10 Things Your Labor Nurse Hopes To See On Your Birth Plan 

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Let’s get one thing straight: your birth plan isn’t just a checklist—it’s your voice when things get intense and decisions need to be made. As a labor and delivery nurse and mom of three, I can tell you that having a clear, thoughtful birth plan not only helps you advocate for yourself but also helps your care team support you in the best way possible. But here’s the catch—there are a few key details that moms often overlook. And trust me, these “small” details can make a big difference.

This isn’t about scripting every moment of your birth (because, let’s be honest, babies have their own agendas). It’s about knowing your options, communicating your preferences, and making informed choices that align with your birth goals. And yes, there are certain things your labor nurse secretly hopes you’ve thought about—things that can help us better advocate for you, respect your wishes, and make sure you feel in control, no matter how your birth unfolds.

So, let’s dive into the top 10 things I love seeing on a birth plan—plus one bonus tip that can make a big difference when decisions need to be made. And if you’re still unsure about some of these choices, don’t worry! My course, The Birth Plan Accelerator, walks you through the risks, benefits, and alternatives to the most common interventions, so you can create a birth plan that’s not only thoughtful but fully informed.

1. Your Pain Management Preferences (Including a Backup Plan)

Whether you’re aiming for an unmedicated birth, planning for an epidural, or keeping your options open, it helps your care team to know your preferences—and your backup plan. Labor is unpredictable, and sometimes things shift unexpectedly. If you plan to go unmedicated, letting us know if you’d consider an epidural if labor becomes prolonged or too intense helps us support you without overstepping. And if you want an epidural right away, that’s helpful to know too! Either way, we’re here to cheer you on and help you feel as comfortable and confident as possible.

2. Your Preferences for Labor Mobility and Positioning

Movement is one of the best tools for managing labor pain and encouraging your baby to move into the optimal position. Whether you want to walk the halls, sway on a birthing ball, use a peanut ball in bed, or labor in the shower, including these preferences in your birth plan helps us advocate for your freedom to move. Even with monitoring or an epidural, there are ways to change positions to stay as comfortable as possible. Letting us know you value mobility helps us get creative in supporting your labor progress.

3. Your Preferences for Pushing (Coached vs. Spontaneous)

When it comes to pushing, you have options. Some women prefer coached pushing, where we guide you to push during contractions, while others prefer to follow their body’s natural urge to push—also known as spontaneous pushing. Both methods have their benefits, but spontaneous pushing often leads to less fatigue, better oxygenation for the baby, and a reduced risk of tearing. Including your preference in your birth plan helps us know how to best support you when the moment arrives.

4. Limiting Cervical Exams Unless Medically Necessary

This one is often overlooked, but it’s a game changer. Cervical exams can be uncomfortable and, after your water breaks, they can increase the risk of infection. Plus, let’s be honest—sometimes they’re done more for the provider’s curiosity than for your benefit. By including a request to limit cervical exams unless they’re needed to guide your care (like deciding whether to start pushing or adjust interventions), you help reduce unnecessary discomfort and avoid the discouragement that can come from slow dilation progress. This small detail can have a big impact on your labor experience.

5. Minimal Use of Continuous Fetal Monitoring

Continuous fetal monitoring is standard in many hospitals, but unless you have specific complications, intermittent monitoring is often just as safe—and it allows you more freedom to move. Requesting intermittent monitoring when possible can help you avoid being confined to the bed, which can make labor more manageable and encourage faster progress. Plus, less time listening to the monitor means less stress over every little heart rate fluctuation, helping you stay focused and calm

6. Declining Routine IV Fluids Unless Necessary

While IV fluids are often given as a precaution, they’re not always necessary—especially if you’re able to stay hydrated by drinking clear fluids or electrolyte drinks. Limiting IV fluids can help you avoid fluid retention (which can sometimes delay your milk coming in) and allows for more freedom of movement. Including this in your birth plan helps us support your mobility and comfort while ensuring you stay hydrated.

Related Read: The Best Way To Make Your Birth Plan Your Reality

7. Your Preferences for Augmentation (Breaking Water or Pitocin)

Labor sometimes needs a little encouragement, but that doesn’t mean interventions should happen automatically. Requesting to avoid interventions like breaking your water or using Pitocin unless labor stalls or there’s a medical need can help your labor progress more naturally. This is especially important if you’re aiming for an unmedicated birth since Pitocin can make contractions more intense. Letting us know your preferences helps us advocate for a hands-off approach unless it’s truly needed.

8. Permission to Eat and Drink During Labor

Gone are the days of strict “no food or drink” policies during labor. Unless there’s a specific medical reason, having the option to eat light snacks and sip on electrolyte drinks can help you maintain the energy you need for the marathon of labor. Including this in your birth plan signals that you understand the benefits and want to stay fueled for the journey ahead. Plus, it helps your care team respect your choice rather than defaulting to outdated restrictions.

9. Delaying Routine Newborn Procedures Until After the Golden Hour

The first hour after birth—often called the “golden hour”—is crucial for bonding, regulating your baby’s temperature and breathing, and kickstarting breastfeeding. Including a request to delay newborn procedures like weighing, measuring, and administering eye ointment until after this hour ensures you get uninterrupted skin-to-skin time. Your baby will be calmer, more alert, and more likely to latch successfully, setting the stage for a smoother breastfeeding journey.

Related Read: 8 Things Your Labor and Delivery Nurse Wants You To Know About Having A Hospital Delivery

10. Delayed Cord Clamping for a Full 3-5 Minutes

Delayed cord clamping is becoming more common, but many providers still wait only 30-60 seconds. Including a specific request for a full 3-5 minutes ensures your baby gets the maximum benefits, including increased iron stores, improved circulation, and better oxygen levels. Waiting until the cord stops pulsing allows your baby to transition to breathing on their own while still receiving oxygen-rich blood from the placenta. This simple delay can have long-term benefits for your baby’s health.

Bonus: Requesting Time and Space Before Making Decisions

Birth is full of unexpected moments, and sometimes decisions need to be made quickly. But unless it’s an emergency, you have the right to take a moment, ask questions, and consider your options. Including a statement like, “Unless it’s an emergency, please give me time and information before interventions or decisions are made,” ensures that you have space to think things through and feel confident in your choices. This reminder helps your care team respect your autonomy and keeps the focus on what’s best for you and your baby.

Conclusion

At the end of the day, your birth plan isn’t just about preferences—it’s about feeling confident, informed, and empowered during one of the most life-changing experiences you’ll ever have. While birth is unpredictable, having these key details in writing helps your care team support you in a way that aligns with your goals, making the entire experience more positive and personalized.

As a labor and delivery nurse and mom of three, I’ve seen how small choices—like limiting cervical exams, delaying interventions, or allowing spontaneous pushing—can make a big difference in how labor unfolds. These details might seem minor, but they often lead to a more comfortable, efficient labor and a smoother postpartum recovery.

And if you’re still unsure about what to include or need more information before finalizing your plan, my course, The Birth Plan Accelerator, is designed to walk you through the risks, benefits, and alternatives of the most common labor and delivery interventions. With this knowledge, you’ll feel confident advocating for your preferences while staying flexible if plans need to change.

Because when it comes to birth, being informed is the ultimate superpower—and your labor nurse will be cheering you on every step of the way.