Should You Create a Birth Plan?
Tips for creating a birth plan you can feel good about
When I gave birth to my two boys more than 20 years ago, I was not even aware of creating a birth plan. I am not even sure that was a “thing” back then. Needless to say for either delivery I did not create a birth plan and I went into the hospital with the general idea that I would be told what to do and when to do it. The team that cared for me during my deliveries was put together by the hospital and my OB/GYN was there for the delivery. I was told basically how the delivery would go and what I would need to do and what would be provided for me. I was never asked what my personal wishes were for either of my deliveries.
I will say for the second delivery, some 4 1/2 years later, there was a bit more attention given to what my personal wishes were. For example for my first delivery they whisked my baby away to the nursery and tended to the stitches I needed and the pain medication that I needed and by the time I was completely doped up on pain medication I spent a lot of time sleeping. No one told me that all I had to do was say that I want to see my baby and they would bring him to me. Late in the day after I gave birth a nurse finally asked me if I wanted to see my baby and I burst into tears. Of course I wanted to see my baby. I just didn’t know that all I had to do was ask. In my defense I was only 18 at the time and had never taken pain medications before. I had also never beens through such a severely traumatic physical experience having a 4th degree perineal tear and lots of stitches.
I was so grateful to see my baby for the first time and he already had a pacifier in his mouth when I first got to hold him and inspect all of his sweetness.
But four years later when I had my second son it was a completely different situation and the doctors and nurses asked me frequently what my wishes were for my child. This time I asked them for the baby to stay in the room with me. I was able to see all of his evaluations, measurements, his first bath, and the nurses frequently asked me about the breast-feeding. It was clear that something had dramatically changed within hospital policy that allowed for the needs and wishes of the mother to be more considered.
Had I known about a birth plan I could have advocated for myself in both situations. And that is the point of a birthing plan. To advocate for your wishes for your labor and delivery and the aftercare for your infant. It is a way to get the entire team on board with the mother’s wishes. And to me, that is a beautiful thing.
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What is a birthing plan?
A birthing plan is a written plan that you create prior to labor and delivery to communicate your wishes to the labor and delivery care team. Creating a birth plan allows you to communicate important aspects of your wishes to the care team and let them know how you want your labor and delivery to be handled, and even extending into the post-birth time frame.
A birthing plan does communicate your wishes but keep in mind, not everything in your birthing plan may be allowed if you are delivering in a facility. But creating the plan gives you the ability to know what you want and discuss those wishes ahead of time.
It is important to understand what a birthing plan is not. It is not a binding contract or a legal document. It is a guide, like a map, that shows what you want and what your vision for the birth and delivery look like. Your doctor may decide to do some things you have expressed you do not want. They will do this for your health and safety and for the health and safety of your baby. No matter how much research you do it cannot compare to the medical professional’s understanding of labor and delivery.
What is included in a birthing plan?
To get started: if you’re wondering what you should include in your personalized plan, use the following four areas as a guide:
- Requests before birth
- Requests during labor and delivery
- Vaginal vs. C-section birth preferences
- Requests for newborn care
The birthing plan can include many different things depending on what you deem to be important. It can include any or all of the following as well as other things you may want to decide ahead of time:
- List your name, doctor’s name and contact information for both
- Emergency contact information and important phone numbers for people you want to be sure are called when you do into labor
- Who you want to be with you while you go through labor
- Whether or not you want pain medications during labor
- External and internal electronic fetal monitoring
- episiotomies vs. natural tearing
- Whether you want pain medications or other medical interferences during the delivery of your baby
- The use of oxytocin to induce or augment labor contractions
- How you want to handle pain management–with or without an epidural, with breathing or other pain management techniques such as massage
- Whether or not you want to be resuscitated if something should go wrong in your delivery (a DNR)
- The use of interventions like vacuum extraction or forceps to assist in the birth of your child
- What activities you want the father or your partner to perform–cutting the cord, doing the suctioning, catching the baby when they deliver or cleaning the baby after delivery
- If you want to save or donate any portion of the cord etc after delivery
- If you want to breastfeed your baby right away
- Artificial rupture of the membranes and/or leaving membranes intact
- Who you want to be with you during the delivery of your baby
- Whether you want the lights dimmed during labor
- If you want certain music played during labor and or delivery
- Whether or not you want someone there to take pictures or to video the birth
- Your wishes regarding labor–for example, if you want to be able to walk around while you are in labor
- The use of an IV or catheter
- If you want to use a labor stool, ball, or chair
- Eating or drinking preferences during active labor
- Specific birthing positions you want to use
- Your wishes regarding cesarean section
- If you want a water birth or other specific type of birth
- If there are people you do NOT want present for your labor and delivery or if there are people to be denied access to you or your baby
- Postnatal baby care–
- Vitamin K shot
- Eye drops
- Circumcision preferences
- Bathing preferences
Babylist.com has some great advice on preparing a birth plan:
“Before you write your birth plan, research your labor and delivery options ahead of time. Tour your hospital or birthing center and find out their procedures and practices. Do they have labor and birthing equipment, like a tub or shower, birthing balls or birth stools? Do they offer nitrous oxide for pain relief during labor? Are there limits on how many people can be in the delivery room at one time? This will help you determine what you want for your labor and delivery, and what to include in your birth plan.”
