In short: a birth plan is a document with your wishes for the period of childbirth and the postpartum period. It does not guarantee a specific scenario, but it helps the maternity hospital team understand your values and preferences. The best plan is short, flexible, and discussed with the doctor in advance.
What is a birth plan and why is it needed
A birth plan is a short document (1-2 pages) in which you describe your wishes for the management of childbirth: methods of anesthesia, positions, the presence of a partner, the first minutes after the birth of the baby.
It is important to understand that a birth plan is not a contract. Medical circumstances may change, and doctors will act based on the safety of you and the baby. But the document helps the team know your values in advance and, if possible, take them into account.
When to make a plan
The optimal time is the third trimester of pregnancy, between 32 and 36 weeks. This allows you to discuss the document with the doctor at a scheduled visit, correct unrealistic wishes and clarify the policy of your maternity hospital.
Come to the appointment with an already written plan or its draft – it will be easier for the doctor to discuss specific points than to answer the abstract question "what is your custom?"
Section 1: Childbirth – General Wishes
Include:
- Who will be next to you (partner, mother, doula).
- Your attitude to pain relief: "I want to try without", "I want an epidural on demand", "I am open to discussion".
- Free movement during contractions (walking, ball, vertical postures).
- Continuous CTG or only periodic monitoring (if not indicated).
- Music, dimmed light, silence.
Section 2: Pushing and Birth
Include:
- Desired positions for pushing (squatting, on all fours, semi-lying).
- Attitude to episiotomy: "only for emergency indications".
- Warm compresses on the perineum.
- Mirror to see the birth of the baby (optional).
- Who will cut the umbilical cord.
- Delayed cord crossing (1-3 minutes).
Section 3: Immediately after birth
Include:
- Skin-to-skin contact: duration, postpone weighing for 1 hour.
- The first attachment to the breast before the procedures.
- Postpone routine procedures (eye drops, vitamin K) until the end of the first "golden hour".
- The first bath is in 24 hours.
- If there is a cesarean - "soft cesarean", contact in the operating room.
Section 4: If you need a cesarean
Even if you are planning a natural birth, think over the cesarean scenario:
- Spinal anesthesia (wakefulness) or general anesthesia – only if there is no choice.
- Screen to see the birth of the baby.
- Skin contact in the operating room.
- Partner in the operating room (if the maternity hospital policy allows).
Section 5: Newborn
Include:
- Breastfeeding – without supplementary feeding with formula without medical indications.
- Joint stay - the baby is in the same room with his mother.
- Without a pacifier (optional).
- Vaccination – consent or refusal (in writing).
How to draw up and submit a plan
Design the plan as a text document: the font is readable, the structure is clear, and the volume is 1-2 pages maximum. A laminated or printed plan in several copies is easier to keep at hand.
Pass the plan:
- To my doctor at one of the last appointments.
- Upon admission, the midwife of the admission department should go to the maternity hospital.
- A copy is given to the partner.
What not to include in the plan
- Categorical demands without an alternative ("never have a cesarean section"): this is dangerous.
- Medical terms that you don't understand yourself.
- Too long explanations of the "why" – it is enough to clearly state the "what".
When to see a doctor
Discuss the plan with your doctor in advance, especially if:
- You have a high-risk pregnancy, a chronic medical condition, or a previous cesarean section.
- you want to opt out of any standard procedures;
- You have concerns or a past negative experience of childbirth.
Frequently Asked Questions
Do doctors read birth plans?
In good maternity hospitals, yes. A concise, realistic plan, communicated in advance, is perceived as cooperation, not as "instructions." A document overloaded with wishes can make the opposite impression.
Do I need a plan if I'm giving birth for the first time and I don't know anything?
Yes, especially then. The process of drawing up a plan is a great reason to understand possible scenarios and ask the doctor all the questions.
What to do if the maternity hospital does not accept the plan?
Find out in advance the policy of your maternity hospital. Most modern perinatal centers welcome the plan. If you are categorically refused to discuss your wishes, this is a reason to think about changing the institution.
Conclusion
A birth plan is a tool for communicating with the maternity hospital team, not a scenario with a guarantee. A realistic, concise and pre-discussed plan helps you feel like a subject of what is happening, and not an observer. Trust your team and be ready to be flexible.
Bibliography
- WHO. WHO recommendations: intrapartum care for a positive childbirth experience. 2018. https://www.who.int/publications/i/item/9789241550215
- ACOG Committee Opinion No. 687. Approaches to Limit Intervention During Labor and Birth. Obstet Gynecol. 2017.
- NICE guideline CG190. Intrapartum care. 2014 (updated 2017). https://www.who.int/publications/i/item/9789241550215
- Pennell CE et al. The development and pilot testing of a birth preferences document. BMC Pregnancy Childbirth. 2011. https://pubmed.ncbi.nlm.nih.gov/21663677/
- Ministry of Health of the Russian Federation. Clinical recommendations: Normal delivery. 2021. https://cr.minzdrav.gov.ru/
This material is for informational purposes only and does not constitute medical advice and is not a substitute for medical advice. If a child's sleep is accompanied by alarming symptoms, a pronounced deterioration in health, problems with breathing, feeding or weight gain, it is necessary to consult a qualified medical specialist as soon as possible, and not rely only on information from the Internet.
