[This is the checklist that I review with women in my care at our Birth Preparation meeting at about 36 weeks]

A BIRTH PLAN is a guide for those who are with you when decisions need to be made.
A simple Birth Plan has two components, A and B.
PLAN A: “I am intending to give birth under my own power, and will do all I can to achieve the best outcomes for myself and my baby.”
PLAN B: “If medical intervention is recommended in order to achieve the best outcomes for myself and my baby, I need to be given the following information in order to make an informed decision:
• What do you want to do? [procedure, test, intervention, advice …]
• Why do you want to do that?
• What is likely to happen if I say 'no' - if I don't allow you to do IT?”
With this decision-making process you will only allow interventions that you believe are best for you and your baby.
(This list is only a guide – Please raise with your midwife any issues that you consider to be important)
LABOUR AND BIRTH:
1. Planned place of birth?
2. Backup hospital (for planned homebirth)?
3. Do you have a written birth plan?
4. Who do you want with you in labour and birth?
5. Information about complications.
6. Ruptured membranes and the risk of infection.
7. Options/preferences for pain management/relief.
8. Immediate contact with the baby.
9. Cutting the baby’s cord.
10. Blood loss, oxytocics.
11. Third Stage, caring for the placenta.

Read more http://privatemidwiferyservices.blogspot.com/2011/07/birth-plan-and-birth-preparation.html