They also recommend:
- Keep it simple
- Introduce yourself
- Print out your birth plan
- Highlight important phrases for quick reference
How do I get a birthing plan?
You can create your own birthing plan. Simply write out what you want, in detail, and discuss the details with your doctor, the healthcare facility, your midwife or doula. If you are using a midwife and or doula services, you will have more control over the details of your labor and delivery.
Many healthcare facilities provide a birthing plan that you can fill out ahead of time. Ask your doctor and the healthcare facility where you will deliver if this is something they have available to you. A midwife or doula should also have their version of a birthing plan that you can fill out ahead of time and discuss with them in detail.
There are also birthing plans available for download online. Here are some of the ones available online:
Let’s Make a Birth Plan
Click HERE to create your free birth plan–Earth Mama
Birth plan creator
Free Visual Birth Plan Template (Doctors & Nurses Love This!)
Top 6 Annoying Pregnancy Skin Issues (and How to Deal)
Birth Plan Template – Fill Online, Printable, Fillable, Blank
download a birth plan template –NHS
Visual Birth Planner
Visual Birth Plan Builder
free visual birth plan download – get your free birth plan!
A Downloadable Visual Birth Plan
Printable birth plan visuals
Apps that help you create a birth plan
My Birth Wishes Birth Plan App
Birth Plan Plus – App for iOS/iPhone
Birth Plan Plus on the App Store
Easy Birth Plan
iBirth™ Daily Pregnancy, Postpartum & Baby Tracker on the App Store
Midwife Birth Plan Form Mobile App – iPhone, iPad, Android
Note: Births do not often go as planned.
The most important part of a good birth plan is flexibility. Childbirth is unpredictable: The best-laid plans don’t always go, well, according to plan.–Tips on Writing a Birth Plan
You also should think through all of the aspects of labor and delivery and how you want them to go, but it goes without saying, things can and will go wrong. It is unlikely, births being as they are, that there will be some unforeseen circumstances that will force you to change your plans. If you take a little time to “what if” with your birthing plan, you may be able to work out other things in advance.
For example, you may decide that you are 100% against a cesarean delivery. But when it comes to the time of delivery and your doctor decides that you must have a cesarean delivery for your safety or perhaps because the baby has gone into duress, you need to be prepared to make that decision in the moment. A birthing plan is a good opportunity to think through some of these unforeseen circumstances and decide how you will handle them.
You will need to be flexible on your wishes–to err on the side of your safety and well-being, your baby’s health and safety, and for reasons that are beyond your control. It will not be the end of the world if everything doesn’t go your way. Just ask my mom!
In my mother’s 5 deliveries she:
- Got stuck travelling through an ice storm for one of the births
- For the first birth (me) men were not allowed in the labor and delivery room. When something went terribly wrong, the doctors came out to talk to my father and asked him the worst question in his life–who should we save if it “comes down to it”–the mother or the baby? (I wrote about this in a personal essay which you are welcome to read. Thank goodness things are different now in the way fathers are handled–also that they should have asked my MOM! My Father Was Asked to Choose — Save the Mother or the Baby.
- My mom got stuck in an elevator, alone, and minutes from delivery. She was in a wheelchair, heading up to the delivery floor (it was her 4th or 5th delivery and she delivered in less than an hour) and my dad put her in the elevator and ran to park the car. Mome rode up the elevator and the front doors would not open. The back doors–the ones the staff of the hospital used–opened. She rode back down the elevator and the front doors opened right up. (?) This process repeated multiple times until someone came to get my mom and assisted her to the delivery floor.
So no matter the planning you do, things may happen differently than how you have it all planned out in your mind or how you have visualized it. But a birthing plan is still a good start to communicating your vision to the staff who will be taking care of you.
If you are dead-set on having full control over your labor and delivery, a natural home birth may be the best option for you. In Considering Natural Home Births and Doula Services, some of the benefits of a home birth are discussed. In bold are some of the aspects of a home delivery preference that are typically addressed in a birth plan:
- They are more comfortable at home
- Less medical intervention
- They can be surrounded by friends or family members rather than hospital staff
- It is cheaper
- They have an aversion to medical professionals or hospitals
- They want full control of their birthing experience
- They wish the birth of their baby to be more of a private and modest experience
- More control over the atmosphere your baby is born into. You can play music you prefer, have the people you choose to be present for the birth, and control the temperature, lighting, and scents in the room.
- You can have more control if you want to have an unmedicated birth or low-medical interference with your delivery.
- You can avoid the bio-threats to your child–though hospitals clean and sterilize, they can still be hubs for things like flu, MRSA, and other harmful pathogens such as Covid-19.
- You can incorporate cultural or religious practices into your labor and delivery experience.
One other aspect not addressed yet in this article, is the aspect of privacy. Many birthing parents prefer a more private environment for one reason or another. The birthing plan gives the birthing parent a way to make sure those feelings and wishes are known to the entire staff.
Note: The term “mom” in this article is not meant to be exclusive. It also includes trans-birthing parents. The term “dad” is also not meant to be exclusive as this could be any partner to the berthing parent.
For further reading
The importance of a birth plan
Christina M. Ward,
Babienet blog contributor
Mother and grandmother
Meta description: Should You Create a Birth Plan? Provides information and advice on how and why to create a birth plan for your labor and delivery.