- Fill in only what matters to you: the French national directive reminds us that you do not have to answer everything.
- Show it to your midwife or doctor before the birth and bring a copy on the day.
- Nothing you write is saved and no e-mail address is asked for.
Printable birth plan template
A free-form sheet to fill in together, by hand. Print it, or save it as a PDF from your browser’s print window.
Shortcut: Ctrl + P (Windows) or Cmd + P (Mac). In the print window, choose “Save as PDF” to get a file.
Our birth plan
Free template, to fill in together · Élan Parental
First names
Due date
Maternity unit or planned place of birth
Midwife, doctor or team following us
Getting to know us
Our resources and strengths; what we want the team to know of our story; our fears or needs around the birth.
How labour begins
How we imagine it (spontaneous start, induction, planned caesarean) and what would reassure us when we arrive.
During contractions
What puts us at ease: light, music, a bath or shower. How we imagine moving: walking, positions, a ball.
Pain relief
Added to the directive. Our wish today, which we can change at any time:
- An epidural
- To try without an epidural first, keeping the option to ask for one
- We do not know yet: we will talk it through with the team
Pushing and birth
Atmosphere of the room, a mirror, the position we imagine, the partner’s place, how we prepared for pushing, protecting the perineum.
Who is at our side
The people we want with us; the role the partner would like to have; what we would like if a caesarean or an instrumental birth became necessary.
Just after the birth
Cutting the cord, the placenta, skin-to-skin with the mother or the partner, newborn care, feeding.
The days that follow
Visitors, length of stay, skills we want to learn, extra support (talking with the team, a psychologist…).
Anything else?
Anything that matters to us and did not fit elsewhere.
This plan expresses wishes: it can change at your request, and some wishes may not be possible for medical reasons. The team will explain, and you will talk it through together.
It replaces neither your maternity unit’s form nor the advice of your midwife or doctor.
Sheet inspired by the French quality directive on the expected content of a birth plan (Audipog, CIANE and perinatal learned societies, July 2023). Free template: print it, copy it, share it. elanparental.com