Is a birth plan really necessary, or is it just one more thing to stress about during pregnancy? In this episode, we answer a listener’s question about whether creating a birth plan is worth the time and effort. Some expecting parents feel it is pointless because birth rarely goes exactly as planned, and even some doctors and midwives may downplay its importance. Learn what a birth plan actually is, when it might not be needed, and when the process of creating one can be especially valuable. Plus, tips to keep it simple and avoid feeling overwhelmed.

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Hi Vanessa,

Thank you for the Pregnancy Podcast I have learned so much from listening, and it has really helped me feel more informed and prepared during my pregnancy. I know you recommend making a birth plan, but I am wondering how necessary it really is. At my last prenatal appointment, I asked my doctor about it, and she said it is not really needed and that the nurses will walk me through everything when I am in labor. My sister said there is no point in making one because nothing went according to her birth plan, and it just left her feeling disappointed. I am feeling really torn. Is it worth putting in the time and effort if things might not go as planned anyway? I want to be prepared, but I do not want to overcomplicate things or stress myself out.

Thanks again for everything you do,

Elise

Your Birth Plan

Elise, thank you for your email and for sharing that you are feeling conflicted about your birth plan. A birth plan outlines your vision for the birth and what happens immediately following the birth of your baby. When you do it right, you know your options, you collaborate with your doctor or midwife so you are on the same page, and you go into your birth confident and prepared. While the result is a concise sheet of preferences, the real value is everything you do to prepare before handing it to your care provider.

When Do You Not Need a Birth Plan?

While I aim to present balanced information so you can make your own choices, there are a few things I strongly recommend, and creating a birth plan is one of them. Although I think it’s a good idea, there are some cases in which it’s unnecessary.

It takes a lot of time and energy to educate yourself and make informed decisions about your pregnancy and birth. Some expecting parents feel confident letting their care provider take the lead and do not feel the need to research every decision. If that is your approach and you feel good about it, that is entirely valid. As a listener of this podcast, you likely value having a say in your birth experience.

One instance in which you may not need a physical birth plan is is when you are confident that your doctor or midwife supports the birth you want. In this case, you have likely been verbally working on your birth plan with your care provider throughout your prenatal care. If you are planning a vaginal birth and circumstances change, requiring a cesarean, are you confident that your provider understands and supports your cesarean preferences as well?

In addition to you and your provider being aligned, you may not need a birth plan if you know, without a doubt, they will be present for your labor and birth. If you are seeing an independent provider, is there a possibility that another patient could go into labor at the same time? Do they have any travel or planned time off that could conflict with your birth? Who is their backup in the event they are not available to attend your birth? If someone other than your primary care provider could attend your birth, you may want a physical birth plan to provide them.

Many practices have a group of providers, and the one who will show up is the doctor or midwife on call. Also, if you are planning to have your baby at home or a birth center, there is the possibility you will transfer to a hospital, and you may want a backup plan to provide the staff there.

Does Your Birth Plan Have to be Written?

Although the value of creating a birth plan has much more to do with everything leading up to printing a sheet of paper, there is value in having a physical, written birth plan. There are several reasons why I recommend this.

First, this is a great way to double-check that everything fits together and there are no conflicts. Seeing all of your preferences in print or on a screen may allow you to catch conflicts or other errors that you would miss when solely creating this in your head.

Reviewing your birth plan with your doctor or midwife is essential to making sure they align with you. Having a written plan makes it easier to reference and helps ensure that you discuss every detail without overlooking anything important.

A written plan provides your partner or anyone else attending your birth with a concise overview of what you want. Support during labor can be from nurses, doctors, or other support staff. You will have support staff present with whom you have yet to establish a relationship, and they will not be familiar with your preferences. Rather than explaining everything and risking leaving out essential details, you can hand them a physical copy of your plan.

What if Nothing Goes According to Your Plan?

Elise, you mentioned that your sister said there is no point in making a birth plan because nothing went according to her birth plan, and it just left her feeling disappointed. First, I’m sorry to hear that, and I’m sure it must have been incredibly frustrating. The process I recommend for creating a birth plan also includes making a backup plan. If you plan a home or birth center birth, you should have a backup plan in the event of a hospital transfer. If you plan a vaginal birth you should have a backup plan for a cesarean. The reason is that if things do not go according to your plan A, you have a plan B.

Evidence shows that having birth plan requests fulfilled influences your satisfaction with your birth. While parents write a birth plan and go into labor with the best intentions, some of those birth plan requests are not fulfilled. In a study of 178 low-risk mothers with birth plans, only 7.9% reported that their birth plan was fully met. 3.4% said the birth plan was not fulfilled on any points. For 27%, only 25% of their total preferences were met. 32.5% reported that half of their preferences were met. 29.2% reported it was fulfilled, 75%. Again, simply providing a written plan does not ensure your provider will follow any of it. It is essential to work with your care provider to ensure they support your preferences.

Is it possible that things may not go according to your plan? Yes, that is a possibility. However, by educating yourself and understanding your options, you will be much better prepared for alternative scenarios. Plus, you will have a clearer understanding of your options. This is especially important during labor, when there may not be much time to discuss the details of the pros and cons of interventions. If you already have a basic understanding, it is much easier to make a confident decision. Especially if the circumstances change and your provider puts you on the spot to make a decision. The more your preferences are acknowledged and supported, the more likely you are to feel satisfied with your birth, even if everything does not go exactly as planned.

Is a Birth Plan Worth the Effort?

When done right, the most significant benefit of having a birth plan is the confidence you have going into labor, knowing what to expect and how to navigate labor and birth. There is so much information you can consume during pregnancy, and you could spend every waking minute planning ahead for your birth. The last thing I want is for you to feel like you are overcomplicating things or stressing yourself out.

I would take stock of the information you currently know and assess whether any specific preferences are important to you at this time. For example, maybe you know that you want to delay umbilical cord clamping. Discuss this with your care provider at your next prenatal visit. Ask them about their practice and let them know that this is something important to you. Also, discuss this with your partner or a doula if you have one, so they can help advocate for you.

If you are feeling stressed out by the process, take a step back and take a break from working on your birth plan. It is okay to pause and revisit this when it feels more manageable. When you are ready to revisit your birth plan, ask yourself: What would this look like if it were easy? The Pregnancy Podcast offers a range of tools that you can use, so you’re not reinventing the wheel. The Your Birth Plan Book features sample plans and a downloadable template that you can customize to fit your preferences. The framework I lay out for creating your birth plan is to walk you step-by-step from start to finish. You can tailor this to fit what works for you.

Whether or not you create a birth plan, be sure to have a conversation with your doctor or midwife. If you feel confident in their response that a birth plan is not necessary and that the nurses will guide you during labor, that is perfectly fine. But if any part of that leaves you feeling uncertain, bring it up and talk through your concerns.

There is no one-size-fits-all approach to planning your birth. Use what is helpful, and let go of what is not. My goal is always to equip you with the information and confidence you need. For many parents, creating a birth plan is a key part of that. Creating a birth plan is not about scripting your birth; it is about preparing for the many possible paths it could take. Whether you decide to make a detailed birth plan or not, you deserve to feel confident and supported as you prepare for birth. Trust yourself, and use the tools that serve you best. You should also feel good that you have trained and experienced experts who will be with you every step of the way through your labor and birth.

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