Giving birth

Why you should have a birth plan—even if nothing goes to plan

Most birth plans go out the window or are abandoned during labour, but having one gives women a platform for expressing their intentions.

During my pregnancy, I heard the usual: Don’t bother with a birth plan. It only sets you up for failure. It was my doula that encouraged me to make a birth plan, despite my initial reluctance. I had made one for my previous birth, and nothing about it worked out, except that I had a baby in the end.

From my hospital bed, I scribbled a birth plan down on a piece of notebook paper that the nurses graciously scanned into my chart. I reminded them several times about my most adamant wishes. The voice tried to talk over me: “You’re setting yourself up for disappointment.”

Did the birth go perfectly? Sort of. Did I regret making one? No. For a long time I couldn’t figure out why I knew it was still worth it, and how to communicate to other birthing parents that if they want a birth plan, to make one regardless of the unpredictability of birth.

The mental health benefits of a birth plan

“Making a birth plan isn’t really about having a piece of paper that says all this stuff on it. It’s really the process that we want birthing people to go through when they’re approaching this incredibly important event in their life,“ explains Dr. Christina Kocis, certified nurse-midwife and division director of the Stony Brook Midwifery practice in New York.

We need to know and understand our options so that if plans change in birth, we can be ready for it. This is what a birth plan is—a tool to help us understand our choices when it comes to delivering our babies.

A birth plan is self-reflection

Even if it doesn’t end up being used, a birth plan is still the beginning of a valuable conversation and self-reflection about your realistic expectations for your child’s birth, explains Rebecca Weinberg, Director of Clinical Operations for the Perinatal Depression Program at West Penn Hospital in Pittsburg.

A birth plan forces you to really think through what you want. For instance, I knew I wanted to delay cord cutting after my baby was born. In creating a plan, it helped me generate questions for my provider. What was the benefit of delaying cord cutting? Why was it important to me? Maybe I wouldn’t get these things, but it helped me think things through about what was important to me.

A birth plan helps you advocate for your own body

With many birthing parents, just having their wishes acknowledged is important. Research shows having a supportive care team makes the experience more positive even if things don’t go to plan.

Parents with a plan feel they’re in charge of, not just their bodies, but of the whole process. “They were in it, in every moment, and felt supported no matter what those moments ended up being,” Kocis explains.

For a multitude of reasons, this is what makes some people want to see a midwife versus an OB when it comes to taking the time for birth plans.

“Midwives have the luxury of not having to see as many patients so we can see them for longer and that translates into more time with our patients,” Kocis says. It’s why, she explains, she chose to become a midwife. Spending time with patients, working through the questions on their birth plans, it gives the chance for a patient and care team to all develop the plan together.

Having a birth plan empowers you

According to Weinberg, birth plans help us pregnant women prepare mentally. “They can help identify skills that [people] can use to make the delivery less difficult and prepares them and their partner to advocate for themselves in all moments during delivery,” she explains. She makes sure to emphasize to her patients the importance of being flexible and to prepare for situations that they may need to adjust their plans to. It’s all about realistic expectations.

A birth plan should get you thinking about options, and the questions you may have about those options.

For me, my plan included that no one bring up the subject of pain medications unless I asked. I had previously talked extensively with my care team and felt knowledgeable about what was right for me. I also wanted, if safety allowed, delayed cord cutting and my baby placed on me after birth, even though she was premature. While it didn’t go perfectly, having that plan helped me adjust my expectations, and overall I felt like I was driving the experience; I wasn’t just sitting in the passenger seat while everyone else decided what would happen with my labor.

Just because some things occur that appear to take away control doesn’t mean you still can’t have a great experience.