How To Write A Birth Plan

Many articles claim to help you write a birth plan. From my experience with many couples in labor, I’ve found that not all birth plans are effective. Here, I’ll show you how to write a truly effective birth plan. I also provide you with a printable birth plan template. If you are wondering whether you should write a birth plan at all, read Should I Write a Baby Birth Plan?

In order to write a truly effective baby birth plan that will enhance your care on the day of your birth, you need to understand who will see your birth plan, and what their role is or can be during your birth. Most people think of birth plans as a document where you write down your preferences for clinical management decisions. (Should we use a vacuum extractor or continue to push? Should we monitor the baby’s heart rate continuously or intermittently, internally or externally?) These are decisions made between you and your doctor or midwife. Your nurse is integral is noticing when a change in management may be beneficial and alerting your doctor or midwife that they are needed, but she* is not in the decision-making seat.

Interestingly, it is your nurse who reads and supports your birth plan. Your nurse will be an advocate for your desires, and she can communicate them to your doctor. Being sure your nurse knows your general preference/approach to management decisions is great. But where typical baby birth plans fall short is that they do not include any expression of what you want from your nurse’s care. Your nurse is the person who will provide moment-to-moment labor support. They are the person who can help you into a new position, encourage you through a contraction, and help you breath and stay calm and confident. Your nurse can set up the environment in your room. It is she who will really be taking care of you during your birth – and letting her know what might work for you is an excellent use of a written birth plan.

Women birth in many many ways. We birth as who we are, and often there are clues from our past challenges about how we will best work through labor. Do you want your nurse to help keep things light and not-so-serious? Would a casual atmosphere and friendly conversation put you at ease? Or are you someone who needs to limit as much distraction as possible so you can focus? Perhaps dim lights and hushed voices are best for you. This is the stuff of a truly effective birth plan!

Your nurse does not have an opportunity to meet you before labor, and it can be difficult to make an accurate first impression of someone when you meet them in the middle of the labor process. Your nurse cannot read your mind and does not know if you want all the hands-on help she can give or if you want to be left alone with your husband or partner as much as possible. Your birth plan can be a written communication that can fill in those gaps, while also communicating your general approach to interventions. It is also a wonderful place to share any unique details about your past health history, your beliefs about birth, and any cultural or spiritual supports that would be meaningful or helpful to you.

Everyone brings different needs to a baby birth plan. Some of us know exactly what environment we need. We also have concrete ideas of what attitudes and energies we want around us during birth and around our baby. Some of us have no idea, and don’t really care all that much. This will change your need for a birth plan.

The Benefits of a Birth Plan

Write a birth plan for the reasons that fit your needs. Put as little or as much time into it as benefits you. Be as general or as specific as you need to be in order to increase your confidence. Confidence in yourself and your attendants is the true gift of a quality birth plan. It is not necessary that you write a birth plan but you may consider the following benefits.

  • It may clarify your vision for a positive birth and postpartum for yourselves and your baby. Sometimes we are limited more by our lack of vision than by our abilities or realities. Imagining and describing what is best for us helps us stand for and create what we truly want.
  • It may be a tool that facilitates clear communication between you and your spouse/partner, you and your care providers, such as doctors, midwives and doulas, or you and your nurses who are caring for you on the day of your birth. We cannot expect people to know our needs and desires if they are not communicated.
  • It may clarify what you can do to optimize your health and preparation.
  • Discussing your birth plan may reveal a deeper level of support than you knew was there for you (from your doctor, midwife, spouse etc) or reveal less support than you anticipated. The former is very empowering, and the later crucial information as you choose your birth attendants.
  • Your values and approach may differ quite a bit from the cultural norm. You will need to request care you desire that is not standard. A written birth plan is there to fall back on if you arrive to the hospital at a stage of labor where talking is a distraction.

Instructions for Writing a Birth Plan

  1. Consult a list of options to consider for childbirth and the first two days after birth (see Options For Labor Management). The written plan that you bring to your birth will cover just this time period. This plan is primarily for your nurses. You may also want to write a plan for the remainder of your pregnancy, for your postpartum, and for unexpected complications for your personal benefit.
  2. Together with your spouse and possibly a childbirth educator or doula, discuss the approaches that fit your beliefs, values, and desires. Make a comprehensive list of what you prefer for each birth procedure option. Discuss these with your doctor or midwife before your birth. Gather information from them related to decisions you are unsure about and assure their support for things you have chosen. (See the list below for ideas of what you may need to know.)
  3. From this comprehensive list, make note of the elements that are most important to you.
  4. For each key element, think about how to best make this a reality. Think about what you can do to encourage what you want, and think about what your nurses, doctor, or midwife can do.
  5. Write a birth plan to ask for the care you desire from your nurses. Focus on the key elements of what you want and on the specifics that your nurses can do for you. Share a bit about yourselves and your approach so that they can understand the values behind your choices. Give them an idea of how you have prepared for this. Keep it to the key points. Do not try to cover every possibility but rather, paint a picture of the type of care you prefer. Bring a copy with you to your birth.
  6. Include in your birth plan an explanation of your general approach to interventions and birth management, and why. Avoid simply making a list of what you do and don’t want. Sharing your thoughts helps your provider understand you and your desires. When a management decision needs to be made they can bring their understanding of you and their understanding of the situation to the discussion, which will enhance their ability to offer excellent professional guidance during your birth. No one, parent or care provider, is equipped to make decisions about interventions before your birth unfolds. Those choices will need to be made as your unique birth needs are discovered along the way. But beginning from the same standpoint with an understanding of the preferred approach allows providers and parents to work together from start to finish, each bringing their best to the same goal.

Gathering Information

  • What is recommended? How do you think this will benefit mom or baby? Does this choice make anything else necessary?
  • What are the possible risks?
  • What alternatives are possible? What are the benefits or risks of this alternative?
  • What are the risks of not doing anything? Or what if we don’t do anything for the next hour?
  • How will this effect the hormones of birth, mom’s nourishment, the ability to move, and our ability to love, believe, and open?
  • Does this fit with me? Does it make sense with my beliefs and my values?
  • What choice to I feel most comfortable with? Is this choice meaningful for me?
  • Do I have a clear idea of how to go about an alternative? Do I truly understand my options? Will I be supported either way?
  • Do I think this is the best option given the circumstances?

A truly effective birth plan template including all of these elements is provided for you. Once you’ve completed it, you can then use your birth plan for birth preparation to get the most out of your birth experience.

Get Ready! Look at the Birth Plan Template Planning Guide.

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*While we affirm males in the nursing profession, we have are using the female pronoun because of the scarcity of male nurses in labor and delivery.