How to create a smart and thoughtful birth plan

Ensure that your health care providers know what is important to you during labor

Pregnant woman talking with doctor

No one can know for certain what will happen on the day their baby arrives, but it’s wise for mothers to think ahead and consider their own wishes for giving birth. Stated birth preferences will help an expecting mom, her family, and her care providers have clear insight into her intentions during a time when she might be, well, otherwise occupied. Here are some guidelines:

Frame the idea. Think of your plan as a set of preferences, rather than as a concrete path or as the way things must go.

Write it down. “Spend some time really thinking about what is important to you and clarifying your hopes and preferences for this birth,” advises Jada Shapiro, founder of boober, an on-demand lactation support provider, and Birth Day Presence, a top New York City childbirth education and doula matching center. Then, she says, put pen to paper. “When you are in the throes of labor, it is much easier to clearly communicate your wishes to people you may not have met before if you have this information written down in a short, easy-to-read, respectful document.”

What to consider. You might highlight your preferences about freedom of movement during labor, your wishes for pain medication (or not), and your desires regarding skin-to-skin contact with the baby after birth. “Remember to use positive and respectful language,” says Shapiro. “For example, you could write, ‘I would prefer to eat and drink during labor. Please reserve an IV for medical situations only.’ Or ‘I would prefer to give birth vaginally. Please avoid cesarean birth, unless medically necessary.’” 

The practical structure. “The best way to frame your birth preferences is to start with a short paragraph directed at your doctor, midwife, and hospital staff, thanking them for taking the time to read through your preferences,” says Shapiro. You might note that you appreciate their expertise and that what follows will outline your hopes in an ideal situation—but that you understand if a birth does require more medical expertise, you will rely on their guidance. “Many parents-to-be also ask that all procedures be communicated to them in nonemergency situations, so that they may be part of any decision-making process,” says Shapiro.

When to bring it up. The earlier you can discuss your birth preferences with your care provider, the better, since discussing your wishes is a way to clarify whether they are a good match for you. “If you are sure you want to stay with your doctor or midwife, then ask them about making a specific appointment to give you enough time to discuss your birth preferences,” says Shapiro.