Jess posed this question recently on the site, and we decided to take it down and build en entire post around it. What do you guys say — did you have a birth plan?

On_my_shelf I know what my options are and am educated on birth as I am in health care (in Canada). I like the hospital my doctor works out of but if I had to go to the other hospital in town I’d be ok with that, too. I don’t have plans to either have or not have an epidural. It’s my first baby so I just want to see how it goes and make the decision as it comes.

I understand why women like birth plans… but I just don’t want one. I find that the idea of a birth plan (for me personally) actually to be kinda stressful. It’s like putting pressure on myself to perform in a particular way when this experience is completely new to me. I know that most women find the birth plan to be reassuring and really enjoy having one. I think plans are a great idea but I still don’t want one. I haven’t met any other women who also feel this way.

Are there any other offbeat mamas who just aren’t doing a birth plan?

Comments on Do I have to have a birth plan?

  1. I never had a birthplan. I knew the hospital I would deliver at because that’s the only one where my doctors’ delivered. I didn’t know which doctor would be delivering me as it just depended on which doctor was on at the time. (I ended up going through 3 since I was in labor for 43 hours). I knew that I wanted to avoid a c-section if at all possible, and I was able to do so. Other than that, I left it up to how I was feeling at that point in time. I ended up having a lot more visitors in there than I ever thought I would, but it was so helpful to me and them to have them coming in shifts since the labor was so long.

    I personally never saw the point in crafting out a specific birth plan, as nature has its own way of handling things for you. I didn’t want to be induced, but my son’s heartbeat dropping and having a cord possibly wrapped around his neck forced that, and I was okay (hey it got me out of 2 1/2 weeks more of pregnancy and bedrest.) It’s all preference, but I never felt a need to.

    Nature worked it’s magic, and even though I was in labor laying in a hospital bed longer than I would ever care to again, my son came into this world, happy, healthy and on my husband’s birthday. πŸ™‚

  2. I had two births in the last three years. The first was a home birth, the second was at a birth center. My partner and I did not have a written birth plan for either deliveries. Instead, we talked extensively with each other about what we envisioned for the experience, discussed back-up plans, and deal-breakers. Once we had all that ironed out with each other, we spoke to our birth team. We were lucky in that none of our desires were denied. My husband used a “birth knife” to cut the umbilical cord – intended to be given to the child upon her first menstruation – the room was dark and quiet, and I did not have a vaginal exam during the second delivery.
    I believe that the birth plan is a physical document recording the desires of the birth team. If you feel that there is a possibility that there will be circumstances that cause you to make a decision while pain may be clouding your judgment, the paper may help to remind you and those around you of the intentions previously discussed.
    In the end, we didn’t feel that the plan was necessary, and it never came up. However, if the document is important to your peace of mind, it could be useful to you and others.

  3. I think the term “birth plan” can be a bit of a misnomer. I mean, it’s a bit impossible to say something like, “I will labor for exactly six hours with exactly these people there and there will be no medical complications.” Sh*t happens, right?

    But I think “not having an opinion” is a little iffy too. I mean, someone’s going to be making decisions at your birth. It might be the midwife, it might be the doctor, it might be you. If you’d prefer that all decisions be made by someone else, that’s valid and worth writing down. If you’d like to give your informed consent to possible procedures (or designate someone to give consent for you) that’s a birth plan. If you’d like to give informed consent in some situations but leave it up to someone else in others (for instance, if a doctor thinks something is immediately necessary for your health or the baby’s health) that’s a birth plan too.

    I don’t think a written birth plan is at all necessary, of course. I just feel like anybody that goes into any situation intentionally leaving it up to other people what will happen just kind of leaves themselves open to things happening that they wouldn’t necessarily have chosen. With birth especially, there are a lot of practitioners who, in the absence of direction from the patient, do things that are more for their own convenience than the patient’s health. That freaks me out, and I think it’s worth avoiding, no matter whether or not you care about epidurals.

