10 Tips for Creating a Realistic Birth Plan

Stating your birthing preferences and managing the unexpected
Newborn Baby
© Can Stock Photo / Molka

A birth plan is usually a simple document that outlines how you would prefer for the birth of your baby to go. You can give your birth plan to hospital staff, your doctor or midwife, and family members. The document should describe your preferences for pain management, who is welcome in the labour room with you, and what music, if any, you want to hear. The following are ten helpful tips to help you create a realistic birth plan.

1. Be honest with yourself

What do you feel strongest about? Are you sure that you want access to a shower but not committed to going all-natural? Good, write that down. A birth plan is meant to communicate clearly with your care providers and partner about the sort of birth experience you want to have. Don’t say that you want an all-natural birth surrounded by family and chanting mantras in your bedroom if what you really want is to listen to Taylor Swift and have your back rubbed with tennis balls at the birthing centre until you’re ready for an epidural. Lay out your true and realistic expectations, and the environment and interventions that you are comfortable with.

2. Make allowances for emergencies

A birth plan is a general plan, but it is not written with a sharpie! Remember that you may need to be flexible as things can change quickly. If what you had hoped for turns out not to be in the best interest of your baby, your nurse or midwife may need to suggest a new course of action. This is also a good time to outline under which circumstances you would be comfortable switching to a C-section birth. Whether you’re planning a C-section or allowing that one might be suddenly necessary, write down how you envision that should go. For example, should Dad stay by your head or get a clear shot of the procedure as he is videotaping the surgery?

3. Check policies

Before you shell out all that dough for an incredible birth photographer, double-check that the hospital or birth centre (if you plan to use one) allows for cameras. Same goes for the rules about candles, flowers and music.

4. Cameras, mirrors, birthing balls, and other extras

I was adamant about having no cameras in the delivery room when I had my children, likewise for mirrors. I had seen enough birth in real life and on YouTube to know what it looks like and I did not want to be distracted (or horrified—I’ll admit that!). If your hospital or birth centre allows it, would you like birthing balls, birth pools, or a shower available? Many women find these things to be helpful for pain management, so make sure your environment can accommodate them.

5. Breastfeeding or bottle feeding?

This is a deeply personal decision and not one that you owe anyone an explanation about. However, you need to have an idea of what you want because that baby is going to be hungry! Check out what support is in place for breastfeeding wherever you choose to (or end up) giving birth. State your position on how hospital staff should handle it if baby is hungry while you’re struggling to learn to nurse. It should also be clear whether your baby will spend time in a nursery or if they can be kept in your room.

6. Where will your partner stay?

If the birth is long, Dad or any other birth partner will need to rest too. Is there a spot that he can stretch out? Will he go home to tend to any other children? If so, who has your other kids while you are labouring? Your personal team needs a birth plan, too!

7. Pacifier or no pacifier?

Some hospitals still offer newborns in the nursery pacifiers. This may cause nipple confusion, so my recommendation is to say, “Thanks but no thanks.” However, this is entirely up to you. Check out this post that offers some food for thought and references on this topic.

8. Who cuts the cord?

My husband was way too squeamish to cut the cord, but I would have gladly allowed a camera in to capture that (singular) moment. In both cases, our midwife did the honours but if you have a particular preference, by all means, let your care team know. This might also be a good time to share any special plans you also may have for the placenta.

9. Eye drops? Heel poke?

If you have a midwife, you will have an opportunity to discuss and ask questions regarding newborn eye drops and the heel poke. Part of the midwifery model of care is to inform the mother about all aspects of the pregnancy and delivery. Keeping Mom in the know and in charge of her body and baby is important. I politely declined eye drops for both my babies and it wasn’t a big deal because I was clear about it from the start.

10. Episiotomies and tearing

Talk about being squeamish! I absolutely wanted a plan to mitigate my risk for vaginal tearing, preferably without an episiotomy. There are strategies available to lessen the likelihood of tearing, such as perineal massage. Being able to talk about it beforehand and understand what measures my midwife would take to try to prevent tearing helped me feel less anxious about it and know what to expect as I healed.

It’s a good idea to create your birth plan well before the birth to discuss your preferences with your care provider. This also allows for adjustments as you ask questions and gain knowledge. If you are unsure how to make certain choices, discussing with your care provider and friends who have birth experience can be incredibly helpful. A doula is also a wonderful source of knowledge, and birth plan writing can be a part of the pre-labour time you two spend together.

Knowing what you do and do not want is important, but preparing for the unexpected should be part of the plan too. Remember that you are not a failure if your birth does not go perfectly according to the plan. Be gentle and kind with yourself, while also standing up for what you want when appropriate. Good luck!

*originally published on April 4, 2016