How to Create Your Own Birth Plan (Plus a Free Printable Template!)

Let’s begin with a statement that I repeat frequently for students and clients:

You can't control the outcome of your birth, but you can influence it.

Identifying your preferences and priorities, not strict planning, is what a birth plan is all about. A birth plan is not a step-by-step outline of how labor will progress. Instead, it's a helpful guide for discussing your values and goals for your birth with provider and labor support team.

Think of your birth plan as a tool for communication throughout your birth.

First, creating a birth plan opens up lines of communication with your provider: After creating a birth plan, speaking with your doctor or midwife about your preferences for birth creates a structured way for you to bring up what's important to you and gauge how supportive your provider will be and whether you and your provider are on the same page.  

Next, a birth plan opens up communication with your birth team as you begin labor. Bringing your birth plan to the hospital with you allows you to easily share your preferences with the provider and nurses who are on call to support you. 

But when should you create a birth plan? Who should be involved? And how can you create your own?

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Let's dive into more detail.

Make sure to download our printable birth plan template to follow along!

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When should you create a birth plan?

Most people choose to create a birth plan sometime during the second trimester of their pregnancy. However, you can develop one at any time.

Often, parents create a birth plan as they participate in a birth education class.

Throughout all Nona birth education courses, we develop a birth plan together as we learn about evidence-based practices. As you gather information during birth classes or other education, you'll be able to identify priorities to incorporate in your birth plan. 

Who should be involved in creating a birth plan?

Usually, the pregnant parent can create their birth plan alone or with their partner according to their preferences and priorities for birth. Next, they can take their plan to their provider and use it as a guide to learn more about their providers's positions and beliefs surrounding birth practices and to learn about hospital policies and whether those conflict with your preferences. 

[Related: Questions to ask your birth provider, plus a free download.]

How can you get started creating your own birth plan?

To get started creating your own birth plan, I recommend learning as much as you can about evidence-based birth practices.

What does evidence-based mean? Practices that have been studied and examined critically – for both their benefits and risks.  When you combine this with provider expertise and patient values and goals, you have Evidence Based Care.

Next, outline your birth plan using the stages of labor as a guide. Within each stage, consider your personal top priorities and preferences for labor. Choosing only three or four priorities for each stage can help keep your plan focused and more likely to be read in the birth room.

For example for first stage you can state: "Please don't offer me pain medication. I will ask for medication if I need it." or "I plan to use various options for coping such as shower, birth ball, regular upright movements, and position changes."

For second stage you could state: "I prefer to push in an upright position of my choice" or "Please do not perform perineal massage, I prefer warm compresses".

For third stage you might state: "Please delay cord clamping until it has stopped pulsing." or "Please don't announce the sex, we would prefer to discover this for ourselves."

[Related: Learn about the stages of labor and birth.]

After you've created your birth plan, it's time to bring your birth plan to your provider and discuss each of your priorities. Will your doctor be supportive of your preferences? Does your doctor have experience with the priorities you identify? Make sure to ask lots of open ended questions.

And finally, bring your birth plan to the hospital with you when you go into labor to aid communication with the staff as your birth progresses.

Finally, remember that a birth plan is not a roadmap that guarantees the outcome of your birth.

Instead, it's a set of priorities and preferences that can help shape your experiences during labor.

If you're interested in learning more about evidence-based practices, take a look at our current class offerings to see which course is best for you. If you're not in the mid-Missouri area, we've created a page of recommended online resources for more reading. 

The Problem with Trusting in Birth

I hear it all the time in the birth world:

“Trust in your body”
“Your body was MADE to do this”
“Trust in Birth”

I don’t completely disagree with these statements.

But there’s a problem with telling parents to simply “trust in birth” or trust in their bodies during birth: Birth isn’t just about the bodies who do the birthing. 

Why? Because our culture, our history, and our politics all shape how we understand and experience birth. And these big, abstract concepts have concrete effects on each individual experience.  

Do you know the saying “no man is an island?” Birth can be viewed in a similar light: No individual birth is entirely disconnected from the culture surrounding it.

Rather than being an experience that’s solely affected by internal factors – the way mantras like “trust in birth” or “trust in your body” indicate – birth is affected by both internal and external factors. Here’s what I mean:

Our internal experience of birth is all about how we think and feel – both physically and emotionally. An awareness of your breath, body, thoughts and emotions are all examples of internal aspects of birth. 

But birth is also greatly affected by external factors – the things going on around us. In an immediate sense, these external factors include things like the model of care, the care provider that’s available to you, the physical environment surrounding you, and the values and beliefs about birth of those supporting you.

Take another step back and even more external factors come to light: the history that shapes our birth practices today, our cultural beliefs about birth, reproduction, and sexuality, and the political climate surrounding these concepts – all of which affect our experiences of birth. 

Birth is not simply a matter of trusting. Birth is cultural, social, personal, historically situated, and political. 

When we tell parents to simply “trust in birth” or to just “trust your body, it was made to do this” we’re also telling them that the outcome of their birth rests on whether or not they trusted enough and on whether or not their body is good enough.

And that’s an extremely harmful system of belief. These sentiments that effectively say if you can’t do this, then you’re not trusting enough, and your body isn’t good enough can lead birthing parents to blame themselves when birth goes differently than they desired. By telling birthing parents that they just need to trust more, we make all the other, bigger, external forces at play invisible in any given birth experience.

And that’s the problem with trusting in birth.

As a therapist, I see how devastating the impact of self-blame can be to new parents. Intense feelings of not being good enough can often be part of the picture when parents experience postpartum depression and anxiety.

So what’s the alternative? What can you trust in?  

Trust in your own resiliency to navigate and cope however you need to, regardless of outcome. Identify your internal and external resources for birth. Learn how to develop a trusting relationship and rapport with your care provider. 

These are just some of the primary goals in the Nona Method of Mindful Birthing. Becoming educated about all of the aspects that affect birth and learning more about building trust in your inner resources are the first steps. 

You can register for Nona classes here.

Or, are you a doula interested in providing mindfulness-based labor support? Check out our Nona Birth Doula Training.

How to be a Non-Judgmental Doula

Doulas have a reputation for judging women based on their birth choices.  Many people even believe that doulas are only helpful if they’re planning a natural childbirth.  Doulas know this is a myth, but there is a reason it has perpetuated for so long, and it’s likely because doulas are judging without even realizing it.

Judging is an automatic process of the mind.  We are constantly judging things as good or bad, which is normal, even necessary.  However, unconscious judgments without an awareness of how or why those judgments are being formed can cause us to act out our biases.  Our unconscious biases can easily turn into an agenda. An agenda in the birth room is anything but supportive and can even be harmful.

Doulas must identify their biases.

Non-judgmental support means knowing your biases so that you can have clarity and awareness about how to offer support and information to your clients based on their needs, rather than your agenda.

So in order to truly provide non-judgmental support, doulas must develop an understanding of their biases, not so that they can get rid of them, but so that they can be fully conscious of them.

How can you be a non-judgmental doula?

You can start by asking yourself what you believe about birth.  What do you know about birth? What opinions do you have?  Write these down in a list and separate the items you know are facts from the items that are your opinions and beliefs.  

Then, ask yourself why you hold those opinions and beliefs?   Are they born out of your own personal experiences?  Stories you’ve been told?  What alternative perspectives are there?  What is the validity of those alternative perspectives?  Are they true for everyone?

A classic example is the belief that a natural or low intervention birth is the best way to give birth.  But, is it always the best?  Is that true for everyone? In what circumstances would medicated birth be the best way?  Why would someone choose a highly interventive birth and why would they still value your support?

Know your assumptions and challenge them in order to recognize your biases.

What Does Non-Judgmental Doula Support Really Mean?

• Recognize your biases and how they might impact the doula support you provide.

• Provide information and resources without an agenda.

• Understand there is no one right way to give birth.

• Developing skills for supporting all kinds of birth scenarios.

• Know how to support parents to make their own best decisions

And that’s just the beginning!  

Be the best doula you can be and register for the next Nona Birth Doula training or watch for the upcoming Nona Advanced Mindful Birth Doula Training.

Learn about the Phases and Stages of Labor

The experience of Labor and Birth can vary greatly from person to person, but we can generally describe the process through 3 stages of labor and phases within each stage.

Stage One consists of three phases:  Early, Active, and Transition

In stage one, the cervix which is the mouth of the uterus, gradually moves forward (if it hasn't already), thins (effacement), and opens (dilation).  Through the process of the cervix opening, muscle collects at the top of the uterus to prepare for pushing. Each contraction of the uterus is effectively doing this work.

Early Labor

In Early Labor, the cervix is usually doing more thinning than opening, and contractions can be pretty far apart and inconsistent.  In fact, sometimes early labor can happen on and off for days or even weeks.  Your baby’s position may influence what your early labor looks like.

Active Labor

In active labor, birthing parents are having to work very actively with their contractions. Most birthing parents will become more internally focused and less willing to engage with others.  Click here to read about the Nona Method for Coping with Contractions.

In Active Labor, contractions become longer, stronger, closer together, and often more consistent.

Transition Phase

As Stage One is almost complete, contractions become very close together and more intense. This is often referred to as the Transition Phase and indicates the transition from Stage One to Stage Two of labor.

Stage Two consists of Pushing and the Birth of your Baby

Stage two begins at the point in which your cervix has opened to 10 centimeters dilation. Some women will feel the urge to push right away while others will get a break while their uterus prepares for the pushing phase or until baby moves lower. There is typically no need to push until you feel the urge which is called ‘laboring down’ and can save a lot of energy. 

Generally, being in an upright and active position will make pushing more effective and will reduce the risk of tearing.

If you have to lie down for some medical concern, consider lying on your side with someone holding your top leg instead of on your back.

Stage Three consists of the Delivery of the Placenta

The delivery of the placenta can happen anytime between 3-30 minutes after your baby is born.  However, it is more typical for placentas to deliver at between 5-10 minutes.  Some birthing parents will feel intense contractions for the delivery of their placenta while others feel very little.

Throughout the whole process, your baby is also very active in attempting to find the most optimal position for birth.  The more active you are the more opportunity you’re giving your baby to find the best position and the more comfortable you will be.

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Watch for more posts about the different phases and stages and tips for how to move through them.  You can also learn more in our childbirth education classes.

Enjoy the Pain Free Moments of Labor and Birth

While most childbirth education classes focus on how to cope during contractions, at Nona, we emphasize what to do in between contractions.  Why?  For most women, the majority of labor is spent in between contractions. This means that for most of labor, women are not actually experiencing pain (with a few exceptions).  In fact, during an average 12 hour active labor, only about 2 hours is time spent in a contraction.  So, at Nona childbirth education classes, one of the primary skills parents learn is how to take advantage of the time when you’re not experiencing contractions.

Most of your labor will be spent in between contractions

Where can you be soft?

One of the ways I teach this is to ask birthing parents to notice where they can be soft in between contractions.  Typically, the intensity of a contraction can cause birthing parents to hold on to tension which over time can increase pain and lead to exhaustion.  While it is very difficult, if not impossible to stay relaxed during a contraction, parents absolutely can be soft in between, which will equal less pain and less exhaustion overall.  

Letting go of tension, or “being soft” in between contractions can mean a less painful childbirth experience!

The key is remembering that you can take advantage of this time, or to have support people who can help remind you.

Focusing your attention on where you can be soft also helps to occupy the thinking mind which may be busy anticipating the next contraction or fretting about how difficult the last one was.  Softening in between contractions; starting with the shoulders, head and neck, hips and low back and even the muscles in the face, helps to keep your thoughts from wandering to things that might cause you to hold more tension and even forget that you’re not experiencing pain in that moment. 

Here’s how it works:

1. After a contraction, get into a supported resting position.

2. Take a deep breath and exhale, allowing your body to release the tension from that contraction

3. Now allow your attention to rest on the breath, and notice where you can be soft in your body, softening a little more with each breath out.

4. When thoughts come through and distract you, just notice them and rather than engage those thoughts, return to the breath and soften where you can.

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That’s it, but it takes practice to feel confident in this skill.  To learn more about the importance of the time in between contractions, register for the Nona Mindful Birth Education Series.  To learn more and to practice this technique, register for the Nona Yoga & Support Series.

