Love them or hate them, birth plans have been a part of the birth world since before I had my first child over ten years ago. Some people ridicule birth plans and the people who create them, saying things like, “There’s an automatic C-section.” Other people, like my first midwives, expect their patients to have a birth plan, and even repeatedly ask their patients (who shall not be named) to please remember to bring theirs to the next prenatal appointment. Some believe that there is no point in having a birth plan because, after all, birth is unpredictable and you can’t PLAN it.

But I disagree. I believe that birth plans do serve an important purpose in everyone’s pregnancy journey. I also believe everyone creates a birth plan whether they realize it or not. And I’m of the mind, if you’re going to do something, why not make it amazing? So let’s get started on creating a stellar birth plan.

What is a birth plan?

Simply put, a birth plan is an idea of how you would like your birth to go.

Some people say, “Oh, I am definitely getting the epidural.” That’s a birth plan. Others say, “I’m just going to let my doctor tell me what to do.” That, too, is a birth plan. And others say, “I’m going to have a natural birth in water while swimming with dolphins.” Yup. You guessed it. Birth plan.

Many people I work with like to write their goals down in order to share it with everyone on their birth team. Others prefer to have a general idea in their head of what they would like and take each situation as it arises. I had a birth plan for all three of my labors, but I only had a tangible piece of paper for my first birth.

A birth plan is NOT: 

• A guarantee your birth will go a certain way
• A contract with your care provider
• Inflexible
• Something you can’t change your mind on later
• Only for control freaks
• An indication that you do not understand that birth can be unpredictable
• Only for those wanting an unmedicated birth
• A curse
• Proof that you only want a certain type of birth, even at the expense of your baby’s safety
• Protection from a care provider or hospital policies you do not agree with

A birth plan IS:

• An amazing communication tool
• A tool to discover available birthing options in your area
• A tool to discover what kind of birth experience you would like to have
• Used by people who understand that birth can be unpredictable
• Flexible
• Unique to each person

When should I create a birth plan?

The earlier the better! I believe birth plans are the most helpful long before someone decides to get pregnant. It is especially important for those situations in which you need to try to become an established patient with highly sought after care providers before they book up. For example, my amazing midwives that I worked with during my first pregnancy book up FAST. They are one of a few groups of hospital midwives in the Houston area. It is easier to get into their practice earlier rather than later. If I hadn’t learned until late in my pregnancy that I could have a midwife AND a hospital birth, I may not have been able to work with them.

By knowing what kind of birth experience you want, you will be able to find a care provider who aligns with your philosophies about birth. A birth plan will not change a care provider’s mind about birth, nor will it cause them to make exceptions that they don’t normally make. A birth plan can’t protect you from a care provider who just doesn’t support birth the way you would like if you want to do something that goes against the norm for that provider. It’s important to find a care provider that already believes what you believe about birth.

What should I include on my birth plan?

Most people include their name, their partner’s name, their doula’s name, their EDD, and their care provider’s name. Some include a short paragraph about their goals for their birth and what they have done to prepare for that type of birth. The meat of the plan should include the options that you feel are the most important for your goals. Here are a few options to get you started.

During labor:

• What comfort measures would you like to utilize during labor?
• What would you like your environment to be like?
• What are your pain relief preferences?
• Do you want to be offered pain medication or will you ask for it?
• Would you like intermittent or continuous monitoring of the baby during labor?
• How often would you like vaginal exams?
• Do you want visitors during labor?

During pushing: 

• What position would you like to push in?
• Would you like to be coached during pushing?
• Would you like an episiotomy?
• Would you like perineal massage during pushing?
• Who will catch your baby?
• Who will announce your baby’s sex?

During the immediate postpartum period: 

• Do you want immediate skin-to-skin with your baby?
• Do you want delayed cord clamping?
• Who will cut the cord?
• Do you want to take your placenta home?
• Do you want your baby to receive: eyes drops, vitamin K, Hepatitis B vaccine, circumcision, bath, bottles, formula, pacifier, etc?
• Do you want to breastfeed?

Preferences for birth interventions:

• What would you like to have as part of your birth in the case of an induction of labor or Cesarean birth?

 

Additional Tips:

• Try to keep this document to one page if possible.
• Try to use positive language. Instead of saying, “Don’t perform vaginal exams,” say, “We prefer to avoid vaginal exams as much as possible.”
• Include unique information to your situation. For example, my husband did not want to be asked to cut the umbilical cord after our baby’s birth. It is a common tradition to ask the partner to cut the cord, and he did not want to be asked. I included that on the birth plan. I did not include, “Please keep vaginal exams to a minimum” because those midwives already do that as part of their policy. If you feel confident that something is already routine with your care provider, it does not need to be included on the birth plan.
• Try to make this document easy on the eyes. I find bullet points and bold headings helpful when I am needing to review someone’s birth plan, especially in a dimly lit room, and especially if I am only able to take a 30 second peek between double hip squeezes.
• Finally, this is a personal preference, but if you are using a visual birth plan, try to make the words bigger. Even though the pictures are super cute, I still have to read the descriptions underneath to know exactly what each picture represents. The words underneath are super tiny, so I’ve had to ask clients to make the words bigger for me so that I could read them.

Have fun with this! This is unique to you, and there is no wrong way to do this.

If you used a birth plan during labor, what tips do you have for someone just starting out making their own?