    • I had no intentions of leaving my birth up to someone else’s discretion. I simply had never been in labor before and wasn’t sure what I wanted yet. It’s hard to tell if you like red wine when you’ve never tasted it before.
      Now that I have had my lovely daughter I am really glad I went without a plan. It allowed me to make the best decisions during the moment things were happening.

      • I’m sorry my post came across that way. What I was trying to say was that all too frequently women in labor aren’t given the chance to make informed decisions unless they actively state their right to do so. That’s what a birth plan is to me–not a statement of exactly what needs to happen when (“I will drink red wine and like it”), but a statement that we don’t leave our rights and humanity at the door when we go into labor (“Don’t make me drink red wine without my consent”).
        I’m glad you were able to make decisions as things happened–I think too many people aren’t given that chance.

        • I think there must be a significant difference in the medical system from Canada to the USA. Here it is very much illegal to perform any kind of medical procedure on a patient with out informed consent. You have to sign that you understand what is going on for example if you want an epidural etc. Even for an emergency c section you still havevto understand what is happening, why and the risks involved and then sign that you agree with whatever procedure is about to happen. If you don’t agree with the Drs assessment then you sign another piece of paper saying that the dr has given you the recommended treatment options, you understand what and why but that you are declining that treatment.
          Of course patients can still be pressured into a procedure that they don’t really want. But unnecessary medicalized birth in Canada(or at least the part i live in) is pretty rare. Most of our OBG’s are women with children of their own who want a good birth for there patients because that is what they also wanted for themselves.

        • Have you read the book “baby catcher”? It is written by a midwife Peggy something who practiced in California for many years. It has these amazing stories and shows how we view birth has changed over the years. It goes from the overly medicalized hospital birth when women had basically no options to when midwifery was atits prime in Caliornia and women could have any kind of birth they chose. It’s really one of the best books I’ve read. If you get a chance check it out. I bet you would really like it! πŸ™‚

  4. I had one and was glad I did although I don’t think the midwife who delivered my baby even looked at it. If you have a plan in mind, I think it’s great way to outline your wishes. If you don’t, I can’t see any reason to make one unless it would help your support team.

    I will say that I know for a fact that I wouldn’t have ended up with a drug-free birth if I hadn’t specifically made that a goal in the first place. I know it’s different everywhere but even the midwife I had was suggesting an epidural. I’m glad my husband knew my birth plan inside and out because just hearing the word ‘epidural’ threw me off course and made it hard for me to focus when I needed to.

  5. I had 2 different birth plans, 1 for if I went into labor naturally, 1 if I decided to be induced due to gestational diabetes. I ended up with a combo, my water broke on the day my induction was scheduled, and labor didn’t start after 10 hours, so I was induced. I was incredibly glad I had my birth plan. A lot of it didn’t end up happening, but It was so incredibly helpful to have a nurse or doctor be able to say, “I know you wanted X, and I understand why, so what if we did Y instead since it’s along the same lines? Your other option is Z.” Instead of just, “Okay we’re going to do Z now.” I think maybe because my pregnancy was so tightly controlled because I was high risk, that I really, really didn’t want a super controlled birth and end up bullied into a C-section birth if my baby didn’t just pop right out lickety split. It really helped give us (and the nurses and doctors for that matter) the opportunity to share opinions and make decisions much quicker. Instead of a long discussion, they could easily see what kind of people we are and how we wanted our birth to be, so knew right away what we want to be offered. For example, usually our hospital does an automatic internal fetal monitor if you use Pitocin. Since I had in my birth plan that I wanted as unmedicated a labor as possible, they offered an external fetal monitor with an extra long cable so that I could move around the room and use the birthing ball, etc. If I hadn’t had a birth plan, I don’t know if I would have been in a mental/emotional place to realize that they were going to use an internal monitor, or to be able to refuse it. I started out not wanting to make a birth plan at all, and my doctor insisted. From his point of view, he just wanted to make sure that we had gone through all our options and had educated ourselves for any “just in case” situation. He didn’t want us to be confused in the heat of the moment and make a decision just because he said so. The only thing I would change is that my birth plan was way too detailed, if I did it all over again I would make sure it was only 1 page, and offered firm but general guidelines, like “We are intending to have as unmedicated a birth as possible, please discuss any IV fluids or medications with us before administering,” as opposed to listing every single thing we didn’t want in like a 15 item list.

