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Do I really need a birth plan?

There's a lot to talk about as you prepare for your little one's arrival, and your birth plan is bound to come up. Just by the name, it's pretty clear what it is, but do you really need a birth plan? Here's what I talk about with my patients and their families.

It's about having a conversation
The best thing you can do is have a conversation with your provider. It's talking through what type of pregnancy you're having, labor and delivery options, and different scenarios that may occur. This gives everyone an understanding of your preferences and expectations before the big day arrives. Capturing the details on paper may be helpful to you too, but it's not a must. When you check in to deliver, sharing the birth plan with your nurse by having a conversation is the most helpful; and be sure to provide any plan you've captured on paper.

What should be talked about

  • Pain management: Almost all women want to know how to control or manage pain. There are many options including different labor positions, birthing tools, hydrotherapy, nitrous oxide ("laughing gas"), integrative services and medicinal options. With so many options, talking through them is helpful.
  • Delivery scenarios: Your labor and delivery may not go as expected. Sometimes this means having an unplanned Cesarean delivery, or other interventions you thought would not be needed. Discussing with your provider about the type of pregnancy you are having and potential scenarios that could happen is a must.
  • Baby care: This is a good time to discuss the routine care that your baby will receive in the hospital, such as a hepatitis B vaccination, vitamin K injection, and antibiotic eye ointment.
  • Special concerns: This goes without saying, but you should feel comfortable bringing these up at any time in your prenatal appointments. This could include: personal or cultural requests; childcare issues and transportation concerns.
  • Who do you want to be present?: Do you prefer only your partner or support person there, or are you OK with having other people present? This often gets overlooked but making your preferences known in your birth plan will lessen confusion and increase your satisfaction. Your provider may have recommendations for how many people to have in the room.

 Planning tips and advice

  • Third trimester: A good time to start talking about the birth plan is in the third trimester if you haven't already.
  • Questions welcomed:  Bring up any questions or concerns—this is your birth plan!
  • Shorter is better:  Try to keep a written plan relatively short and to the point, otherwise the most important aspects may get lost in the details.
  • It's a goal, meant to be flexible: The birth plan is really a birth goal or guideline for what we hope to happen. I think it's important everyone has a realistic understanding of what may or may not happen while being open to changes if needed. It can help alleviate stress when unexpected delivery scenarios have already been discussed, causing less disruption.
  • Change is OK: It's OK to change your mind on something, like pain management options. We never know how long labor and delivery will take and the goal of this journey is to have a healthy mom and baby.
  • Self-care for the support person: Eat and stay hydrated if you are supporting mom through labor and delivery. Life will be wonderfully different after baby has come, so make sure you are taking care of yourself leading up to the little one's arrival.


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