A Midwife’s Tips on Making a Birth Plan
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Published on January 13, 2017

pregnant woman with hands on belly

A Midwife’s Tips on Making a Birth Plan

When you’re preparing for the birth of a child, it’s pretty common to have high expectations.

Many women believe they will be admitted to the hospital, assume the “birth goddess” position and quickly deliver a healthy baby. It will be a beautiful, miraculous, Facebook-worthy event, free of missteps and stress.

Others may worry everything will go wrong. They will require a cesarean delivery when they wanted a “natural” birth. They won’t be allowed to hold their baby and fail when it comes time to breastfeed.  Their therapist is standing by due to anticipated trauma.

When an expecting mother says “I have a birth plan,” some nurses, doctors and even some midwives might cringe. As a midwife, I worry these women may be disappointed or upset if they don’t have their expectations met. That’s why I encourage patients to write down a birth “vision statement” that spells out what is important to them. We can review it together during a prenatal appointment. It helps me, along with the rest of the care team, to keep the focus on preferences. We can talk about goals, expectations and naturally the most important goal: Healthy mom and baby.

Consider these ideas:

  • Use the phrase “We hope to …” instead of “We don’t want …” How you frame preferences can impact how happy or disappointed you may be with your experience.
  • How can we help you in labor? It’s not uncommon to see, “Do not give me medication, even if I beg for it.” I had a patient make this request. She later begged me for IV medication, and I refused. The family thought I was the meanest midwife ever, but happily the natural-childbirth-focused patient was grateful. Maybe write, “Don’t offer me medication for pain; if I want it, I will ask.”
  • Who is going to be with you? It could be your spouse, your mother or perhaps your third cousin and her volleyball team, but please: be picky and specific. We haven’t set up bleachers yet, but we will aim to meet your requests and discuss what’s reasonable.
  • What if you need a cesarean birth? What is your plan if the baby needs to go to the Neonatal Intensive Care Unit? It’s important to stay positive, but birth can be unpredictable. It’s best to have specific plans for these scenarios, because you are the owner of your plan.

We know you may change your expectations as you go. That’s OK! One of our patients had a very extensive birth plan with her first baby, but by her fourth pregnancy, her goals changed. She said, “I plan on coming in labor, getting my epidural, taking a nap and then pushing out a baby.”

We always hope to exceed your expectations, and we celebrate that every woman’s goals are unique. A birth plan – or even a one-sentence vision statement like the above – will help us make what is important to you priority.

I close this with a nod toward the nativity scene. I doubt that Mary, mother of Jesus, predicted her birth would take place in a foreign land where a stable designed to house animals became her delivery room.  Yet it’s one of the most beautiful births in history; it was perfection. It’s a good reminder that great things still can happen even when they don’t go according to your (birth) plan.

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