  6. I totally get the no plan plan! I’ve started reading stuff about what things can happen during labor and all I’ve done is made myself afraid to move. Either the vaginal birth or cesarean dilivery paths have their freaky bits that make me afraid of getting to the finish line. My hubby told me it was in my best interests not to keep reading about it if it was going to make me worry so much. Now I am going with the whatever it takes to safely deliver my baby plan which could be one of a million different options, in the end I’m going to leave it to my body, our baby and the sage advice of my doctor in the moment and not a minute before! Women have babies all over the world in all sorts of circumstances so I don’t think it’s worth me over thinking it any more!

  7. I didn’t have a birth plan other than “give birth” and really, I’m glad for it. I ended up in labor for 47 hours, had to get an epidural (for various reasons not only did I *want* it by hour 30, but I was informed that it was pretty much non-optional due to a pre-existing condition that I have), and didn’t get to spend a single minute in the tub – all things I never would have included in a “plan.”

    I did write one for the benefit of talking through things with my doula and taking stock of what was important to me, but that was it. I’m really grateful that I wasn’t attached to any of the ideas that I wrote down as labor is unpredictable and I truly didn’t want half of what I *thought* I would. I had contractions every three minutes for 30 hours before checking into the hospital and honestly, all I wanted was to be on my hands and knees with someone pushing on my back. No soothing music necessary.

  8. I’ve always thought birth plans were a way to make the doctor and nurses stop a second and realize that all women birth differently and that they shouldn’t come rushing in with their routine interventions and try to fit me into the hospital birth machine. A more appropriate term would maybe be “List of Things You Should Only Do If It’s Really, Truly, Medically Necessary, Not Just Because You Do It To Everyone.” So if you know you want continuous monitoring, Pitocin and an epidural, you don’t need a birth plan. But maybe I understood it that way because I’m distrustful of maternity care in this country. I was lucky enough to try for a homebirth with a midwife, where it wasn’t necessary to list off all of the things I didn’t want her to do, because I already knew she wasn’t going to do them unless medically necessary. So I didn’t have a birth plan. Reading these comments, I think I may have misunderstood the term! Whoopsies.

  9. I hate planning things, and the thought of planning something that I had never experienced before? No, thanks.
    My midwives (my [Australian] town’s hospital had a free midwife clinic for antenatal care) asked me to at least think about the basics and let them know, so I did tell them that I wanted to avoid an epidural but I wouldn’t be against having one, that I was fine with using other drugs if I wanted them, that my partner didn’t want to venture any further south than my head, and that included not cutting the cord (god love his squeamish self), and that I wanted skin-to-skin contact straight away. They were happy with that, just so they had some notes for when I came in, and most of what I wanted was how they liked to do things, anyway. As it turned out, it was all pretty superfluous because my son wasn’t waiting for anyone or anything when he came flying out twenty minutes after I arrived at the hospital.
    I won’t be making a birth plan for any subsequent babies, either. Like others have mentioned, I felt better not having one. Definitely think about what could happen and what you would want to do, but for me, a set plan just seems like pressure and a disappointment waiting to happen.

  10. i didn’t feel like having a birth plan. i heard from my midwives and other mothers that the more devoted one was to the plan, the less likely one was to have it go that way. plus i just don’t tend to work well with plans. but then the baby went breech, and i realised i was likely to have a hospital birth instead of a homebirth. so i made a plan, figuring i could ignore it if i wanted to. the baby turned, i had a homebirth, the plan was forgotten. so my advice is to make a plan, then forget about it. that way you have it if you need it.

