Creating a Birth Plan

Creating a birth plan can be one of the most empowering parts of your pregnancy as you prepare for your birth. A birth plan is an essential tool that can kindly but firmly let your care providers know your needs and desires for your labor, delivery, and immediate postpartum. But the real power comes in researching to write your birth plan. When you look up information about your choices during pregnancy, birth, and postpartum from non-biased and research-based resources, you gain an education that couldn’t have been achieved without your time and studies. This knowledge can lead you to change plans, change care providers, ask questions, and advocate for yourself in ways you might not have known about without your newfound knowledge.

The best birth plans are short and to the point. Most care providers prefer a birth plan that is easy to read with bullet points or simple graphics. If your care provider asks for a birth plan or has a place for your birth plan built into their system, this is a green flag. Care providers that care about your preferences and needs during your birthing time make for a safer birth.

One of the best places to get non-biased, evidence-based information is www.evidencebasedbirth.com. On this website, you will find that the author and researcher, Dr. Rebecca Dekker, goes into research surrounding birth practices and explains in lay language what they mean and how they impact birth. Rebecca also has a podcast, if you are more of an audible learner, that provides much of the same information on her website. When creating your birth plan, you must educate yourself with the best possible information and the most current research. Not all studies are created equally, and any good care provider will let you know they have biases about the information they give you.

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The other big thing to remember is that YOU are the expert on your baby and your body. Yes, your doctor or midwife is an expert on birth in general, but you are the person who knows your body best. As you write your birth plan, it is important to remember that only you can understand your needs and how they can be met.

One of the best tips that I give birthing parents is to write an A, B, and C plan for their birth. The A plan would be your plan if everything went perfectly, and you could have everything your heart desires for your birth. If your planned birth location is at home, this would be your home birth plan. If your ideal birth is unmedicated, this would be your unmedicated plan. The next plan you will write is your B plan. If you are birthing at home, this plan would be your transfer to a hospital plan. If you are planning to give birth at a hospital, this plan might look like the things you are willing to be more lenient on or what your plan would look like if you ended up getting induced or with an epidural. The last plan you will write is your C plan or your cesarean section plan. If you are planning a repeat cesarean, you can scratch plans A and B and simply write your cesarean birth plan. Unlike many would imagine, you still have some options regarding a surgical birth. Knowing these options can give you more peace going into the procedure, especially if this was not something you had planned on or is being done in an emergency. 

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Once you make your A, B, and C plans, give your birth partner or doula your plans, and don’t look at your B or C plans again during pregnancy. Because birth is something we have little control over, having multiple plans can help you and your care team stay on the same page no matter how the birth goes.

My other tip for parents preparing for childbirth is to use the acronym B.R.A.I.N when working to advocate for yourselves and your baby. This stands for,

B-Benefits What are the benefits of this procedure that you are suggesting?

R-Risks What are the risks of this procedure that you are suggesting? Do not take the answer “there are no risks” as an appropriate answer. If this is given, ask them to have that written out and signed by them for your record. There are always risks to any procedure, and it is in your rights as a patient to know them.

A-Alternatives What are alternatives to this procedure?

I-Intuition What does your and your partner(s) intuition tell you is best? Remember that you are the expert on yourself and your baby. Trust that knowledge.

N-Nothing What would happen if we didn’t do anything? This question is one of the most powerful ones you can ask because it gives you insight into what waiting or declining might lead to.

Knowing to ask these questions when faced with procedures like induction, epidurals, Pitocin, transfer to the hospital, etc., can create even more empowerment during your birthing time. While pregnant, birthing, and postpartum, you, as the parent, will face your first opportunities to advocate for your child. These moments will be the first of many to come and are great chances for you to use your voice in that role.

What does a good birth plan look like? Below we will give you a template you can use to create your birth plans. Of course, you do not have to make a birth plan that looks like this, but this is a great starting point if the task feels daunting. Remember, you can learn one thing a day or one thing a week, and you will still have plenty of time to create birth plans that feel right to you.

Birth Preferences:

Name:

Partner(s) Name(s):

Doula Name:

Labor:

- Ability to move freely during labor

- Intermittent fetal monitoring or Portable monitor

- Food and drink as needed

- Saline Lock for IV

- Cervical exams only if asked

- Do not offer an epidural

Delivery:

- Delayed cord clamping until the cord is white and no longer pulsing

- Cord to be cut by partner

- Immediate skin to skin

- Golden hour without interruptions

- No episiotomy

Newborn:

- No Vitamin K, No Eye Ointment

- Baby will room in, if baby needs to go to NICU, partner will attend

- No bottles or sugar water

- No newborn bath

Cesarean Birth Preferences:

Name:

Partner(s) Name(s):

Doula Name:

Birth:

- Spinal/Epidural anesthesia

- Partner and doula always present

- Videos and photos taken of birth by a doula

- Free hands, do not tie them down

- No shop talk from nurses or doctors this birth is as sacred as a vaginal birth

- Clear drape and/or mirror to see the birth

Postpartum:

- Vaginal seeding immediately after birth

- Immediate skin-to-skin in the OR

- No separation of birthing parent and baby

- Delayed cord clamping and partner cuts the cord

- Nursing encouraged in the recovery room

Baby:

- No pacifiers or bottles

- No newborn bath

- All pediatric exams are to be done in the recovery room with the parents present

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