When I was pregnant with Ellie, I spent hours researching birth plans. I knew exactly what I wanted for pain management, who would cut the cord, and my preferences for immediate skin-to-skin. What I didn’t anticipate were all the smaller moments that would shape my experience just as much as the big decisions.
By the time Milo came along, my birth plan looked different. Not because my core values had changed, but because I’d learned that birth unfolds in unexpected ways, and the details that matter most aren’t always the ones you’d think to write down.
After talking with countless other moms and reflecting on my own two very different birth experiences, I’ve gathered the things we all wish someone had told us to include. These aren’t meant to replace your main preferences. They’re the additions that can help you feel more prepared, more heard, and more at peace with however your birth story unfolds.
1) Your preferences for the room environment
Most birth plans focus on medical interventions, but the atmosphere of your birthing space can profoundly affect how you feel during labor. Research from the Journal of Midwifery & Women’s Health suggests that environmental factors like lighting, noise levels, and privacy can influence labor progression and a mother’s sense of control.
Think about what helps you feel calm in stressful moments. Do you want the lights dimmed? Would you prefer minimal conversation during contractions? Some moms bring battery-operated candles, a specific playlist, or even a familiar pillowcase from home. Others request that staff knock before entering or keep the door closed as much as possible.
Write these details down specifically. “I would like dim lighting and quiet voices during active labor” gives your support team something concrete to work with. When I was laboring with Milo, having my own music playing softly made the hospital room feel less clinical and more like a space where I could actually let go and focus on my body’s work.
2) Who speaks for you when you can’t
There will likely be moments during labor when you’re deep in concentration, managing contractions, or simply too exhausted to advocate for yourself. This is where having a clearly designated decision-maker becomes essential, and it’s worth spelling out in your birth plan.
Talk with your partner or support person beforehand about your priorities. What are your non-negotiables? Where are you flexible? If a situation arises that wasn’t covered in your plan, what values should guide their response? Having these conversations before labor means your advocate can speak confidently on your behalf.
In your birth plan, you might write something like: “My partner Matt is authorized to make decisions on my behalf if I’m unable to communicate. We have discussed my preferences in detail.”
This clarity helps medical staff know who to direct questions to and ensures your voice is still present even when you’re focused inward. It also takes pressure off your support person because they’re not guessing what you’d want. They already know.
3) Your wishes if plans change unexpectedly
Here’s something I learned the hard way: birth rarely follows a script. Having backup preferences written into your plan isn’t pessimistic. It’s practical, and it can actually help you feel more in control when things shift.
If you’re planning an unmedicated birth but end up wanting an epidural, what matters to you about that experience? If a cesarean becomes necessary, do you want the drape lowered so you can see baby emerge? Would you like music playing? Can your partner stay with the baby if they need to go to the NICU?
As noted by the American College of Obstetricians and Gynecologists, discussing potential changes to your birth plan with your healthcare provider ahead of time can help you feel more prepared for different scenarios.
Writing “If a cesarean is needed, I would like immediate skin-to-skin in the OR if possible and my partner to remain with me throughout” gives you agency even in unexpected circumstances. You’re not planning for failure. You’re planning for flexibility.
4) Preferences for the golden hour and beyond
The first hour after birth is often called the “golden hour” for good reason. It’s a sensitive window for bonding, initiating breastfeeding, and helping your baby regulate outside the womb. But hospital routines can sometimes interrupt this time if you haven’t made your preferences clear.
Consider what you want those first moments to look like. Do you want all newborn procedures delayed until after you’ve had uninterrupted skin-to-skin? Would you prefer the initial assessment done while baby is on your chest? What about visitors, whether that’s grandparents eager to meet the baby or well-meaning staff popping in?
Be specific in your plan: “We request that all non-urgent newborn procedures be delayed for at least one hour to allow for skin-to-skin and initial breastfeeding attempts.”
You might also note preferences about the vitamin K shot, eye ointment, and first bath timing. With Ellie, I didn’t realize I could ask for her first bath to be delayed, and I wish I had. That vernix has purpose, and those early hours of uninterrupted closeness are precious.
5) How you want to be supported emotionally
Physical support during labor gets a lot of attention, but emotional support matters just as much. And what feels supportive varies wildly from person to person. Some laboring moms want constant encouragement and eye contact. Others need quiet presence and minimal touch.
Think about how you cope with intense experiences.
Do you want your partner close, holding your hand through every contraction? Or do you need space to move and vocalize without anyone trying to “fix” the moment? Would affirmations help you, or would they feel hollow? Do you want to be told how dilated you are, or would you rather not know?
Write these preferences down for your support team. “Please don’t ask if I’m okay during contractions. Just be present.” Or “I find verbal encouragement helpful. Remind me that I’m strong and that each contraction brings me closer.”
This kind of guidance helps your partner and doula support you in ways that actually feel supportive, rather than accidentally adding to your stress.
6) Your postpartum room preferences
Your birth plan doesn’t have to end when the baby arrives. The hours and days after delivery are their own journey, and having preferences documented can make your recovery smoother and more restful.
Think about things like: Do you want baby to room in with you, or would you like the option of the nursery for a few hours of sleep? What are your feeding preferences, and do you want lactation support sent to your room? How do you feel about visitors during your hospital stay? Would you like staff to offer formula, or do you prefer they check with you first?
You might also consider your own physical comfort. Do you want to be reminded to take pain medication, or would you rather be asked first? Are there any foods or drinks you’d like your partner to bring from home?
After Milo was born, Matt brought me my favorite tea and a soft robe from home, and those small comforts made such a difference in how human I felt during those hazy first days.
7) A note to your care team about your values
At the top or bottom of your birth plan, consider adding a brief personal note. This isn’t about medical preferences. It’s about helping your care team see you as a whole person with a story, not just a patient in room 4.
You might share something like: “This is our second baby after a difficult first birth, and feeling heard and respected is very important to us.” Or “We’ve been trying to conceive for three years, and this pregnancy is deeply meaningful. Please be patient with our emotions.” Or simply: “We value informed consent and would like all options explained before any interventions.”
This human context can shift how staff interact with you. It invites them into partnership rather than positioning them as authorities making decisions about your body.
Dr. Sarah Buckley, a family physician and author specializing in the hormonal physiology of birth, has emphasized that feeling safe and respected during labor can actually support the natural hormonal processes that help birth progress smoothly. Your care team wants to support you well. Giving them a glimpse of who you are helps them do that.
Closing thoughts
A birth plan isn’t a contract, and it’s not a guarantee. It’s a communication tool, a way of saying “this is who I am, this is what matters to me, and this is how you can help me feel supported.” The goal isn’t to control every moment of your birth. It’s to enter the experience feeling prepared, heard, and as empowered as possible.
As you finalize your plan, remember that flexibility is a strength. The moms I know who felt most at peace with their birth experiences weren’t necessarily the ones whose plans went perfectly. They were the ones who felt respected, who had support people who truly understood their values, and who gave themselves grace when things unfolded differently than expected.
Your birth story is yours, however it happens. These additions are just tools to help you feel more like yourself in the middle of one of life’s most transformative moments.