  11. I found that having a birth plan helped me identify the kind of birth I wanted to have. It made me feel more confident and positive about the birth experience. I also made sure I remained flexible on my decisions just in case things didn’t go the way I had planned. Β  I also found it to be extremely important for my midwife to know what I wanted as an ideal labour. There are so many different ways to bring a child into this world, and my birth plan ensured that my midwife knew what I hoped for. It gave her the direction she needed to provide me (and my child) with the right kind of care in my situation. As an example, the plan explained that I wanted as natural a labour as possible. This helped her guide me through the various natural pain management options as opposed to initially offering things like epidurals and pethidine.

    • Could you point me in the right direction for researching natural pain management options? I would like to have as natural a labor as possible, too, but i have to admit that i am a big baby when it comes to being in pain and i also have panic disorder and being in a lot of pain can trigger a panic attack, which i recently, unfortunately, have learned. Thanks in advance πŸ™‚

      • TENS machine, TENS machine, TENS machine. Seriously. I had one when I had my baby, and I recommend them every opportunity I get, especially since so few people have heard of them.

        As for research, the book Birthing From Within is good in general, and it has a very good overview of the various pain management options for labor, including the not-so-natural ones. Also anything by Ina May Gaskin.

  12. I didn’t read the rest of the comments, but here’s my say. I live in Canada too and just had my first baby. Being an obsessive planner, I was all about the birth plan, but in the end found that I didn’t really need it. What was good about it was that it really forced me to research my options in great detail and to be confident about what I wanted. However, once I got down to having the baby, I found three things:

    1) I was able to let the nurses know I wanted on the fly. I had expected that I’d be so out of it that I’d need a birth plan for them to know I wanted the lights down low and didn’t want an epidural, but it wasn’t like that at all.

    2) Just talking to my doctors beforehand was a much better way to go. They were all very awesome. If you can’t just talk to your doctor (or midwife), you need a new one. (Fortunately in Canada, I think we have much better doctors).

    3) Absolutely nothing went according to plan, and it wasn’t anyone’s fault. This isn’t a reason not to have a plan, but you have to be flexible about your expectations. I had wanted a non-medicated birth with a doula, and ended up with high blood pressure, two failed inductions and finally a traumatic c-section and a very difficult recovery. We all pulled through it, but it taught me that you really have to let go and trust yourself and your birthing team.

  13. We definitely didn’t have one and our birth was natural and smooth sailing. I firmly believe this is because we were so open to going with the flow. If you don’t set yourself up for disappointments, you can’t have any!

  14. I worked in L&D for 3 years and it seemed that those who had pretty set in stone, detailed birth plans were the ones who ended up needing the most interventions, including emergency c-sections. That’s just what happens when you try to plan the unpredictable. Sometimes it just good to let whatever happens, happen. I’ve seen so many people feel so disappointed/depressed when their birth wasn’t perfect as planned.

  15. Good question. I’ve been thinking a lot about this as my first baby is due in mid-August. I know that i want to leave specific instructions about a few things, like no bottle feeding because i plan on breast feeding, and no episiotomy. I also want the nurses and drs to know that i have panic disorder. I’ve asked my OB about creating a birth plan and he suggested that i make an appointment with the birthing center at the hospital to take a tour and a birthing class or two and then decided if i want to create a plan and what to include in it. I think keeping the fact that things don’t always go according to plan in mind is good advice as well.

