Birth Plans and Choosing Where to Give Birth

Who can care for you

• Obstetrician (OB-GYN): a doctor trained in all pregnancies, including high-risk care and cesareans.
• Family physician: some provide pregnancy and birth care.
• Certified nurse-midwife (CNM) or certified midwife (CM): trained in low-risk pregnancy, birth and gynecology; work in hospitals, birth centers and homes. Certified professional midwives (CPMs) mostly attend home and birth center births.
• Maternal-fetal medicine specialist: co-manages higher-risk pregnancies.
• A doula is a trained support person, not a medical provider. Continuous labor support is linked to fewer cesareans and interventions and to more satisfying births.

Where to give birth

• Hospital: full access to epidurals, monitoring, cesarean and newborn intensive care. Many have midwives, tubs or birthing balls. Ask about their cesarean rate, induction policies, and whether they offer vaginal birth after cesarean (VBAC).
• Accredited birth center: a home-like setting for low-risk pregnancies, run by midwives, with fewer interventions and no epidurals. Ask how and where transfers happen.
• Home: ACOG considers hospitals and accredited birth centers safest. If you're considering home birth, it's best for a low-risk, single, head-down baby at term, with a certified midwife, a plan to transfer quickly, and a nearby hospital.

What a birth plan is for

A short list of your preferences that helps you learn your options and talk them through with your team ahead of time. Keep it to one page and expect flexibility: labor changes, and safety comes first.

Things to decide or ask about

• Who will be with you, and who you'd prefer not to be.
• Pain relief: whether you want an epidural early, want to try without, or will decide in labor. See the pain relief options in labor guide.
• Moving around, eating and drinking, and laboring or giving birth in water where available.
• Monitoring: intermittent listening may be an option for low-risk labors.
• Pushing positions and whether you want a mirror or to touch the baby's head.
• Delayed cord clamping (at least 30-60 seconds for most healthy babies), and who cuts the cord.
• Immediate skin-to-skin, including after a cesarean when possible. See the skin-to-skin guide.
• Feeding plans, and newborn care: vitamin K and eye ointment are routine, and the AAP recommends a first hepatitis B vaccine dose within 24 hours of birth; you can discuss timing with your baby's pediatrician ahead of time.
• If a cesarean is needed: a clear drape, your support person present, skin-to-skin in the operating room.
• Cultural or religious practices, the placenta, photos, language interpreters, and how you'd like to be addressed, including pronouns.

Making it work

• Share it at a visit around 32-36 weeks and bring copies to the birth.
• Use "I'd prefer" wording, and add a line about what matters most if plans change.
• Tour or watch a video of your hospital or birth center.

When to check in

• Ask early, before 30 weeks, if you want to switch providers or settings; some fill up.
• Talk with your provider if you're feeling dread or fear about birth; extra support helps.