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Birth Plans: Yay or Nay?

This is the second chapter of our free ebook Your Best Birth: Providers, Plans, and Being Proactive.

If you’re a pregnant person today, chances you’ve considered making a birth plan. Maybe you’ve heard they’re a must-have –  “Ensure your wishes are respected!” or maybe you’ve heard the opposite – “Birth plans are only for uber Type A’s who want to control everything about their births!”

Neither is necessarily true.

Birth plans (sometimes called birth preferences, lists or documents) are just another tool in your toolbox. And this toolbox should also hopefully contain a birth place where you feel safe, an awesome provider, solid childbirth education, and a supportive birth team. A birth plan will not make or break your birth, but there is nothing wrong with going through the exercise and having some written guidance on your preferences. 

Here are four birth plan tips and considerations from Felicia Roche, a San-Francisco area doula and childbirth educator of over fourteen years:

1. A birth plan is a guide, not a guarantee.  

As Felicia likes to remind her clients and students: “There is nothing about a written piece of paper that is going to change the outcome of your labor. You have to know how to drive what you want yourself.”

 

Tips for writing your birth plan

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    Keep it short.

    Your birth plan should be one page, max, with bullet points.

    You want any nurse or provider to be able to skim in easily and see what you’re thinking. Keeping it to just 5-7 of the most important items, is ideal.

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    Prioritize.

    To keep your list short, consider which items you can take off.

    What can your partner advocate for on your behalf or take care of for you? (lights, playlist, etc.)

    What are the things your hospital/birth center will already provide or have a protocol for? (bath/no bath after birth, delayed cord clamping)

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    Phrase it positively.

    Write about what you want, rather than what you don’t want.

    For example, if you’re hoping to avoid an episiotomy (a cut made between the perineum and vagina to widen the vaginal opening), phrase it as “I would like perineal support” rather than “I do not want an episiotomy.”

     

     

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    Don’t forget baby.

    Consider plans for after birth, too, including skin-to-skin and cord-cutting as well as other newborn procedures and what you would like to happen in case baby needs to go to NICU.

 

2. The best value to come out of a birth plan happens before the big day.

The act of writing your birth plan (or preferences list) is a terrific way for you and your partner to get on the same page about your baby’s birthday, including ways they can support you in your vision. Consider it a safety net against surprises or conflicts when you’re in the throes of labor (surprises and conflicts are the last thing you’ll need!)

 

Consider the act of writing a birth plan with your partner as a safety net against surprises or conflicts when you’re in the throes of labor.

 

For example, if you write that you’d like to keep the lights low in your room, your partner may understand that and take it upon themselves to remind staff of this preference (or even just turn the lights down when the time comes). To tackle these small reminders and roles, Roche suggests you set aside dedicated time with your partner to write down ideas for your birth together—and then talk them over, openly and seriously.

 

3. Use your birth plan as a way to start informed conversations with your care team.

The process of making a birth plan is also useful for starting informed conversations with your doctor or midwife.

Bring your questions and ideas into an office visit so you can fully understand your doctor’s training, expertise, and views, as well as how hospital policies may affect your birth.

 

The process of making a birth plan is also useful for starting informed conversations with your doctor or midwife.

 

You can learn a lot from talking with your provider—you may find, for example, that skin-to-skin contact for an hour after birth is standard procedure where you are giving birth, so not something you need to waste any birth plan ink or energy advocating for.

 

4. Have full confidence in what you want (and don’t want) and why.

While there are plenty of easily Google-able birth plans out there, not all of them will be relevant to your personality, clinical situation, birth place, and preferences.

 

Everything detailed in your birth plan should matter to you.

 

Make every item on your list personal, with a strong reason behind it. You don’t want to have any items on your birth plan just because it’s something you’ve heard about, something a friend did, or something that was recommended in a class, book, or blog post. Everything detailed in your birth plan should matter to you. Roche says,  “If you don’t want an IV while in labor, you should know why that is important to you and what it means. If it’s not important to you, it’s not going to hold water during your birth.”

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About Carrie

Carrie Murphy is a certified birth doula and freelance writer living in New Mexico. She has an MFA in Creative Writing (Poetry) from New Mexico State University and is the author of two books of poetry.

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