Sample Birth Plan
- Lyndsey Paprota
- Oct 7, 2025
- 2 min read
A birth plan is not a script, it’s a guide to help you communicate your preferences clearly and confidently during labor and delivery. The goal is flexibility while maintaining awareness of your body and values. Below is a natural birth plan sample that blends holistic care and homeopathic options. I would bring 4 copies with you to the hospital available for your care team.
Attached below: two sample birth plans
Birth Plan
Personal Information:
● Name:
● Estimated Due Date:
● Care Provider:
Labor and Birth Preferences:
Environment:
○ I would prefer a calm and quiet atmosphere with dim lighting, soothing music, and minimal interruptions.
○ If possible, I would like to have aromatherapy (lavender or frankincense essential oils) diffused in the room.
Support Team:
○ My support team will include ,
○ I would appreciate continuous support from my birth team, including encouraging words and physical comfort techniques.
Pain Management:
○ I plan to use natural pain management techniques, such as deep breathing, visualization, and meditation.
○ I would like to try using a birthing pool, warm water, or a shower for pain relief.
○ If pain becomes overwhelming, I am open to discussing alternative pain relief options like homeopathic remedies (Arnica Montana for soreness or Caulophyllum for contraction assistance) and acupressure.
○ I would prefer to avoid an epidural unless absolutely necessary.
Labor Positions:
○ I would like to remain mobile and change positions as I feel necessary during labor.
○ I am interested in using a birthing ball and squatting bar to help with the process.
○ I would like to labor in various positions, such as standing, on hands and knees, or sitting, as this may help manage pain and encourage labor progress.
Birth Preferences:
○ I would prefer a natural, unmedicated birth unless there is a medical emergency.
○ I would like to avoid an episiotomy unless absolutely necessary.
○ I prefer delayed cord clamping and would like my partner to cut the cord if possible.
Postpartum:
○ I would like immediate skin-to-skin contact with my baby after birth.
○ I plan to breastfeed as soon as possible, and I would like assistance if needed.
○ I prefer to delay routine newborn procedures (like weighing, bathing, and vaccinations) until after bonding time. (minimum 1 hour)
○ If I experience soreness, I would like to use herbal or homeopathic remedies, such as witch hazel or sitz baths, to promote healing.
Unexpected Situations:
○ If complications arise, I would like to stay informed and involved in decision-making.
○ I understand that my birth plan is a guide, and I am open to medical interventions if they become necessary for the health of myself or my baby, however my support person will be present with my baby at all times no exceptions.
Signature:
Date:
