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How To Create A Birth Plan In 5 Steps, According To A Midwife

Image by Natalie Jeffcott / Stocksy

We know what you might be thinking: What is a birth plan, and what's the point exactly?

The purpose of a birth plan is threefold: The first is to get educated about the many choices and interventions available to you for the birth of your child. The second is to learn the language of childbirth. And the third (and what I believe is most important) is to create a conversation with your care provider, not only to create a trusting relationship but also to find out if your expectations match your reality.

So how do you get there?

Think of birth planning as building a house. Before you pick out paint colors and couches, you need to make sure that the building is being built on a solid foundation, so you work with an architect who helps with the overall vision.

After you lay the foundation, you work on the structure; you have conversations with the different specialists to make sure the walls are properly supported so your building doesn't collapse, the doors open and close correctly to keep you safe, and there is a roof over your head that does not leak, to keep you warm. 

After the structure is sound, then you pick out your paint colors and furniture, sometimes with the support of a designer or friends, other times by yourself on Pinterest.

Before we begin, it's important to take off your “judgment hat" and put on your “choices hat," meaning the information presented here may or may not be the right choice for your family, but that doesn't mean it isn't the right choice for another family.


Determine if you are low-risk or high-risk.

Did you know that assessing your risk can determine not only where you can birth (home, hospital, or birthing center) but also the choices about who can support you during labor (OB, midwife, or family practitioner)?

Ask your care provider whether they consider you high- or low-risk and why.


Understand your care provider's skill level.

No two births are ever the same in the way that no two children are ever the same. The best approach to childbirth is an individualized approach in which you are seen and heard as a unique person. A starting place for understanding your care provider's skill set is understanding their training.

Has your care provider had extensive training so they will be able to educate you about nutrition, exercise, and mental/emotional well-being? Then chances are they understand how to support a low-risk person in childbirth.

Have they had extensive training on emergency surgeries? Then chances are they are a high-risk specialist.

Understanding the nuances of your care provider's training will help you understand how they may and may not support you based on your risk.

Image by Natalie Jeffcott / Stocksy

Educate yourself about necessary & unnecessary interventions.

Interventions can be natural or medical and are used in childbirth for various reason, which include, but are not limited to: supporting the body's birth wisdom, relieving pain, supporting an efficient birth, or saving a life. As in anything, when used inappropriately, they can be harmful, and, when used appropriately they can be supportive.

Take some time to educate yourself about the differences between low-risk and high-risk interventions. Explore the differences between naturally occurring medicines and those that are man-made and more medicalized. Spend some time asking your care provider how they use their interventions.

Do they use them routinely no matter your risk? Or do they see and hear you as an individual and use interventions on an as-needed basis?

You do not need to become a medical professional to understand the ins and outs of every intervention, but having a trusting relationship with your care provider can help you feel safe in knowing that any intervention that is suggested or used is in support of your ideal experience while making sure you and your baby are healthy.


Figure out what safety means to you.

Just because things look safe doesn't mean they feel safe; these are two different things. That is why there are many different choices in childbirth, because there are that many different ways to feel safe.

When you understand your risk and understand the different choices that are, or are not, available to you regarding where you can birth, and who can, or must be at your birth, then you can figure out what safety feels like to you.

If you find yourself getting triggered and you are unable to settle your nervous system, take some time to explore your thoughts and feelings with someone else. Ideally, you will make friends with all choices in childbirth—both low- and high-risk—as you never know what your journey will have in store for you.


Get realistic with your expectations.

For instance, if you are wanting a water birth and your hospital doesn't do water birth? You either need to find a new place to birth or take it off your list.

Or is your blood pressure high and there is a chance you could have a seizure during labor? You are considered high-risk. You need to have your baby listened to 24/7 during labor with continuous monitoring, and having a birth with a surgical room down the hall is a really good idea!

When you line up your expectations with your reality, there is more room, not only to find new choices but also more the choices you may not have.

No matter what your birth plan is, every birth is unique, and the most important thing is to know that these guidelines you create are just that—guidelines—and the safety of you and your baby comes first.

Elizabeth Bachner

Elizabeth is a midwife and founder of Gracefull Birthing in LA. She is dedicated to humanizing childbirth all over the world. She’s been a speaker at spirit weavers, choices in childbirth and the birthfit conference; appeared as an expert on the doctors, love and hip hop Hollywood and Extra; and taught online at Dona. Her insightful childbirth education courses are available both in person and soon to be online. You can find Elizabeth’s free eBook: Childbirth planning–All The Questions to ask at Get inspired and figure out the questions you want to ask by listening to her podcast: Big Birth Junkie