What is a Birth Plan and Do You Need One?

Read on for all you need to know about birth plans — what to ask, what to include, and why we at Peanut prefer preferences to plans.
*Before we answer the question what is a birth plan?, a quick note on language.

While the phrase “birth plan” is commonly used, we prefer the term “birth preferences.”

In fact, it’s part of our #RenamingRevolution.

It’s our goal to do away with all the insensitive and often harmful terms that leave us feeling less than.

Like “geriatric pregnancy”.

Um.

We’ll take 35+ pregnancy, thank you.

And “morning sickness”?

Unfortunately, it’s far from contained to the AM hours.

So we’re going with pregnancy nausea rather.

And then there’s birth plan.

Before we get into why the phrase should be tweaked, let’s start by discussing what this term means.

In this article: 📝

What is a birth plan?

A birth plan contains details about your wishes for how you’d ideally like your baby’s birth to go.

It can include everything from the kind of birth you’d like to who you’d like in the room, to how you plan to feed your baby.

It may start with your personal details and pertinent medical information like allergies, doctors’ names, etc.

Then, if you’re planning for a vaginal birth, it usually moves into how you’d like to labor.

A birth plan template might look something like this:

• I’d like everyone to refer to ”surges” rather than contractions (if you are hypnobirthing, for example).
  
• I’d like the lights to be as dim as possible and the curtains drawn.
  
• Please do not offer an epidural unless I ask for one.
  
• I’d like to avoid a routine episiotomy. (That’s an incision between your vagina and anus to make the opening bigger for a vaginal birth.)
  
• I’d like my partner to cut the baby’s cord.
  
• I’d like to initiate skin-to-skin as soon as possible.
  
• I would like to formula feed.
  
• I’d like my baby to room with me at all times.

Cesarean birth plan examples might look something like this:

• I’d like both my partner and doula to be allowed into theater with me.
  
• I’d like peace and quiet and no mundane chatter. I’d like the first voice my baby hears to be mine or my partner’s.
  
• I’d like x album to play over the speakers.
  
• I’d like the sheet to be lowered so I can see the baby being lifted out.
  
• I’d like the pediatrician to do the Apgar test (that checks your baby’s health and need for medical care) while my baby is on my chest.
  
• I would like my baby to please stay with me in recovery.
  
• I’d like to breastfeed — please do not offer formula unless necessary.

So why birth preferences rather than birth plan?

Sometimes things happen that mean your birthing team needs to change things up.

You may need to have a cesarean birth instead of the vaginal birth you’d hoped for.

Or you may choose to ask for some pain relief, even though you initially wanted an unmedicated birth.

A plan is something to try and stick to at all costs — an order or an arrangement of things.

Things go “according to plan”.

And when they do, they are said to be successful.

If you fail to plan, you plan to fail and all that.

And failure is a word we want to remove from birth altogether.

Plans sometimes change.

That’s life.

So we work with preferences instead.

A preference is what we’d like in a best-case scenario, but it acknowledges that we cannot control everything.

That things could change.

That, while we hope for things to proceed in a certain way, we know that they may not.

Language matters.

It impacts how we feel and our expectations.

And the expectations of others.

If you have a list of birth preferences, your team will be able to see if or when things deviate from what you had envisioned and discuss the change with you.

And suddenly, your birth becomes something you have an active role in, rather than something that is done to you.

There is plenty of research to show that how a person is made to feel while giving birth impacts how they feel for the rest of their life.

So this really matters.

When should you make a birth plan?

You can start thinking about your birth preferences as soon as you find out you’re pregnant, knowing that they might change as your pregnancy progresses (once again why preferences beats plan!).

In fact, you may already have some ideas.

The best thing about assembling these ideas into some sort of cohesive document is that it nudges you toward thinking about certain practices that surround birth.

Researching things like episiotomies, skin-to-skin, and pain relief strategies can help you make informed decisions about your care.

You may find birth preparation classes give you a springboard into developing your birth preferences.

Or you may have a doula to bounce ideas off.

We recommend working on your preferences sooner rather than later.

It’s really important that you discuss them with your doctor or midwife and see where they stand on certain procedures.

They may routinely work in a certain way — if it’s their policy not to deliver babies in water, for example, your dream of a water birth may feel like it has to fly out the window.

Being prepared means you can look for a provider who supports your wants and needs for birth.

What is typically in a birth plan?

Let’s get you started on the sorts of things you could include:

• Who would you like in the room while you’re in labor?
  
• Who would you like in the room/theater during delivery?
  
• Are there any special phrases to include or exclude? Surges, waves, waters releasing, etc.
  
• What sort of atmosphere do you hope for? Quiet and dimly lit? Will you or your doula be hanging fairy lights or birth affirmations on the walls?
  
• Do you want freedom of movement to be able to labor on a birthing ball, for example, or take a shower or relax in the bath?
  
• Would you prefer staff talk to your partner or doula as far as possible so you can remain in your zone?
  
• Would you like to have particular music playing?
  
• Would you like to cover the clock, so you don’t count time?
  
• Would you prefer not to be told “how many cms” you are so that you don’t focus on the numbers?
  
• Would you like food and drink?
  
• Would you like to be offered medical pain relief? And if so, which?
  
• Would you like to deliver your baby in a position you find most comfortable — on all fours, squatting, or on a birth stool rather than on your back?
  
• Would you like to have the epidural reversed for the pushing stage?
  
• Would you like to have guided pushing or a mother-centered approach? (This is when medical personnel follow the birthing person’s urge to push or even wait for the fetal ejection reflex, which is when your body expels your baby without you pushing).
  
• Would you like to avoid an episiotomy?
  
• Would you like to have your partner announce your baby’s sex?
  
• Would you like your baby placed skin-to-skin immediately?
  
• Would you like to bottle or breastfeed?
  
• Would you like the screen lowered so you can see the baby raised? Some doctors allow the birthing person to deliver their own baby in a cesarean birth!
  
• What pain relief options are there for you post-cesarean delivery?
  
• Would you like your baby to stay with you in recovery?
  
• Would you like the vernix left on your baby?
  
• Which arm would you like any IVs entered into (your non-dominant arm is usually the best)?

How do you make a birth plan?

The American Academy of Obstetricians and Gynecologists has a very comprehensive birth preferences template you can download.

Or you can use a template that allows you to use at-a-glance illustrations, like those from The Positive Birth Movement.

Basically, there is a birth preferences template for everyone and every birth!

Choose one that speaks to you.

It’s a good idea to print out several copies to refer to during the birth — one for your doctor, another for your partner, and another for your doula if you have one.

You can also place a copy on the door of your labor/hospital room.

And make copies available to the staff.

Not everyone chooses to outline their birth preferences, and it’s by no means compulsory.

But it can really help if you want to be actively involved in the decision-making and fully empowered in the moment.

It’s your birthing experience, after all. 💛