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What's In A Birth Plan?

At the first prenatal visit I have with my clients, we spend a great deal of time covering birth plans. Some of my clients have a very clear idea of what they want; some are just beginning to think about their preferences. Some have multi-page documents, others have a handful of important points jotted down on a notepad. I love walking through these choices with clients, as it really helps me see what your values are in your birth, what your fears are, and how you will need my support.

I’ve seen a lot of clash online lately between those who have thought through every detail and those whose sole plan is to get the baby out. The first group is pegged as high maintenance or unreasonable, and the second is considered uninformed.

Neither assessment is true.

There are benefits to planning. You often find that you have opinions about things that you never considered before, and that you have certain anxieties that we can address. You may find that, even if you love your provider or your birthing location, their approach isn’t likely to meet your specific desires. Plus, planning can help you make informed choices during your birth.

Going with the flow also has its benefits. Every birth is so unique, and flexibility in planning can help cope with unexpected changes. Especially for those who have not given birth before, open-mindedness allows you to let the experience guide your choices without feeling disappointment later.

But ultimately? Every birth plan, no matter how short or detailed, is valid and worthy of respect.

That doesn’t mean that every birth plan can be followed to the letter. It’s entirely possible that you may decide that pain meds are the only way you can get enough rest to push, or an unplanned C-section could end up being the safest way for your baby to be born. You may find that staying mobile in birth feels good, and the epidural you planned on doesn’t sound as awesome as it did a week before.

But your providers and your support team should still honor those wishes and support you in making them happen, as well as supporting you through any desired or necessary changes. If they don’t support your choices or treat you with respect, ask why, and if their answer doesn’t sound reasonable, get a second opinion. It is always okay to ask more questions, to seek outside opinions, and to listen to your intuition. You can even ask for a different nurse while you’re in labor!

No matter what your birth plan contains, it is my honor to hold space for you and your preferences. I love preparing for birth with my clients.


So, what should my birth plan include?

While any plan that feels right for you is a good plan, there are some things that you might want to consider including:

Do you want pain medications? If so, do you want to remain mobile? Do you want your providers to offer meds, or do you want to ask when you decide it’s time?

Do you want a waterbirth, or for your partner/support person to catch the baby? Does your birthing place offer this, and do you need to complete any paperwork or have labs done beforehand?

If your provider suggests induction or augmentation of labor, would you prefer pitocin, cytotec, cervidil, membrane sweep, or AROM (breaking your water)? Would you rather try to encourage labor with non-medical options (e.g. pumping, sex, castor oil, etc)? Some options may not be an option based on your specific situation.

Are you comfortable with student nurses, student midwives, medical students, or OB residents attending your birth?

Do you want to have your placenta encapsulated, or otherwise bring it home from the hospital? What are your hospital's policies regarding this? Who is your encapsulator, and will they be picking up your placenta, or will you or your doula be taking it out of the hospital to bring it to them?

In the event of a C-section, do you want a “gentle cesarean” or “family-centered cesarean” (clear drape, partner cuts/trims cord, immediate skin-to-skin, etc)? Who do you want in the OR with you, and does your birthing place allow this? Do they need to complete any paperwork? In the event of an emergency C-section, do you want your baby’s first cries recorded? (Want to avoid a C-section? One of the best things you can do is look up your hospital‘s C-section rate. Here’s the Twin Cities info as of 2014 on the ICAN website)

This list is by no means exhaustive. You also do not need to include any of these things. These are merely options that not everyone thinks to consider. If you feel comfortable and confident with your approach and you trust and feel supported by your providers, that’s a great place to be.

If you’re just starting to think about birth plans, don’t hesitate to reach out! There are also some great free resources online. Here are my favorites:

May your birth be peaceful and efficient!


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