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The 8 sections of Doula Leanna's birth plan template

24/9/2026

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Leanna Mae is an author, women’s health educator, and birth doula. Her degree is in health sciences. She is passionate about patient education. Leanna loves to write and share helpful information. She loves to teach! She's also passionate about patient rights and healthcare ethics. Leanna became a birth doula in 2008, a certified breastfeeding specialist in 2014, and graduated college in 2018. After graduating, she started teaching classes. She now offers online classes and in-person classes in western Ohio as well as birth doula services in the greater Dayton/Springfield area.  
Hi! I’m Leanna Mae. I’m a birth educator that teaches a class on birth plans. Let’s talk about why I set up my birth plan template the way I do with 8 categories.
 
 
#1 – Overall goals
Give me an introduction to what your overall goals are. What kind of birth experience do you want? You don’t have to fill up the whole box. This could be one sentence or a few. I think this is a good starting point to open communication about the kind of maternity care you want and the kind of birth experience you are hoping for.
 
 
#2 – What I want most
I always want to know what things are the most important to you. Is there anything you want to emphasize? Any special moments you want to have photographed? I also ask clients/students what they are most excited about. What’s important to you is important to me. If I’m your doula, I’m going to do my best to support you in having your best birth experience.  
 
 
#3 – What I am okay with
This is your box of yeses. What routine practices and interventions are you okay with having? Do you have a preference on method, if applicable, such as induction? You can bullet point this if you want. You don’t have to go into a lot of detail.
 
 
#4 – What I don’t want
This is your no thank you box. If there are any routine practices or common interventions you do not want, make a note here. You can say no to anything. You can ask for more information about anything. It’s also okay to decide as you go along. Don’t hesitate to ask questions.
 
 
#5 – Fears and concerns
This may seem like an odd section to include, but I’ve found that it tells me a lot about what kind of education and support they need. It’s okay to tell your OB/midwife and nurses what you’re worried about. They can walk you through it. This is something that I ask about in the beginning of doula support at our first prenatal appointment, and I encourage parents to feel comfortable mentioning fears or concerns to their OB or midwife as well.
 
 
#6 – Anything noteworthy
Is this a rainbow baby? Previous birth trauma? VBAC goals? Military family? Is there anything you’d like us to know about you and/or your birth? It can be things about mom too such as FYI I’m on the spectrum and get overstimulated etc. It can also be things like history of substance abuse and this patient is in recovery. It’s okay if you don’t have anything to put in this box. If there are special circumstances, this is the section to put it in.
 
 
#7 – For my support
This section is to give a 101 on the kind of support you anticipate needing. You can have a more detailed plan with your doula on support supplies and methods you plan to use. Is there anything you want the staff to know about supporting you? You don’t have to have it all planned out. You never really know what you’re going to need until you’re going through it. This is a simple section to draft support plans.
 
 
#8 – Environment preferences
What are your thoughts on how you want the environment? Sometimes birth goes quickly and there’s not time to set up the room. If you have time, how do you want the environment to be for you to feel safe and calm and be able to labor best? This can be things like dim lighting, soft voices, intentionally calm, quiet, etc.


Check out the template below

birth plan summary

$2.00

This birth plan template is for women who want a customized communication tool that reflects their values. The way it is structured gives you effective communication with your care team. It explains what's most important to you and what your values are. This is a high-quality birth plan template.


This download contains a Word document you can edit and print and a printable PDF for you to summarize your birth plan goals in a simple 2-page setup. The birth plan summary is from my online class on birth plans. To learn all about what to fill in here, check out the class on my website. There is a PDF of a sample birth plan included.


PERMISSIONS:

  • This may not be modified to remove my website or credit to the creator.
  • This may not be sold.
  • It cannot be distributed.
  • While professionals in women's health do have permission to show the template, I ask that their patients/clients download directly from my website please.
download

I’d also like to invite you to check out my free class on birth plans through the button below.
birth plan class
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Leanna Mae is a small-town Ohio girl who loves to write. She’s the author of several nonfiction paperback books: Happily Frugal, The Subject of Salvation, and Lessons on the Author Life. She has also written many blogs, and focuses on sharing her faith through blogging. Her heart's desire is to reach the world with the message of her faith through her website. Leanna is a devout Christian, Apostolic Pentecostal. She’s passionate about Jesus, her faith, writing, and teaching. Leanna Mae is an author, women's health educator, and birth doula. Her degree is in health sciences. She is also passionate about patient rights, healthcare ethics, and women’s health. Her favorite word is scripturient. You can learn more about Leanna Mae, her books, blogs, and services by exploring www.LeannaMae.org


Leanna Mae

Apostolic Pentecostal Christian

international author

maternal-infant wellness educator

birth doula

breastfeeding specialist

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  • Home
  • About Leanna
  • My Christian Faith
    • My faith journey
    • Written by an Apostolic Pentecostal woman
    • bible study from The Subject of Salvation
    • Bible reading schedules
  • My books
    • where to purchase
    • Happily Frugal
    • The Subject of Salvation
    • Lessons on the Author Life
    • press kit
  • My blogs
    • topical blog directory
    • timeline blog directory
    • the scroll
  • Maternal Infant Wellness Education
  • Classes I teach
  • Doula Leanna
  • Shop
  • Donate
  • Contact