupture of membranes if labour is progressing slowly, oxytocin augmentation if contractions slow, episiotomy versus allowing natural tearing, assisted delivery with forceps or ventouse, and the threshold at which you'd want your care team to discuss a caesarean with you.

The goal here is not to refuse interventions categorically. That approach creates rigid plans that can't flex to real situations and puts you in a difficult position during labour. The goal is to communicate your general orientation: for example, that you'd like to discuss any intervention before it proceeds rather than having it offered without explanation, or that you're open to all interventions if the team recommends them.

Caesarean preferences

Even if you're planning a vaginal birth, including a section on your preferences if a caesarean becomes necessary is practical rather than pessimistic. Around one in three Australian babies are born by caesarean. Preferences worth noting include skin-to-skin in theatre if possible, delayed cord clamping where safe to do so, having your support person present throughout, and being informed of what's happening during the procedure.

If you're having a planned caesarean, this section will be more detailed and will cover things like your preferred music in theatre, whether you'd like the screen lowered for the birth moment, and early skin-to-skin contact.

Cord clamping

Delayed cord clamping, which involves waiting at least one to three minutes before clamping the umbilical cord, is now recommended by many Australian maternity bodies as it increases iron stores in the newborn. It is worth stating your preference explicitly as practice varies between facilities and care providers.

Third stage: delivering the placenta

Active management of the third stage, involving a hormone injection to help your uterus contract and deliver the placenta quickly, is routinely offered in most Australian hospitals. It reduces the risk of postpartum haemorrhage and is the recommended approach. If you have a preference for physiological management, meaning allowing the placenta to deliver without medication, discuss this with your midwife before your due date as it is not available in all settings and requires specific conditions.

Skin-to-skin and newborn procedures

Note your preference for immediate skin-to-skin contact after birth where safe to do so. Routine newborn procedures including the vitamin K injection, eye drops, and newborn observations can be delayed briefly to allow uninterrupted skin-to-skin in most circumstances. If you have preferences around these, include them.

Feeding

A brief note on whether you're planning to breastfeed or formula feed means your care team can provide appropriate support from the outset rather than assuming. If you're planning to breastfeed, noting that you'd like support from a midwife or lactation consultant in the early hours is useful.

If things don't go to plan

Some women include a brief note acknowledging that their preferences may need to change based on how labour unfolds, and that they trust their care team to keep them informed and involved in decisions even when deviating from the plan. This framing sets a collaborative tone and is often genuinely appreciated by midwives and obstetricians.

How to present it

Keep it to one page. Use clear headings rather than dense paragraphs so it can be scanned quickly. Bullet points work well for preferences within each section. A brief introductory sentence about who you are and what matters most to you sets a human tone.

Print two or three copies. One for your hospital bag, one to give to your midwife or obstetrician at your final antenatal appointments, and one spare. Digital copies on your phone are useful but physical copies don't require unlocking a screen in a busy labour room.

Discuss it at your antenatal appointments rather than just handing it over on the day. A midwife or obstetrician who has read and discussed your plan before your due date can tell you which preferences are straightforward to accommodate, which may need adjustment based on your specific situation, and which facilities your hospital has available. This conversation is as valuable as the document itself.

Early labour comfort

The birth plan conversation at your antenatal appointments is also a good opportunity to discuss early labour, what to do at home before it's time to come in, how to stay comfortable during early contractions, and what to pack for the journey.

If you've been using a Bumpnest Maternity Pillow through the third trimester, the back wedge and knee components are compact enough to pack and take with you. Resting between contractions in early labour at home or in the hospital room is considerably more comfortable with the support setup your body is already used to.

A note on birth plans and flexibility

The women who find their birth plans most useful are typically those who have used the process of writing them as an opportunity to think clearly about what they want, and who then hold those preferences lightly on the day.

Labour is not controllable in the way that a well-organised birth plan might imply. What is controllable is the quality of communication between you and your care team, and your ability to make informed decisions in real time when circumstances change. A birth plan supports both of those things. It is a starting point for a conversation, not a contract.

The most important thing you can put in a birth plan is probably the last thing: that you trust your care team to keep you informed, involve you in decisions, and prioritise the safety of you and your baby, and that within those parameters, these are the things that matter to you.