A bit about birth plans

“What you get by achieving your goals is not as important as what you become by achieving your goals.” – Henry David Thoreau

Recently, there seems to be some increasing controversy and disagreement about birth plans.  Comments like these have become more and more common: “You cannot plan your birth”; “birth plans set women up to feel bad when things don’t go the way they want on paper”; and “a birth plan is a surefire way to land yourself in the operating room.”

It seems some would have the impression that writing a birth plan is like submitting a blueprint to a builder or placing an order in a restaurant.  In fact, this is not true at all. This is not the image of a birth plan that I like to convey to my clients.  This is not what a birth plan is or what it should be.

A birth plan doesn’t mean a predicted outcome. 

A birth plan is not synonymous with a blueprint.  It’s a plan, not a promise.  A birth plan is not intended to be a specific set of directions that will yield a very specific outcome.  A birth plan is about considering your desires for treatment.  A birth plan suggests that you are well aware of the variations that labor can take, and you have considered (ahead of time) the various scenarios.  A well thought out birth plan is not rigid; in fact, it can actually help you deal with the unpredictability.  A birth plan is one way to indicate your preferences—in other words, informed consent.

Whether or not you create an actual paper document that you share with your providers, in hopes of it becoming a part of your chart, is really not the point of a birth plan.  Although this is fine and a perfectly logical outcome, it’s not a necessary one in order to still benefit from the birth planning experience.  Creating a birth plan is not about a guarantee, it’s about the process.

Creating a birth plan is really about doing some research, goal setting, and preparation.

The birth planning process in 3 simple steps:

1.   Research

Find out what your options are.  Yes, there are many.

Read up on birth. We all know there are lots of great books out there on childbirth, as well as blogs and other online resources (check the resources section of this page to start your search).   You likely are also going to speak to your friends and family about their births.  The truth is, you’re going to hear about it whether you ask or not!

Consider this:  Let’s say that a cesarean birth is not plan A for you.  If you don’t consider it as a possibility and think about what you might like in that scenario (personal care and well as baby care) you might not know to advocate for the baby to have immediate skin-to-skin contact with you or your partner.  You might not think to ask for the baby to remain in the room with you (pending no emergency) rather than go to the nursery.  You might not think about having a support person (doula, etc.) come with you to the birth so that if/when the baby (or your partner) leave, you do not have to be alone in the operating room.

If you spend the time to research the evidence about the full continuum of birthing options and determine what choices you would like to make surrounding those options you will not only know what to ask for when confronted with these choices, but be more likely to feel empowered throughout the process.

2.     Set goals

After exploring the whole process and experience of birth decide what you think best fits you.  Make sure to really think about why you are setting the goals you are.  Understanding our underlying beliefs about something is a big piece in achieving a goal.  I’m a lot more likely to achieve my goal if I’m doing it for a reason that is personal and meaningful to me.  Ask yourself what do you want and why do you want it.

3.     Prepare to achieve your goals

Without making meaningful preparations towards the achievement of any goal the goal becomes simply an idea – wishful thinking.  Has there ever been a time that you set a goal and it manifested without some degree of investment in preparation – without actively working on achieving it?  I doubt it.  This is no different.  I have a retirement plan, like many folks.  Let’s say my plan includes retirement and a pension at age 55 (wishful thinking).  If I told you that wasmy goal but I didn’t have a plan of how I was going to get there, would you laugh and sarcastically wish me “good luck?”  I bet you would – and I’d probably deserve your doubt!  If I told you my goal and then laid out my logical, well-researched financial plan, would you laugh then? .

Thoughtful birth planning encourages the exploration of many alternatives. 

When creating your plan it’s important to think about various scenarios.  During the read up on birth part you were hopefully doing this.   Looking into, and understanding, the ‘what if’s’ in birth is exactly the point.  What would you do if…, what would you like to see happen if…, what’s your best case scenario when…?  Asking yourself these difficult questions will help you better prepare for, and even cope with, the possible outcomes each presents.

Let’s look again at my retirement plan.  Might I achieve my goal and retire with a full pension at 55, if I follow my plan?  Maybe.  Might life, as they say, ‘happen,’ which may necessitate some reassessment and adjustment to my plan?  Maybe.  But, I betcha, I’m a lot more likely to get pretty close to that goal because I’ve laid it out.  Even when twists and turns in life happen, as they inevitably do, I’m a lot more likely to make decisions that 1) I’m comfortable will and keep my goal in mind and 2) keep me as close to or back on that original course I laid out.  In the end, even if I don’t retire at 55 with a full pension, I’m more likely to be pleased with the outcome I did achieve and I’m also more likely to be close to that goal because I had a plan in place rather than just leaving my retirement to chance.

What I aim to point out here is that it is the process of engaging in critical thinking and pre-birth decision-making can actually help you, not only during your birth, but also when birth starts to take some twists and turns.

Share your birth plan

Whether or not you actually type it up or not, be sure your support person(s) are aware of your desires (your plan). They are your support persons for a reason – they want to see you succeed (and if they don’t, I might suggest you start seeking immediate replacement support person(s)).

Although your partner loves you and at times I know we wish/think they can read our minds, really they cannot.  Tell them what it is you want.  What is your best-case-scenario for your birth?  Tell them what you’d like to see if _________ happens or is ______ is suggested.  Being specific and detailed does not mean you are narrow-minded and not open to alternatives.  It means you’ve explored the alternatives and have a clear picture of what you would feel most comfortable with.

Give voice to your desires.  After all, it is YOUR birth – you do have a say.

Immerse yourself in the process

I believe the very purpose of a birth plan is because birth is unpredictable (“no two births are the same,” and “you never know…”).  Engaging in the process of creating a plan for your birth is about educating yourself, identifying you desires, and then advocating for yourself.  All of these outcomes are positive and can lead to more positive feelings about your experiences – whatever they may be – in the end.


4 thoughts on “A bit about birth plans

  1. Great post, PH Doula! Informed Choice is so important. You make wonderful points here. Your readers would enjoy my book. Wise Childbearing discusses pros and cons of routine procedures which typically play a role in the majority of birthing rooms today, and more need-to-know information including birth plans and how to get more of what you want, and less of what you don’t want. Birth plans, however you decide to write one in the end, helps you–yourself to first decide what is right for you personally. Keep up the great work, PH Doula!
    My best,
    Jennetta Billhimer CD(DONA), CCBE, BS
    Director, Association for Wise Childbearing
    Wise Childbearing, What You’ll Want to Know as You Make Your Birth Choices

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