Hands resting on a pregnant belly

Preparing for birthBirthpreferences

6 min read · Last updated September 2026 · Written and reviewed by Emma, Birth & Mother

On this page

  1. 01Why I say preferences
  2. 02The reason behind each choice
  3. 03Your key priorities
  4. 04How you would like to be spoken to
  5. 05Preferences for labour
  6. 06When an intervention is suggested
  7. 07If labour does not start on its own
  8. 08The birth itself
  9. 09If an emergency procedure is suggested
  10. 10The first hour
  11. 11Knowing your rights
  12. 12Recognising disrespect
  13. 13What helps you feel safe
  14. 14Writing it down
You can’t know exactly how your birth will unfold.But you can prepare for how you want to meet it.

01

Why I say preferences

I use the words birth preferences instead of birth plan (Geburtsplan). You can prepare for a birth, but nobody can plan how it will go, and a plan written as a list of things that must or must not happen can become a limit in itself.

Preferences are a record of what matters to you, why it matters, and what you would like if the day goes another way. For a midwife walking into the room at the start of a night shift, they are the quickest way to get to know you: who you are, what you hope for, and how you would like to be cared for.

02

The reason behind each choice

Birth preferences can be as simple as:

I would like to be asked before every vaginal examination, and told what it is for.

I would like the cord to be clamped once it has stopped pulsing (delayed cord clamping), also if I have a caesarean.

I would like my partner to stay with me throughout, including in theatre.

Each one is stronger when you know what it is for. Waiting to clamp the cord, for example, lets more of the blood still in the placenta reach your baby. When you know the reason, the choice is your own, and your midwife can see why it matters to you.

For each preference, there are three questions to take with you:

  • A pregnant woman in cream, her hands cradling her bump
    01What is it for?I know why this matters to me.
  • A pregnant woman standing between white curtains at an open window
    02What does the evidence say?I know what the evidence says.
  • White roses against a blue sky
    03What if it is not possible on the day?I know what I would like instead.

03

Your key priorities

A midwife on a busy labour ward may only have a minute to read what you have written, so your two or three key priorities go first. For example:

To be part of every decision.

To move freely in labour.

To hold my baby straight after the birth.

If you are not sure where to start: what would you most want to remember about this birth, whichever way it goes?

04

How you would like to be spoken to

How information, consent and decisions are handled is a preference too. You might think about:

Whether you would like things explained, and why, before they happen.

Time to talk a decision over, where there is time.

Who is spoken to, you or your partner, and when.

An interpreter for important decisions.

05

Preferences for labour

Some of the things you might think about:

Moving around, positions, a birth pool or bath.

Lights, music, your own clothes, eating and drinking.

How your baby's heartbeat is listened to: every so often with a handheld device, or continuously with a belt (CTG).

How often you would like vaginal examinations, and whether you would like to be told the result.

Pain relief: what you would like to try first, what you would like to be offered, and what you would rather not be offered unless you ask.

The pain relief options are in In labour.

06

When an intervention is suggested

During labour you may be offered an intervention: breaking your waters (Blasensprengung), a drip to strengthen your contractions (Wehentropf), or help with the birth using a ventouse (Saugglocke) or forceps (Zange).

Some of these can be out of anyone's control. You can write “no episiotomy” (Dammschnitt, a cut to widen the vaginal opening), but if the situation on the day calls for one, the page does not change that. What you can write is how you would like it talked through with you.

Doulas use BRAIN for decisions like these, five questions for anything you are offered:

B

Benefits

R

Risks

A

Alternatives

I

Intuition

N

Nothing

You can also ask how long you have to decide: can we wait fifteen minutes? What happens if we wait an hour, or a day? The answer tells you how much time there is to think, or to talk it over with your partner.

07

If labour does not start on its own

Labour may be induced (Einleitung) if you go past your due date, or if there is a medical reason to bring the birth forward. You might think about:

Whether you would like a membrane sweep (Eipollösung) first.

Which methods may be used and in what order (tablets or gel, a balloon, breaking your waters, a drip), and what each one involves.

What would help you through the waiting: food, your own things, your partner staying with you.

More on this in Past your due date.

08

The birth itself

You might think about:

Your position, and whether you push when your body tells you to or are guided.

Touching your baby's head as it is born, or lifting your baby up yourself.

Finding out the sex yourself, or being told.

When the cord is clamped, and who cuts it.

Waiting for the placenta to come on its own, or an injection to help it along.

09

If an emergency procedure is suggested

Sometimes a decision has to be made quickly, for an assisted birth or an emergency caesarean (Notkaiserschnitt). Some preferences still apply, and writing them down means nobody has to work them out in the moment:

That someone explains what is happening, even briefly.

That your partner stays with you, if that is possible.

Skin to skin in theatre, or with your partner if you cannot hold your baby straight away.

Music, or the screen lowered so you can see your baby born.

More on this in When birth changes course.

10

The first hour

Skin to skin, your baby straight onto your chest after the birth, is routine in most hospitals and birth houses in Germany, so you do not usually need to ask for it. It is still worth knowing that this time belongs to you and your baby, and that you can ask for it if it does not happen.

You might also think about:

Time together before your baby is weighed and measured.

Whether your baby's first check (U1) can happen on your chest.

Help with a first feed, whether breast or bottle.

