Are Birth Plans Reliable?

In a word no. Birth plans are not reliable. Birth can go exactly as you imaged or go off the rails at any point. When I help clients prepare for birth, I call these plans, preferences. I usually go through all scenarios and make the best preparations for each scenario–even if it is one they don’t want or is not expected.

If you are planning a holistic natural waterbirth with a medicine woman using anointing oil and chanting children who are smudging your space with sacred white sage, plans can and will change. Without thought and some preparation (like a list of preferences), something that derails in your plan can set your mind on fire and fill you with fear. Even if the hospital cannot grant some of your preferences, the mere fact that you know what may happen in each scenario will put you at ease, lessen fear and allow you to accept a birth story that is different from your envisioned one.

Does a doula help with birth plan preferences?

Yes. A hundred percent yes. I would be leery of a doula who doesn’t go over all scenarios. If your doula is simply writing down all your wants and then putting it on a nice sheet of paper for your doctor or midwife and neglecting to go over alternative scenarios, then they may be doing you a disservice. You should know what may happen in X scenario or Y scenario or even Z scenario.

Won’t I be sad if my birth doesn’t go to plan?

Firstly, remember there is no plan. There are preferences.

Secondly, if you have your heart set on a specific plan and it goes sideways and no thought has been put in to alternate scenarios, you may be sad. That’s not really for me to say. What I will say, is the better prepared you are, the less likely fear and anxiety will take hold should things go differently than what you envision.

Let me explain what I mean by preferences for different scenarios. Below is a quick example of a birth plan that I tend to use. What is in each category is entirely up to you. This is one I used for a recent hospital birth.

After the preliminaries such as who the birth person is, their support people, the EDD, allergies, etc., it looks something like this-

Labor Preferences

We wish to have a calm hospital birth. We will be using hypnobirthing techniques therefore
environment and language is very important to us. We would appreciate not using the words pain and
contraction and use surge , strength, power and intensity.


Intermittent monitoring is requested and preferably with a wireless unit so I can maintain mobility.


Sight- It is very important that the lights be dimmed throughout labor with use of electric tealights
and/or Fairy lights. Our doula and photographer will be taking photographs. She does have a flash unit
and if it causes distruption in my labor, she will turn it off.
Sound- We have our own music soundtrack.
Smell- We will have essential oils.
Touch- I may use a Tens machine during early labor. I will be wearing a hospital gown.
Taste- I plan to eat and drink normally. I will be bringing snacks and drinks to the hospital.

Pain Relief

Please remind me of the tools I do have which include my breathing techniques, visualizations,
massage, heat pack and cold pack, positive affirmations and shower. Please do not offer pain relief
as I will ask when it is needed.
Additionally I do not want any opioid pain medications, but will consider an epidural only if I am unable
to rest or unable to progress due to discomfort. I would like a “walking epidural” if possible to retain
some movement and awareness.

During Birth

Ideally I do not wish to be lying on my back. I would like to be in a position that promotes
UFO–upright, forward and open which facilitates a quicker and easier birth.
I do not wish to be coached to push, but rather follow the lead of my body and breathe baby down
so baby is born gently and calmly.

After Birth

I would like baby brought to my chest immediately after. If that is not a possibility, I would like my
partner to do skin to skin.
It is important for the environment to remain calm after baby has been born.
I would like delayed cord clamping until all the blood has gone to baby.

Assisted Delivery

Unless there is a medical Emergency

I would rather wait longer, than rush the process.
Unless the baby is in distress, I prefer to obstain from the use of any aggressive measures
including vacuum or forceps. There would need to be a significant medical need for
an episiotomy.

Unplanned Cesarean

I would like to request a gentle cesarean.
I would like to receive my baby to my chest immediately before cleaning or weighing.
Please ensure any electrodes are placed on back to not inhibit this important skin to skin time.
I would like to request delayed cord clamping.
I would like to see my baby being born, so please lower the curtain or have clear draping.
I would like the lights dimmed at the head end, so when baby is brought to my chest,
baby is not subjected to a bright light.

I would like my choice of music played in theater.
If baby needs to go to the NICU, then I want to be able to care for him/her as much as possible and
use my breast milk. I would like help to make sure this happens.

Anything Else

This is where you can put your desire to have the Vitamin K injection, eye ointment, or the HepB vaccine.

Thank you

Thank you for taking the time to read our birth preferences. I am looking forward to the birth of my
baby and planning for a positive and empowering birth experience. I believe this is possible however
my birth plays out. Thank you for supporting us in this very special time in our lives.

Will a hospital pay attention to my birth plan preferences?

It has been my experience that the nurses will read your birth preference and most midwives and OBs. Most are very happy to have it, but some are outliers and feel it is a waste. Will they be able to accommodate everything you have written? Not likely, but it is important that your support person has a vested interest in what it says so they can advocate for you when your energy is elsewhere. The way the above is written is non threatening, lets them know you have done your research and that you are prepared for different scenarios. I like to add the thank you at the end, reminding them they are appreciated, but it is your birth.

I hope this was helpful for you. If you have any questions or are think about a doula (and birth photographer!), feel free to contact me and learn more.

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