Birth Plans: What You Should Know & How to Create One

Content medically reviewed by April Kautzman, APRN, CNM

If you're currently expecting a child, you may be wondering what you can do to prepare for your birthing experience. A birth plan outlines your desires and preferences regarding labor and delivery.

"A birth plan is a written summary of preferences for care during the labor, birth, and postpartum period," said April Kautzman, APRN, certified nurse-midwife (CNM) at Essentia Health. "It is an excellent way for patients to tell their labor and delivery team what they want for their childbirth experience."

Because articulating your childbirth preferences may be difficult during labor, creating a birth plan ahead of time can be an alternative and effective way to self-advocate. The birth of your child is a deeply personal experience, after all. Learn what to include in your birth plan to be more empowered during your childbirth experience.

What Should I Include in My Birth Plan?

The important thing to remember about your birth plan is that it may not be followed perfectly. Labor is a unique and sometimes unpredictable process. Prolonged or preterm labor may change the ability to implement some or all of your labor choices. Because labor is a fluid experience, your birth team recommends an open mind as labor evolves.

In your birth plan, you may want to include:

• Environmental preferences. You can include in your birth plan what temperature you would like the labor and delivery room to be, whether you would like music playing, whether you would like to use aromatherapy, and more.
• Who stays in the room. You can decide whether you would like your friends and family in the room during birth or just your partner.
• Pain management. You can specify which pain relief methods, if any, you would like to receive, including epidural or nitrous oxide (laughing gas).
• Birthing positions. There are various birthing positions to consider. You can specify whether you'd like to give birth while reclining, side-lying, squatting or kneeling. Birthing ball options may also be available to you.
• Umbilical cord preferences. You may choose to state preferences about cord clamping. A delayed cord clamping can help your baby's blood volume. You may also express whether you want skin to skin contact with your baby after delivery, and if so, for how long.
• Instructions for newborn care. Outline the kind of care you want your newborn baby to receive. If you want to hold your baby skin to skin immediately after delivery, make a note of this. Also include details regarding your plans to breastfeed or formula feed, whether you'd like your baby to receive antibiotic eye ointment and a vitamin K injection, and when the baby will be bathed for the first time.

"As a provider, my goal is a healthy mom and baby, as well as a positive childbirth experience," Kautzman said. "A patient's experience and what the patient wants during this period is important."

Essentia provides patients with a birth plan template. If you're interested in a more natural birthing style, Essentia also assists with a low-intervention birth plan.

You may also have preferences pertaining to after birth, particularly breastfeeding support and mother/baby bonding. Many of Essentia's hospitals are Baby-Friendly® designated hospitals, which means they've achieved the gold standard in maternal-child care. They provide education on feeding choices and the skills necessary to help new moms feel confident in their choices.

Know How to Organize Your Birth Plan

When it comes to organizing your birth plan, make it straightforward and easy to follow. By making your plan accessible, you can ensure that the labor and delivery team will know exactly what you want.

"I suggest you start creating a birth plan sometime around 28 weeks or your third trimester," Kautzman said. "When organizing it, separate your preferences based on which point in time you would like that type of care to take place, such as labor, delivery, and postpartum."

Use These Tips to Create the Perfect Birth Plan

For expectant parents who may be anxious about the birthing process, writing a birth plan is a helpful tool for educating yourself and making informed decisions.

Before you draft your birth plan, you should:

• Ask about the birthing options available to you.
• Confide in other parents for support.
• Enroll in a pregnancy and birthing class or program.
• Review your plan with your partner.
• Research different birthing options.  
• Tour the hospital or birthing center.