Birth Plans – Tool or Terror?

Is it possible to plan a birth?

Does creating a birth plan lead to disappointment and feelings of failure if the birth doesn’t follow the intended path?

What happens if everything changes during labor?

We all know that unexpected things happen in labor, right? And most people agree that “healthy mom, healthy baby” is the ultimate goal. So, directing our clients and students to make a detailed plan for labor seems like setting them up for failure! Is it a better idea to enter labor with an open mind so there is no disappointment if things change along the way?

Birth plans have come in and out of fashion a number of times over the years. The argument against them tends to go as written above. It seems to make sense, right?

Today, I’m going to encourage all of us to look at birth plans in a slightly different light! First, let’s break down some of the statements above.

Is it possible to plan a birth?

Perhaps we can blame the commonly used name “Birth PLAN” for this particular misunderstanding! If you write a birth plan to determine how your labor will unfold, then you may very well encounter disappointment. Thankfully, this is NOT the intended use of a birth plan. When studies look at birth plans and their relation to birth outcomes, they find that having a plan does not guarantee an improved outcome (shocking!). However, studies that look at women who used a birth plan as a communication and education tool show that both the women and their birth attendants found the plans to be valuable.

Education Tool

There are two educational purposes for creating a birth plan. First, the act of creating the plan causes the parents to search out and think through all of the options that are available to them with their care provider and at their birthing location. In order to write a narrowed down list, they will need to sort through which choices are the most important for the mom and for her baby. In the professional world, we call this “values clarification”. When preparing for birth, there can be an overwhelming amount of options! The exercise of creating a birth plan causes parents to think through which are the most important choices for their unique family in their unique situation. We can guide this process through classroom activities, or simply allow the parents to discover on their own which items are the most important to include in their plan.

Communication Tool

Second, a birth plan acts as a communication tool. As the mother and her labor partner/team discuss what she wants to include in her plan, it ensures that everyone is on the same page and hopefully all on board! If not, this can be a good opportunity to talk through any disagreements BEFORE they get into the delivery room! Once written, the birth plan should be taken to a prenatal appointment to look over with the care provider. He or she can look at each option and let the parents know whether that is something that is available and/or possible. They can also find out which of the items on the list are already standard practice at the hospital or birth center.

What happens if everything changes during labor?

Labor is unpredictable – as we all know well! A mother may plan to have an natural birth, a water birth, or a birth center birth, but due to unforeseen circumstances, she finds herself with Pitocin, an epidural or even a C-section. There is a real chance of her feeling disappointed with her outcome. This can lead to increased stress, tension in close relationships and an increased risk of postpartum depression. Still, the answer is NOT to avoid making a plan! Since we’ve just learned that the purpose of a birth plan is education and communication, here is where you can really help her to increase her benefit. I encourage all of my students and clients to make a Birth Plan B. Once the parents you are working with find the ideal choices for their birth, you can guide them through how those choices would change if they needed the above interventions—especially a C-section. Most parents are totally surprised to learn that entering an OR to have a baby does not mean they no longer have any options!

Having a plan means that they can continue to be active participants in making decisions for themselves and their babies. As doulas, we are taught to protect a mother’s memory of her birth. To safe guard it whenever we can. Because we know that a mother’s view of her birth—how she felt she was treated, whether or not she felt listened to, and how much she participated in the decision-making processes during her labor—are nearly always more important than the actual twists and turns that the labor takes.

The mothers who struggle the most are the ones who feel like all of their choices were taken away. When things feel out of control, when the mother feels disrespected or forced into a decision, that is when we start to see some of the negative outcomes listed above. If her first plan goes out the window, knowing that she has already thought through other options keeps her from trying to create a plan b in the middle of plan b!

Healthy Mom, Healthy Baby

This is a phrase that many people use. Many teachers teach it. Many families adopt it. There is some obvious truth to this statement. But what about the moms who come out of their labor healthy and with a healthy baby, but they still find themselves feeling traumatized from their birth experience? Should we tell them not to feel that way because they achieved the Healthy Mom, Healthy Baby goal?? (Of course not!) What about the moms who have a baby who is not perfectly healthy? Do they have cause to believe they failed in some way?? (Of course not!)

As you can see, there is a lot more to this issue! There are so many layers to this process we call childbirth. To oversimplify it discounts or dismisses many families’ experiences. However, providing our clients and students with the tools they need to remain active participants in decision-making stacks the deck in their favor. Knowing their options and being equipped to communicate them clearly can transform how they experience their birth process—which can have lifelong effects.

So, what are we to do?

While a birth plan cannot guarantee a smooth, satisfying birth outcome, it can be one piece of the puzzle that helps parents prepare to make choices and navigate the waters of labor and beyond.

We want to set our students and clients up for success! By using birth plans as a functional tool for education, values clarification and communication, we can help them set realistic expectations and prepare for the unpredictable with confidence!


Laura Speece

CLD, CCCE, Childbirth Educator & Labor Doula Faculty

In addition to being a Faculty Member, Laura is a CAPPA certified labor doula & childbirth educator. She is also the Essentials Program Director at Vintage Remedies, a school of natural health. These two passions blend together beautifully and allow Laura to offer classes that meet a variety of needs in her community – from preparing for birth to caring for your family’s health naturally. She currently resides in Charlotte, NC with her husband, Eric, and their five young children. For nearly a decade, Laura has had the honor of working with families all over the Charlotte area. As Childbirth Educator Faculty, she is thrilled to help equip others to do the same! To learn more, you may visit her website at www.naturalabundance.me.

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