What a Birth Plan Actually Is

A birth plan is a place to communicate what support you need and how you want to be treated.

That's it. That reframe changes everything.

It's not about the procedures. It's about the people — how you want the medical team to interact with you, what matters most to you in terms of how decisions get made, and what your baseline needs are as a human being going through something enormous.

I made my birth plan with my therapist. My question to her was: from your perspective, what do women typically overlook in birth planning? Her answer was immediate: most women who hold their birth plans too tightly end up disheartened when birth inevitably gets complicated. The goal, she told me, wasn't to script my birth — it was to prepare for what was in my control and trust the people around me when the time came.

That reorientation changed how I approached the whole thing.

What to Actually Include

Here's the framework that actually matters. Keep it to one page. Anything more than one page is unlikely to be read in full by a busy labor and delivery team, and the more you write, the more you've left to feel disappointed about.

Your top priorities. What matters most to you? Healthy mom and baby? Feeling informed before decisions are made? Managing pain effectively? Being treated with kindness rather than clinical efficiency? These don't have to be elaborate — they just need to be honest.

How you want to be treated. This is the piece most people skip entirely, and it's the one that will probably affect your experience more than anything else. Do you want things explained to you before they happen? Do you want gentleness over directness? Do you need time to process before decisions are made, or do you prefer people to just tell you what needs to happen and do it? Your medical team are professionals — but they can't know your preferences unless you tell them.

Here's what I put in mine: I prefer gentleness and kindness over being prescriptive or getting tough love. If a procedure or change needs to happen, I would like to understand why the choices are being made and to understand my options.

Simple. But it shaped every interaction I had with the staff in a way that mattered to me.

Your thoughts on pain management. This is important to name clearly, because it's also where a lot of people encounter pressure they didn't expect. Pain management during birth is a decision made by the person in pain — full stop. Your baby will be perfectly healthy whether you manage pain with medication or without. This is about what youneed, not what anyone else thinks you should want.

It's also worth knowing that managing pain effectively can sometimes help you avoid interventions later — if you're less exhausted when it's time to push, you may have more strength for delivery. So whatever your preference is, own it without apology.

State clearly whether you want all forms of pain management offered to you, whether you plan to get an epidural, whether you want to wait and see, or whether you intend to go unmedicated. And make sure your partner knows how to advocate for those wishes if you're not in a position to advocate for yourself in the moment.

Your feeding intentions. State this clearly, especially if you're delivering at a Baby-Friendly Hospital. A Baby-Friendly designation means the hospital implements protocols designed to promote breastfeeding and parent-child bonding — which sounds good on paper, but in practice can mean staff who are quite militant about maintaining an exclusive breastfeeding plan even when your baby isn't getting enough food or you aren't getting enough rest.

If you only state that you intend to breastfeed, you may find it very difficult to get formula supplementation or any flexibility later — even if breastfeeding isn't working, you're exhausted beyond functioning, or you simply need a break. Even if you are completely committed to breastfeeding, I'd recommend stating on your plan that you are open to both breastfeeding and formula. It creates space for you to make real-time decisions based on what's actually happening, rather than what you planned.

Here's how I phrased mine: I intend to do both and would like to be coached on how to do both from the start. We are optimizing for a fed baby and a mom who can recover.

That framing — a fed baby and a mom who can recover — became a north star that helped me make a difficult decision about breastfeeding in the days that followed. It gave me permission to choose my own wellbeing as part of the goal, not in opposition to it.

What support you need in the hospital. Don't overlook this one. You are going to be recovering from a major physical event. You will be exhausted. You will be learning how to care for a newborn with almost no sleep. What do you actually need from the nursing staff?

For me, this was: support around how to care for the baby while I'm in the hospital, and help with some of the baby care so I can have time to recover.

That part of my birth plan led directly to one of the best moments of my hospital stay. A nurse came into my room after a long day and asked if I was exhausted. I just nodded. She said: if you explicitly tell me to, I can take the baby and give them a bottle of formula so you can rest. And if you tell me you need me to take the baby to the nursery, I can take them for up to an hour.

She took him for three hours. I got three consecutive hours of sleep. That nurse saved my sanity.

And in case you're wondering: those three hours away from me did not ruin our baby. We have a very secure, happy, well-adjusted child. A healthy, rested mom is better able to take care of her family. Period.