Creating a birth plan is a helpful, and often recommended, exercise for any expecting mom. It makes total sense to prepare for the big day by envisioning what will make you and your partner feel comfortable, safe, and empowered. The best birth plan is one that allows for flexibility. Labor may not be what you anticipate – the discomfort level, or any other unexpected issues that may arise – so give yourself and your trusted care providers permission to adjust the plan as necessary.

Think of the plan as preferences or wishes, rather than rigid demands. If you feel the need to approach the plan in a defensive way, then consider the possibility that you may not be with the right provider or best birth site to begin with.

You may have an overarching wish to have no intervention unless medically necessary, and even then, only after adequate discussion of why the intervention is needed and any risks associated with the procedure, except in the event of an urgent situation that requires immediate action. For some, that statement says it all. Others prefer to include more detail in their plan, which is also fine. One rule of thumb – try to keep the plan to one page. If you start to get into too much minute detail or include an entire story of how poorly your past birth went, then your provider and nurses will have more difficulty focusing on what is most important to you for this birth.

There are many birth plan templates available for free over the internet. These templates offer you the opportunity to think through your wishes and write them down. These notes, in turn, can be used to have a conversation with your provider. With the advent of electronic medical records, your midwife and doctor can then type your birth plan right into your chart. This way you won’t have to worry about forgetting to bring your notes to the hospital. For this approach, you want to be extra careful not to get too wordy.

What are some of the requests that may be included in a birth plan?

Try to focus on elements that are not automatically offered at your birth site. For example, if your birth site already promotes rooming in, there’s no need to list that item as a request. You do want to share what your desires are for pain relief, such as natural comfort techniques, nitrous oxide (if available), analgesics, or epidural anesthesia. If you choose non-medical comfort methods, list the ones you hope to use – relaxation, the labor tub, walking, breathing exercises, the birth ball or peanut ball, massage, or position changes. Find out if your provider and birth site support snacking during labor and which foods are OK. Review options for ways to monitor your baby’s heart rate. Continuous monitoring is generally not needed for a normal labor and it diminishes opportunities to be more mobile. Intermittent external fetal monitoring or intermittent auscultation, which involves the use of the doptone rather than the machine, are other options that you may request. Let your birth partner, your nurse, and your provider know if you have any aversions to being touched during your labor and also what kind of environment is most soothing for you: dimly lit and quiet or a more chatty atmosphere with the TV on as a distraction? Finally, share your plans for feeding your baby (breastmilk or formula), and if you have a boy, whether or not you plan to have your baby circumcised.

The best birth plan is one based on trust in those who are caring for you. Your birth partner, provider, and nurse are your support team and have your health and safety, and that of your baby, in mind. More important than what you write down in your plan is your relationship with each member of that team. Make your preferences known but be tactful as you would in any relationship you are building or maintaining. Be sure that your partner is aware of all your wishes so you have an advocate throughout the experience which will free you up to focus on the most essential piece: moving through your labor as safely and easily as possible.