Printable template

Birth plan template

This is a simple hospital birth-plan template you can open as a PDF document, print, or bring to your late-pregnancy review. You do not need every box completed. It is most useful when it highlights what matters most to you and what you still want to discuss.

Dr Jan Adlam

Hospital birth-plan worksheet

Bring to your 36-week review if helpful.

1. Support and communication

Notes for the team

2. Signs and timing

Timing notes

3. Comfort, movement, and coping

Comfort preferences

4. Pain relief plan

Pain-relief notes

5. If the day becomes more medical

Intervention notes

6. The first hours after birth

First-hours notes

7. Practical planning and questions

Questions for my next appointment