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From pain meds to cord cutting, having a plan helps you outline your desires for the big day

By Gina Roberts-Grey

Pregnancy can be overwhelming, with its constant choices — keep drinking regular coffee or switch to decaf? Build baby a nursery or buy a bassinet for in-room sleeping? And that’s not even considering labor and delivery decisions, which you definitely don’t want to rush. That’s where a birth plan comes in: it gives you the chance to think about baby’s arrival in advance. 

Planning for labor and delivery means you and your partner can bounce ideas off each other, your healthcare provider and your family before contractions set in, says Afshin Malaki, MD, an ob/gyn with Banner Health Center in Surprise, AZ. “The more decisions you make ahead of time, the fewer last-minute decisions you need to make while in labor,” says Malaki — since your thinking is likely not as clear then. 

For example, your baby’s umbilical cord can be cut immediately or you can wait until it has stopped pulsating, says Malaki. “There are medical benefits of both, so it’s best to consult your doctor during one of your prenatal check-ups to decide which is best for you before giving birth,” he notes.

Why Is a Birth Plan Important?

“Birth plans reflect a woman’s wishes regarding various aspects of her labor, delivery and postpartum course,” says Beth Davis, MD, an ob/gyn at Texas Children’s Pavilion for Women andprofessor of obstetrics and gynecology at Baylor College of Medicine in Houston. This record of your specific decisions, like whether or not you want an epidural, lets the delivering doctor or midwife, attending nurses, and your spouse, birthing partner, or doula know your preferences at every step of the way. 

Keep in mind that some choices, such as breastfeeding, skin-to-skin contact with baby after delivery, and having baby sleep in the recovery room with you, have been shown to be the healthiest options for you and your baby. If you have something else in mind, a birth plan is a good opportunity to talk with your healthcare provider about the important benefits of these best practices.

How to Create and Distribute Your Birth Plan

Birth plans are best created in the third trimester, when your ob/gyn has a clear idea of your health and the baby’s and can advise you appropriately about delivery day.

Ideally, aim for a one-page document that’s easy to read. The most helpful birth plan is one that’s concise, Davis says. Using key headings (such as “pain management,” “feeding baby”) with bullet points beneath is often the easiest. Your hospital or provider’s office may provide a template for you to fill out; we've created a birthplan worksheet for you. 

Davis suggests reviewing your plan with your provider to make sure expectations are clear on both sides. “Your physician will also inform you of any hospital policies that may affect some of your delivery preferences, because some hospitals limit how many people may be present in the delivery room or don’t allow video of the delivery, for example,” she says. 

Once you’ve finalized your plan, tuck it in your hospital bag so you and your spouse, birthing partner or doula can refer to it, if needed, throughout labor. Bring extra copies in case of shift changes among hospital staff. You may be able to include your birth plan formally in your hospital record, too; check with your provider.

Know That Things Can Change

Remember that despite the best-laid plans, labor is not something you can script. Even if you want an all-natural birth, Davis suggests jotting down a few notes in case of a C-section or epidural. “Flexibility is key when it comes to birth plans, and it is a good idea to have back-up plans in case the unexpected occurs,” she says.

Flexibility is also helpful in case you want to think twice about something once you’re in the delivery room.

“Just because you make decisions before labor, there’s nothing wrong with changing your mind once you actually go into labor,” says Malaki. “Considering the possible changes while crafting a birthing plan helps you be prepared for several ‘just in case’ situations.”

And remember, whether you follow your birth plan to a T or decide to go off the script, “Everyone will still be focused on both mom and baby having a healthy labor and delivery,” says says Carlos W. Benito, MD, MPH, MHA, a maternal-fetal medicine specialist in Morristown, NJ.

Published on November 13, 2015.

Gina Roberts-Grey is an award-winning writer based in upstate New York who specializes in health and wellness articles and celebrity interviews.