Before my first baby was born, I had everything planned. I wrote that plan down for my midwife, my hospital staff, and anyone else that might end up involved. My body and my baby didn’t really care about my plan, though, and for the most part it went right out the window. If you're pregnant and have specific hopes or expectations for your baby's birth, it's not uncommon to ask yourself, "Do I need a birth plan?" According to experts, you don't have to have a meticulous plan unless you want one. But if you do decide to create one, there are a few things you should keep in mind.
So, what's a birth plan, anyway? According to the March of Dimes, a birth plan is a document or checklist detailing how you'd like your baby's birth to go. They can include things like pain management, who you want in the delivery room with you, what kind of interventions you do (and don’t) want for you and your baby, and how you’d like to spend your first moments with your baby after they are born.
Birth plans can take a variety of forms, from a simple check list to a detailed document. In one study published in the journal Birth, the most common requests included in birth plans were no pain medication and exclusive breastfeeding. The requests that were most often fulfilled, according to the same study, were no episiotomy and no instruments used in vaginal delivery.
So, will having a birth plan change how your labor goes down? Will the absence of a plan somehow negatively alter your childbirth experience? Research says not really. One study published in the American Journal of Maternal and Child Nurses revealed that, for the most part, birth plans don’t improve or worsen outcomes for either laboring people or their babies.
Birth plans can definitely impact your experience and how you feel about labor and delivery, though. Not surprisingly, a study published in Birth showed that a person’s satisfaction with their birth experience depended highly on whether or not it met the expectations included in their birth plan. The more requests a person had in their birth plan, the less likely they were to be satisfied, which makes a lot of sense, because the more plans you make, the more opportunities there are for those plans to go unfulfilled.
While birth plans are intended to increase communication between a laboring person and the staff who will help birth their baby, they can actually create tension in the delivery room. One study published in Midwifery shows that birth plans might irritate health care providers, especially if they feel pressured or annoyed by unreasonable requests. It might also make you focus too heavily on avoiding outdated or rare procedures. Additionally, if your birth plan is too long or detailed, staff may not have time to review your concerns and address them adequately.
A better alternative, according to Amy Michelle DeBaets, PhD in her article published in the American Journal of Obstetrics and Gynecology, is to meet with your provider before your due date to express concerns, ask questions, and get a better idea of what might be possible for you considering specific hospital policy, your health, and your baby’s health. If you do have a birth plan, it might be better to look at it as a "best case scenario" and go into labor and delivery knowing (and more importantly, being OK with the idea) that everything might not go according to plan.