Writing down what you want
Birth preferences, and how to write ones that get followed.
A long document listing everything is easy to ignore. A short one naming a few specific, actionable things tends to get followed.
The items in this tool with the strongest evidence behind them, and which do not happen unless requested:
- Warm compresses and perineal support during pushing
- No episiotomy without a stated reason and prior notification
- Delayed cord clamping
- An uninterrupted hour of skin-to-skin unless the baby needs help
- Ask before every internal examination, and tell me before any sweep
- Continuous support person present throughout
Hand it over twiceOnce at a prenatal visit so it goes in the notes, and once to the nurse or midwife on admission. Preferences discussed weeks earlier are far more likely to be honoured than preferences raised for the first time in labor.
Where this comes from:
216. Aasheim V, Nilsen ABV, Reinar LM, Lukasse M. Perineal techniques during the second stage of labour for reducing perineal trauma. Cochrane Database Syst Rev. 2017;(6):CD006672.
231. McDonald SJ, Middleton P, Dowswell T, Morris PS. Effect of timing of umbilical cord clamping of term infants on maternal and neonatal outcomes. Cochrane Database Syst Rev. 2013;(7):CD004074.
232. Moore ER, Brimdyr K, Blair A, Jonas W, Lillisköld S, Svensson K, et al. Immediate or early skin-to-skin contact for mothers and their healthy newborn infants. Cochrane Database Syst Rev. 2025;(10):CD003519.
Covered in the essential classes
Continue
More from The rest of pregnancy
This page is educational. It supports the conversation with your own clinicians. It is not consent to any treatment, and it cannot assess you. If you are worried about a symptom now, see urgent warning signs.