Move Through your Contractions

What’s the number one thing everyone wants to learn about childbirth?  

How to get through the contractions!  

We’ve already talked about how to rest deeply and the importance of the time in between contractions. Now we’re going to talk about the key to coping with the intensity during contractions.

Tension is a normal reaction to pain, but holding tension in your body throughout labor can lead to exhaustion and diverts energy away from the uterus. While it’s normal to experience some tension with your contraction, you will not hold nearly as much tension if you are moving your body.

Moving your body = moving the tension.  

Being still = stuck tension, more pain

Movement = Less Pain

This works regardless of the position you’re in or the type of breathing you do.  It’s very simple: moving rhythmically will help you cope with the intensity of your contractions.

It’s easiest to do rhythmic movement in an upright, active position such as standing and swaying, sitting on the birth ball, or being on hands and knees. But, you can integrate rhythmic movement even if you have to be lying down for some medically indicated reason.  You can rock your hips, or move your feet or even rock your shoulders back and forth during the contraction.  

Any movement in the body that is intentionally rhythmic will help you to cope.

I like to encourage birthing parents to let their breath be the guide for their rhythm. In other words, allowing your body movement to be in sync with your breath will be helpful. Partners and support people can also attune to the birthing parent by matching their own breath and movements with the birthing parent’s rhythm.

After rhythmic movement through a contraction, get into a position to rest deeply and soften.  

Move through your contractions.
Rest deeply in between them.

To learn more about coping with contractions, register for the Nona Mindful Birth Education Series.  To learn more and to practice this technique through yoga and discussion register for the Nona Yoga & Support Series.

5 Reasons to Invest in an Independent Childbirth Class

When I'm at a childbirth event in the community, I'm frequently asked why someone would spend so much on a childbirth class when they can take a class at the hospital for a fraction of the price.  Here are my top five reasons to invest in an independent class:

What's the difference between my hospital childbirth class and an independent childbirth class?

1. Most independent childbirth classes teach you what the evidence says is best practice, regardless of hospital policy.

Hospitals function from a policy and procedure protocol that does not always follow evidence based care or what is considered the “gold standard” for care.  For example, many hospitals do not allow laboring women to eat or drink yet there is absolutely no evidence to back up this policy for normal labors. Your doctor might even be supportive of eating and drinking; yet they may not be able to encourage you to go against the policies of the hospital that they practice in.

2. Independent childbirth classes can teach you how to navigate hospital protocol and routine procedure.

Because independent childbirth educators are not bound by the rules and regulations of hospital policy and liability, they not only teach you the best evidence, but also how to identify and navigate restrictive and non-evidence based policies.

3. Independent classes teach couples how to tell the difference between routine use of intervention and medically necessary intervention along with the risks and benefits associated with those interventions.  This information is necessary for the legal right to informed consent.

Because many routine procedures are part of hospital protocol for the management of labor, hospital classes may not differentiate between routine use of intervention vs. necessary use determined by each individual birth.

4.  Independent classes teach you all the comfort measures and labor support skills you could possibly use, including when the best time is to get an epidural in order to reduce risks of further intervention and what you need to know about experiencing a cesarean section birth.

Decades of routine use of epidurals and other interventions has created a loss of knowledge of how to support women emotionally and physically during an unmedicated or low intervention birth.

5.  Independent educators have invested in specialized training and are often passionate and excited to teach couples about how to have a childbirth experience that is based on that couple’s individual goals and one in which they felt supported and informed.

While Lamaze is traditionally associated with hospital childbirth classes, many hospitals do not hire certified educators. Instead their educators are often labor and delivery nurses who are teaching as part of their nursing job and may or may not be aware of or allowed to teach the best evidence, particularly if the policy and procedure of that particular hospital is not backed by evidence based care.

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I often recommend that couples take both a hospital class and an independent class to be the most informed.  It’s also important to keep in mind that some hospital classes have wonderful and passionate educators!  

The important things to point out here are the systemic and institutional protocols that may interfere with best practices when it comes to maternity care and childbirth education.  Individual doctors and nurses may be very supportive and aware of what the evidence says is best practice.  You can ask your doctor how she or he uses the best evidence to inform the care they provide if if they face systemic barriers in providing that care.