Creating a Birth Plan


Today, Tammy continues her series on making informed choices for your upcoming birth. If you missed her previous posts, find them here: Taking Charge of Your Birth, Choosing Where Your Baby will be Born, and Choosing Your Birth Team.

The next consideration in your birth journey is creating a birth plan. Some friends, physicians, nurses, and family members may tell you that creating a birth plan is “asking for everything to go completely opposite of the way you want your birth to go.” To me, the birth plan serves as a starting place for you and your partner to get an understanding of what you may encounter on the day of your child’s birth and what options you have. It allows families to explore the pros and cons of the various aspects of labor care and get questions and concerns addressed before the actual birth day.

Tammy - Creating a Birth PlanI have had different experiences and encounters over the years that have led me to strongly encourage families to create a birth plan and share it with their provider(s). One example that I share often is of a mother who was explaining how excited she was for her baby’s upcoming birth and that she was thankful that the hospital had a great tub with jets because she really wanted a water birth. We discussed that, as far as I knew, none of the local obstetrician groups would “allow” a water birth in the hospital. For this mom, this was a vital part of her birth vision, and knowing ahead of time that it wasn’t an option – versus being told in the throws of transition that she had to get out – was critical to her emotional stability during labor.

As another example, most moms don’t know that they can wear their own clothes, labor (and even push) in various positions, and decline any option they are presented with.

With that said, a birth plan should be SHORT and to the point. I suggest that a birth plan never exceed the front of one page of paper. (For a place to start, go to, and under the pregnancy tab, there is a section at the bottom labeled Free and Helpful, and under that there is a free birth plan option. Click on that and it will take you through various parts of a birth plan and let you check some options and then print off a copy. The final product will be pages long, be sure you condense what is important into ONE page). There is no need to highlight things on a birth plan that are considered standard of care, meaning that they are done on a routine basis. For instance, you wouldn’t need to include on a birth plan that you want to wear a gown, don’t mind a hep-lock/IV access, or if you are planning on consenting with all of the newborn procedures.

Here are some topics that may be included on a birth plan:

  • A quiet birth environment – keeping lights dim, noise down, and doors closed
  • Minimal fetal monitoring (with doptone) after initial 20-minute monitor strip
  • Minimal exams and no artificial rupture or stripping of membranes without permission
  • Free choice of positioning for labor and birth (e.g. squatting, standing, use of labor tub)
  • Preference for no IV access unless it becomes necessary
  • Please do not offer pain medications – I will ask if I feel I need some
  • Ideally, would like time to dilate naturally and have no restrictions on pushing time
  • No episiotomy, with guidance on when to stop pushing to decrease chance of tearing
  • Delay clamping of the cord until it has stopped pulsing
  • The father wishes to cut the cord
  • Place baby on mom’s abdomen immediately after birth
  • Please delay ALL routine newborn procedures until after first breastfeeding
  • Delay/decline the newborn eye ointment/vitamin K shot/hepatitis shot/metabolic screening
  • Desire to use immediate breastfeeding to help expel the placenta and control bleeding
  • No formula, sugar water, or pacifiers to be given to the baby – we are exclusively breastfeeding
  • Baby will be rooming in with us

Additionally, if a Cesarean becomes necessary:

  • The father (and doula/photographer/grandmother) will be present in the delivery room
  • I would like to be awake and have one hand free to touch and talk to the baby after birth
  • Father to hold baby in the delivery room and stay with baby if going to the nursery
  • I want to hold the baby and breastfeed ASAP (even in the recovery room if baby is healthy)

The above is merely an example of most things someone would include on a birth plan that may differ from the standard procedure. You may choose to share it with your provider at a prenatal appointment and/or with your nurses once you get to the hospital, or just ask questions addressing your desires and make sure your birth team is advocating for those at the time.

Bottom line: do your research, know your options, and make an informed decision! There is no one perfect “plan” for every family. As I tell so many families, what you choose in the moment isn’t the only consideration – it’s that you made the choice with all of the information and can own that choice.

Feel free to leave a comment and I can send you an example birth plan to use as a template!


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