Writing Your Home Birth Preferences
Making a home birth plan is a unique process, quite different from preparing for a hospital birth. In the hospital, birth plans often focus on clinical decisions and how to navigate the many options available. At home, your choices around medical interventions are more limited—pain relief options are fewer, and fetal monitoring is typically done intermittently with a Doppler, rather than continuous monitoring (which is standard in hospitals).
The beautiful trade-off for fewer clinical choices is the comfort, autonomy, and freedom you gain by laboring and birthing in your own space. Your home birth plan can serve as a vision board or story of how you imagine your birth unfolding. It’s a source of guidance for you during early labor, and a helpful reference for your birth team, so they can support you without pulling you out of your birth mindset with unnecessary questions.
Letting Go of Expectations
The workbook I provide my clients includes exercises to help you release expectations around birth. There are things you can control, and things you can’t: ultimately, babies have their own ideas about how and when they want to be born! It’s wonderful to have dreams and intentions, but holding them lightly and staying flexible is important for avoiding disappointment.
Part 1: Early Labor
Come up with at least five activities that feel comforting or grounding as you begin labor. Here are some ideas to get you started:
Go for a walk or hike
Gentle yoga or labor warm-up exercises
Bake a birthday cake for your baby
Share intimacy with your partner
Take naps (rest is always a good idea!)
Go swimming or take a relaxing bath
Part 2: Questions to Consider
Reflect on the following prompts to help clarify your preferences:
Who will be supporting me in labor?
What do I want to eat and drink during labor?
Do I want verbal encouragement from my birth team?
What will help create a peaceful and calm environment? (Candles, flowers, essential oils, music, etc.)
What coping measures do I want to use?
Where do I want to birth the baby? (If planning a water birth, how important is that to you?)
Would I like to be reminded to touch my baby’s head as they are born?
Who’s going to catch the baby?
Do I want photos or videos of the birth?
Who will cut the cord?
What do I want to do with my placenta?
Would I like the standard Vitamin K injection for my baby?
What do I want my first postpartum meal to be?
Are there any cultural or spiritual traditions I’d like to incorporate into labor, birth, or the immediate postpartum period?
Part 3: The Back-Up Plan
While the goal is a home birth, it’s wise to have a backup plan in case a hospital transfer becomes necessary. In such situations, it’s usually because you or your baby need the additional resources a hospital provides; perhaps after a long labor, for pain relief, for continuous monitoring, or if a cesarean becomes necessary.
Your health and your baby’s safety always come first. The next priority is that you understand what’s happening and feel empowered to make informed choices.
What to Include in Your Hospital Backup Plan
Your name
Everyone on your birth support team and their relationship to you (partner, sister, mother, doula, midwife, etc.)
Preferred positions for pushing
Any specific requests (mirror to watch the birth, photos, warm compresses, partner assisting with catching the baby, etc.)
Preferences for the umbilical cord and placenta (delayed cord clamping, who will cut the cord, keeping the placenta)
Baby medicines (Vitamin K, erythromycin eye ointment, and Hepatitis B vaccine are standard in hospitals)
Preferences for a cesarean birth (see below)
Note: The “golden hour” of skin-to-skin contact after birth is now standard practice in most hospitals, so you don’t need to add this unless your hospital has different policies. They will only not provide immediate skin to skin if the baby needs resuscitation.
Hospitals and providers in Sonoma County are (generally speaking) as non-interventive or interventive as is suited to the situation. They will do their best to ensure you have the birth you are hoping for.
Gentle Cesarean Preferences
Even if a cesarean is unlikely, it’s helpful to consider your preferences in advance. Most cesareans are not emergencies, so you usually have time to discuss your wishes. Common requests include:
Slow birth to mimic the vaginal “squeeze”
Arms left free (not strapped down)
Photos of the birth
Clear drape, or lowered drape as baby is born
Music of your choice in the OR
The surgery explained as it is happening
Cord left long so you or your partner can trim it later
Delayed cord clamping (usually up to 90 seconds in the OR)
Skin-to-skin in the OR (with you or your partner, if you are unable)
Any “birth plan” is a living document. It is not set in stone. It is meant to reflect your hopes, your values, and your flexibility. It’s a tool for communication and empowerment, not a rigid script. Trust yourself, trust your team, and trust the process. However your birth unfolds, you are making thoughtful, loving choices for yourself and your baby.