A pregnant woman standing in soft window light

11

Knowing your rights

Your midwife and doctors need your consent before any examination or procedure. You can ask what it involves and why it is being suggested, you can ask for time, you can say no, and you can change your mind. Saying yes to one thing is not saying yes to the next.

You may have heard a lot about birth already, from friends, from books and from the media. Each hospital and birth house works in its own way, and some have more room for your preferences than others.

Sometimes your doctors need to act more quickly, for example if you have gestational diabetes, or in an emergency. They are looking after you and your baby, and keeping you both safe is their job too.

In my experience, women who know about the procedures before the day feel more familiar with them when the time comes, and that can help make the birth a more positive experience.

What to ask about where you plan to give birth is in Questions for your birth space.

12

Recognising disrespect

Mistreatment during birth has a name: obstetric violence (Gewalt in der Geburtshilfe). It includes:

An examination or procedure done without asking you first.

Being pressured into a decision, or not given time to make one.

Your questions being dismissed, or your pain being played down.

Being spoken to harshly, or spoken about as if you were not there.

Knowing what it looks like means you, your partner or your doula can speak up at the time, and you have the words for it afterwards.

13

What helps you feel safe

Some preferences are about who you are, and what your care team should know to look after you well. You can share as much or as little as you like, and you do not have to explain why.

Your culture and faithPractices that matter to you. Who you would like in the room, and who you would not: being cared for only by women, or no male presence. Customs around the placenta, the cord or your newborn.
Your boundariesTouch, privacy, and how much of your body is uncovered. Vaginal examinations (cervical checks): none, as few as possible, or only with a clear reason. No physical examination without a conversation first.
Your historyAnything from a previous birth or your personal history that may affect this one. Survivors of sexual abuse do not have to disclose anything to be cared for with respect. It can be enough to write what you need: explain before touching me, ask each time, check in with me if I go quiet.
Your support peopleWho helps you feel safe, and whether they can speak for you when you cannot.

Who can care for you depends on who is on shift, so it is worth asking at your registration appointment (Geburtsanmeldung), while there is time to plan around the answer.

14

Writing it down

One page is easiest to read during a birth, with your key priorities at the top. You can write it yourself, with your partner, your midwife or a doula, and take it to your registration appointment.

A gentle note

This page is here to inform you. Decisions about your care rest with you, your midwife (Hebamme), your gynaecologist, and the team where you give birth. If you have questions about a particular procedure or what it would mean for you, your midwife or gynaecologist can talk them through with you.

Hands resting on a pregnant belly in low light

A look inside

Your birth preferences

In the Birth Preferences Session we work through a workbook together, in person or by video: what matters to you, the procedure behind each preference, the questions to ask when something is suggested, and what helps you feel safe.

Afterwards I write your birth preferences for you, as a document of your own. It is a reminder for when things change, and this is the kind of thing it holds. A doula, an antenatal class or your midwife can also help you think your preferences through.

The Birth Preferences SessionWhere to give birth
Birth & Mother · Birth preferences1 / 5

What matters to me

read this first

My key priorities
1To be part of every decision
2To move freely in labour
3
How I would like to be spoken to
  • Please explain what you would like to do, and why, before you do it.
  • Please ask before examining me, each time.
  • Please speak to me, or to my partner during a contraction.
  • Please tell me how long we have to decide.
In the room
Light, sound, clothesLights low, my own music
Moving, water
Pain relief
Birth & Mother · Birth preferences2 / 5

The reason behind each choice

what it is for, and what if not

My preference
The cord clamped once it stops pulsing
What is it for?
More of the placenta's blood reaches my baby
What does the evidence say?
WHO: wait at least a minute
If it is not possible on the day
Tell me why, and wait as long as is safe
Birth & Mother · Birth preferences3 / 5

When something is suggested

take a breath, then ask

BRAIN
BWhat are the benefits?
RWhat are the risks?
AWhat are the alternatives?
IWhat does my intuition say?
NWhat if we wait, or do nothing for now?
I can
  • ask what it involves, and why now.
  • ask how long we have to decide.
  • say yes, say no, or say not yet.
  • change my mind. Yes to one thing is not yes to the next.
Out loud

“Can we wait fifteen minutes?”

“How are my baby and I doing right now?”

Birth & Mother · Birth preferences4 / 5

When things change

the parts nobody can plan

If labour slows, or needs help to start
  • What are my options, and how long do we have to decide?
  • What would each one involve for me and my baby?
  • What would help me through the waiting?
If things move quickly
  • Please tell me what is happening, even briefly.
  • My partner stays with me, if that is possible.
  • Skin to skin in theatre, or with my partner if I cannot hold my baby yet.
  • The screen lowered, or music, if I would like it.
Afterwards
  • Someone to go through what happened with me, when I am ready.
  • My questions answered before I go home.
Birth & Mother · Birth preferences5 / 5

What helps me feel safe

as much or as little as I choose

About me
My culture and faith
My boundaries
My history
My support people
Speaks for me when I cannot
After the birth
  • My baby on my chest, and time together before the checks.
  • Help with a first feed, breast or bottle.
  • Quiet time before we share the news.
A baby lifted onto their mother's chest in the moment after birth
A hand resting on a pregnant belly, lit against a dark ground
A newborn asleep against their mother's shoulder

You can’t know exactly how your birth will unfold.But you can prepare for how you want to meet it.

Birth & Mother, there with you through the life-changing moment of birth, and on into motherhood

Find your support