Do You Really Need A Birth Plan?
Monday, March 2, 2020
If you are pregnant, you’ve likely already heard that you shouldn’t make plans for your birth: things don’t go as planned, birth is unpredictable, planning for it might just set you up for feelings of failure or disappointment. You’ve probably heard that your only plans should be to have you and your baby come through the birth healthy.
In a recent New York Times article about doula support, one of the doctors interviewed, Neel Shah, said, “It is important to remember that people have goals other than simply emerging from childbirth unscathed.” He continued: “Safety during labor is the floor of what people deserve. What we should all really be aiming for is the ceiling: care that is not just safe, but also supportive and empowering.”
I want that for you and I believe making plans for your birth is essential to having a supportive and empowering birth experience. Having a birth plan is about helping control the elements that are controllable, making choices that resonate with your desires, and understanding what to expect, including how things might change.
Making plans for childbirth is akin to planning travel adventures. Every year my family takes a summer vacation and there’s a lot of unpredictability and surprises. Yet I book airline tickets, even though flights are sometimes cancelled, delayed, or overbooked. I reserve hotel rooms and rental housing even though we’re occasionally disappointed by the quality or cleanliness of our lodging. You’ve likely had similar experiences.
Even with the possibility of being let down, we make plans. We do this because making plans ultimately reduces the chances of having those disappointing experiences. For my family, the plans we make are part of what makes the vacation pleasurable. We know ourselves. We know what we like from our experiences. We know how this might differ from what other people might enjoy.
Your birth is no different.
While childbirth is unpredictable, there are a limited number of variables to understand. If your doctor has high Cesarean birth rate and you don’t want a Cesarean birth, you should consider the plans you’ve made and whether you want to alter that plan to more closely match your desires. That said, if you are planning a Cesarean birth, this same doctor might be an excellent match. If you’d like to avoid an epidural and pick a hospital that offers other labor-coping options (nitrous oxide, tubs or showers, mobility, for example) then you’ve made a plan that matches your desires.
You know yourself. You have lived in your body your entire life and you likely do not need to radically reorder who you are in order to have your baby. In your birth, you can want whatever you want, make whatever choices match your preferences, and do whatever you need to do. It’s not about the specifics of the birth plan you are making but, instead, about the process of making the plan and figuring out what you’d like from this experience.
You might already have really clear ideas about what you want or you might not know enough yet to make those plans. Gathering information to make choices about where you are going to give birth, who you are going to have with you on your birth team, and what it looks like for you to have a positive experience might be what you still need to do as you imagine and plan for your birth. You might read childbirth books, listen to podcasts, talk to family or friends, take a childbirth class, or read birth stories online as you gather information and think through your preferences.
And, it is true that birth can be unpredictable. Sometimes plans need to be altered and being able to embrace change is valuable.
A birth plan, and the research and conversation involved in making it, not only helps you know what to expect but it also helps you make sure you are in the right place to get what you want. Each provider and birth location will have different routine practices, policies, and protocols and they vary widely. A birth plan (and the process of making it) helps prevent spending time during your birth in conflict. If you are opposed to an IV, for example, picking a provider who routinely supports people without IVs is good planning. If you know you want access to a tub during labor, picking a location where this is available is key. If you want an epidural in early labor, having a provider that is supportive of this will prevent conflict or disappointment. Planning for your birth ensures your desires and well aligned with the birth team you have built and the birth location you have selected.
Further, planning for your birth helps you communicate with other people who’ll be assisting you during birth: partners, doctors or midwives, nurses, doulas, family, assistants. While it might be partially a plan you write down—and I recommend you do write some things down—it’s also a conversation. Letting people know what you’d like, what will help you feel safe and supported, and if there are things you don’t want is important and can ensure your team is able to be there for you in the ways you need.
As much as childbirth is unpredictable and plans can change, you do ultimately have control over many elements of childbirth and the plans made leading up to birth are important. Having a healthy baby and coming through birth “unscathed” really is the base level assumption of goals in childbirth. You can want more! If you do, plan for it.
\*Parts of this essay are adapted from Your Birth Plan: A Guide to Navigating All Your Choices in Childbirth.
Megan Davidson is a certified labor doula, postpartum doula, childbirth educator, and lactation counselor. She is the author of Your Birth Plan: A Guide to Navigating All of Your Choices in Childbirth, as well as several essays about doula support and body size in pregnancy.
Megan has attended nearly 600 births in NYC hospitals, birth centers, and homes and she has supported almost 1300 families postpartum. She has assisted clients with every type of preference, intervention, and outcome available.
Beyond her certifications and extensive birth experience, Megan has experience working as a rape crisis and domestic violence advocate in hospitals and police stations and brings this background in nonjudgmental advocacy to her birth work. Megan also has a PhD in Anthropology from Binghamton University (SUNY). She lives in Clinton Hill, Brooklyn with her family.
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