I’m not always the best planner. Setting a date for a family visit can take weeks (sorry, Mom!), and despite my efforts, I’ve never successfully made a weekly meal plan. So when I was expecting and read about making a birth plan in many of my pregnancy books, I felt overwhelmed and unprepared. I could barely make a plan to go on a walk in the evening — how the hell was I going to plan out my birth?
While they may seem intimidating at first, birth plans are a great way for expecting parents to figure out what they want from their pregnancies and who they need in their support group to make that happen, certified labor doula Lisa Gould Rubin tells SheKnows. “By putting together a birth plan, you’re getting familiar with the different birth practices early on in pregnancy,” Rubin, who co-authored the book The Birth That’s Right for You and founded The Good Birth Project, a virtual doula company, says. “It gives you a launching point for how to know which questions to ask your potential care provider, doctor, midwife, and to know if they’re in the same camp as you are.”
What exactly is a birth plan, and what should you include in one? And is it worth it for you to spend the time to make one?
The birth plan basics
At the core, birth plans are a way to look “at your expectations, your fears, your needs, and your coping strategies,” Rubin says. And while “birth” is in the name, expecting parents should use them as a guide to help them draft their wishes and preferences throughout their entire pregnancy.
Preferably, you should start formulating a birth plan “early in pregnancy or even before becoming pregnant,” says Lauren Arrington, a certified nurse-midwife at the University of Maryland St. Joseph Medical Center. This way, you can select the kinds of practitioners — be they midwives, doctors, or doulas — who will best fit your needs from the start.
Think of your birth plan as a wishlist for your ideal pregnancy and delivery. Where are you? Who’s in the room with you? What do you need to make your experience as comfortable as possible? Ask yourself these basic questions and jot down your answers to get a better understanding of your expectations.
Be patient with yourself too. There’s so much information about pregnancy and birth, which can feel “completely overwhelming” at times, Rubin says. Don’t worry about not being an expert in everything pregnancy-related, though. Begin “with the understanding that you’re the best expert about you” and go from there, she adds.
Over time, you can compile your notes and create a document that you can pass along to your birth team. “Having a written birth plan on your chart is a great way to quickly inform the health care team of your individual preferences,” Arrington says. “This is especially useful because your care providers will change over the course of labor, birth, and postpartum recovery, and your birth plan will keep them, literally, all on the same page.”
Be realistic
I hate to be the one to break it to you, but the chances that your pregnancy and birth experiences will go exactly the way you want them to are, well, slim — and not just because your labor likely won’t be the orgasmic, magical experience the bohemian Instagram influencers promised it would be. So many things can change throughout the process, and it’s best to be prepared for a multitude of scenarios.
“The first thing I talk to my students and my clients about is this premise of staying flexible,” Rubin says. “Because when your birth story starts to go in a different direction, the key is that you feel heard, and you feel respected, and you ultimately feel agency within your collaborative team. The whole point is: what do you need to feel good about yourself when things don’t go the way you envisioned?”
For Cristina Aquia, a senior clinical nurse in labor and delivery at the University of Maryland St. Joseph Medical Center, health comes before anything else.
“Sometimes, a new mother has this set vision about what her labor and birth plan should look like and can be extremely disappointed when her baby’s birth deviates from the plan she had in mind,” Aquia says. “Like, anywhere else in healthcare, issues can arise and changes in the plan could, and should, happen for the safety of mom and baby. My best advice: When creating any birth plan, think ‘safety first.’”
What you should include
Know this: You will not cover every single possible scenario in your birth plan. It’s just not possible, so don’t stress yourself out trying. Instead, start with the basics: Who do you want on your team (partner, doctor, midwife, doula, parents)? Do you feel comfortable with a male practitioner? Where do you want to deliver (hospital, home, birthing center)? Do you want to try to deliver vaginally? Are you open to a C-section or an induction if recommended? Do you want an epidural, or would you prefer to go medication-free?
Once you’ve thought those things through, you can “consider things you want that you might not even have considered, such as delayed bath, delayed cord-clamping, and immediate skin-to-skin contact,” says Aquia. More serious considerations include what happens to you or the baby if, god forbid, something went wrong.
Birth plans are also an excellent opportunity for families to share their stories, Rubin says. “If you don’t share about you, how do you expect your team to be able to meet your needs and support you in the way that you need to be supported?” she adds. “Have you had miscarriages? Did you do six rounds of IVF? Did your mother have two babies born still? What is in your head? What’s happened for you in your life that you feel you’re safe enough to discuss so that every time another nurse comes in the room, and she reads this paragraph or two about your history, it’s humanizing. It makes you a person. It’s not about procedures. It’s about your story.”
Rubin also suggests sharing your other preferences, such as how you want the room to look and feel. If you want to be surrounded by crystals with the lights dimmed while listening to James Blake, say so! Even if your hospital has stricter policies, they’ll likely be able to find some accommodations for you. You won’t know unless you ask.
Not just for traditional pregnancies
Birth plans are vital for families who choose a gestational carrier, says Lisa Schuman, LCSW, of The Center for Family Building. Though intended parents and surrogates draft legal contracts, these documents rarely cover the more emotional or day-to-day sides of the process. “There are always situations that can arise, and having the families really sit down and hash out the what if’s and make a general plan helps everyone involved more comfortable,” she adds.
Schuman suggests both parties talk about what the regular communication will be; who’s going to be in the delivery room (support people, midwives, doulas, etc.); if the gestational carrier will breastfeed or pump milk; and what happens if there’s a complication. For her, skin-to-skin contact is also a must-include stipulation for intended parents who are eager to start bonding with their baby.
So, should you make a birth plan?
Writing a birth plan can be incredibly useful throughout your pregnancy and labor. But “even if you don’t write a birth plan, it’s important to share your expectations for birth with your healthcare provider and discuss the benefits, risks, and alternatives of various options,” Arrington says.
Ultimately, thinking through a variety of scenarios will help you feel more empowered and prepared so you can enjoy your pregnancy through every stage.
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