  16. I think a birth plan which lets the birthing staff (midwives, doctors, obs) how you feel about key areas is really important – and can address all scenarios in some way. Let’s call it birthing preferences, rather than a plan. You may want to give a “natural” birth a good go, for example, before accepting an epidural (which puts you at higher risk of having a caesarean). On my birth plan I addressed the possibility of me having a caesarean (which I didn’t end up having) where I might be fully knocked out by a GA (and also with a spinal anaesthetic where you’re awake). It was really important to me that my baby had skin-to-skin contact with one of us after being born, and if I wasn’t able to, then I wanted them to give bub immediately to my partner to have skin-to-skin contact, rather than being left isolated in a crib & this being their first experience out of the womb. Other things which may be important to you are your partner cutting the umbilical cord. Unless you have a birth “plan” somebody else may automatically the cord, and your partner (if present) then misses out on what could be an amazing experience. Also, for the health of your baby (2 months worth of their iron supply) you might state you’d like them to wait until the cord stops pulsating before they cut it. Stuff like this keeps you somewhat in control of the birthing process – in areas where you can. It’s your birth, and I wouldn’t leave it up to a medicalised system to medicalise your birth (if you’re having a hospital birth, for example) without having some say. Just a single page of bullet points is all you need. Guess I’m just saying try and stay in control of things that are important to you – rather than having things simply done to you and your baby. All the best!

  17. I had a birthplan, and I ended up throwing it out and doing what I felt like at the moment. I don’t regret my decision at all, but having a birthplan made me feel more in control of the situation. It helped keep me calm going in. Even though I didn’t use mine, I would recommend it.

    • Let me add that I think it’s important to understand in your mind that you may have to change that plan and to allow yourself to be ok with that if it happens. Otherwise you may end up dissapointed and guilty.

  18. There’s no word count on a birth plan. You only have to put the things you have a plan for.

    That said, my wife and I are both teachers, so while we like plans, and we’re good at making them, we know that they can readily be chucked out of the window when unexpected things transpire.

    I’d like to echo what several people have said, in that the act of setting out a birth plan is an important way of letting your birth partner (and yourself) know what you want. When you’re sucking gas and air between gutsy moos, it’ll be your birth partner who has to talk to the midwives.

    But then again, if it’s stressing you out, don’t stress about it. Whatever happens happens, although the hospital staff might like to be told that your birth plan is not to have a birth plan. Show them that you’ve thought about it, but your happy with whatever happens.

    James

  19. I think if we all started referring to THE BIRTH PLAN as “my wish list” we’d all feel less disappointed if it didn’t go the way as planned, or find it easier to negotiate different outcomes if they arise. That being said, I didn’t have one, but my husband and I had talked endlessly for months on what we thought was “the right way” and the “no way” so that when we were in labour and it went REALLY REALLY fast we could both react to the situation as needed and remain flexible. I think flexibility is really important but of course it can be very hard for everyone to feel flexible and relaxed when impending birth is on the way! So, do what makes you happy, but think of it as the wish list so that when Baby Santa doesn’t bring what you want you won’t have to cry like that time you didn’t get the Care Bear you really wanted for Christmas πŸ™‚

  20. I didn’t have a birth plan with either of my babies, and just went with the flow with what my needs were at the time and I wouldn’t change that for the world. I had a natural birth with my first and had an epidural with my second. I was married with the first one and divorced with the second. They were very very different experiences but both resulted in beautiful healthy perfect little girls so I was happy. All I cared about was healthy babies and that’s what I got. As long as you do what you feel is right for YOU and your baby thats all that matters.

  21. Wow I really appreciate everyones opinion on birth plans. It’s neat to see what works for different people and there is such a variation! Great comments! πŸ™‚

  22. You sound very calm and sensible about this. Why don’t you use your own judgement and have as much or as little of a birth plan as possible.

    I didn’t do any. The people I know who did them were utterly disappointed with the unstoppable need for intervention/unavailability of epidural… Without exception.

    My midwife friend says that when confronted with a birth plan, she nods and says ‘okay, okay…’ and then does whatever needs to be done.

  23. I am also in Canada and had a baby in 2010 at a large maternity hospital. I was very freaked out about interventions. Most of what I read was American; I found it hard to find detailed Canadian information and I had very little idea of the practices and procedures at the hospital where I gave birth. (The pre-natal classes and hospital tour help a bit).

    To me, the main reason for having a birth plan was that it seemed that everyone I knew who gave birth without a strong stated preference for minimal intervention got the full meal deal, including a c-section.

