# Birth Plans and Choosing Where to Give Birth

> Hospital, birth center or home, OB or midwife, doulas, and what to put in a one-page birth plan.

Stage: pregnancy - Topic: Getting ready - Page: https://www.askcladle.com/guides/pregnancy/birth-plans-and-where-to-give-birth

Grounded in: ACOG Committee Opinions "Planned Home Birth" and "Approaches to Limit Intervention During Labor and Birth", ACOG guidance on delayed umbilical cord clamping, AAP guidance on newborn care at birth, and the American College of Nurse-Midwives. Summarized in Cradle's own words; none of these sources endorse Cradle. General information, not medical advice.

Reviewed: 2026-11

## TLDR

- OBs, family doctors and midwives all deliver babies; hospitals and accredited birth centers are the safest settings per ACOG.
- Keep a birth plan to one page of preferences (support people, pain relief, moving, feeding) and expect flexibility.
- Share it at a 32-36 week visit, and ask before 30 weeks if you want to switch providers or settings.

## 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.