    Knowledge helps me to feel more comfortable so I did a great deal of research. I knew I’d be faced with making some potentially important decisions with not much time to reflect so I wanted to know how I felt about the various interventions that could happen and when they might be necessary so that if I did have choices, I could make informed ones.

    My birth plan was pretty simple: minimal interventions, going to try for no drugs. The only two things I really, really didn’t want were an induction (because adding pitocin increases the pain of contractions making it harder to go without drugs, and the continuous fetal monitoring limits the mother’s movement which limits non-drug pain relief options), and a c-section (I had laparoscopic surgery about 10 years ago and couldn’t believe how long it took me to recover – I wanted no part of a larger incision if I could help it). I didn’t state preferences with respect to lighting, music, etc. only the big stuff.

    Well, my water broke 2 days before my due date and I didn’t go into labour naturally, so I did end up with the induction, but I was able to labour drug-free and got lucky – I had pretty much the birth I’d hoped for.

    I don’t know if a written plan is as important as some background knowledge and a general sense of what you hope for and how you feel about the various things that might come up. I think it’s also important to understand the consequences of particular choices. For instance, nowhere in my prenatal classes did they mention that having an epidural increases your risk of a c-section. My hospital had a 97% epidural rate for first time moms. If I’d just been thinking, “why feel pain if I don’t have to?” I’d probably have gotten one. But because I understood how that would make it harder to stay away from a section, I was able to use that knowledge to steady me through the tough bits of labour.

    In retrospect, I think it’s important to find out what the standard procedures are at your hospital. Then you can focus on those things you want that are different from the usual.

    The other reason to have a basic plan is that not all moms want the same things and knowing what you’d like helps the hospital staff do their best to see that it happens for you. When I did the hospital tour I thought I wanted what pretty much every new mom wanted: to have my baby put on my chest right after the birth and to breast feed right away. But another mom-to-be in my group said she wanted the baby taken away immediately and not brought back to her until s/he was washed and wrapped in a blanket. It made me realize that labour and delivery nurses have to provide support to moms with wildly different ideas about what they want. I would have been horrified and very pissed off if they’d whisked my baby away for no reason; this other mom would likely have been equally horrified if they’d put her newborn on her chest.

    I probably spent too much time thinking about it, but in the end I was really happy with how it worked out.

    Good luck!

  24. I used the standard template birth plan that my hospital offers. Most of the answers were “no preference”. However, I appreciated the option to specify that I wanted to be the one to ask for pain medication rather than have it offered. I also opted for a stupid long labor in the attempt to avoid a c-section, which ultimately ended in the OR anyway. However, the midwife and doctors were very sensitive in approaching the subject and gave me time to adjust to the idea since they knew my preference. I do wish I has specified that only my husband and necessary med staff attend while I was in active labor. Having the ***inlaws show up while the midwife was digging around like she was trying to get the last bit of peanut butter out of the jar was uncomfortable for everyone.

  25. I’m in Canada as well (Calgary) and I took a class through the local health region. One of the exercises we did was to go through a birth plan exercise where we were given about 15 cards that had sort of opposite outcomes on either side i.e. Vaginal birth or c-section? Epidural or no? Lots of intervention or little intervention etc. The most important card said healthy baby or unhealthy baby. We started with all 15 cards but then had to whittle down to 10 cards, then 5 and then finally 3. What I discovered was that I already had a pretty good idea of what could happen, what sort of interventions would be offered etc. but my husband had no idea. Instead of figuring out a birth plan we ended up having a really heartfelt talk about how we both hoped the birth would go and what was really important to each of us. We ended up with an understanding that births can be complicated and as long as our baby was ok at the end of it, we were more than prepared to let go of a lot of our plan if necessary. This talk also reassured me that if I wasn’t able to speak up for myself my husband could because he knew what I wanted. So, did we have a birth plan? Not really. Instead we had agreed how we hoped it would go but were prepared to be flexible depending on the situation. I was lucky that everything went pretty much how I had hoped but if it hadn’t I think I would have been able to cope.

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