What You'll Learn

• What People Think A Birth Plan Needs To Include
• What A Birth Plan Should Actually Include
• When Labor Doesn’t Go According To Plan
• For Moms Who Have Had Traumatic Birth Experiences
• Advocating For Yourself During Birth And Labor

I remember when I was getting ready to have my first baby and researching all the options out there—it can be so overwhelming! When it’s your first child, it’s hard to know what your birth plan should include, and as useful as the internet is, not all information is created equally. Or maybe you're approaching birth for the second time and your last birth didn't go according to plan, so you want to feel better prepared.

Mommy Labor Nurse and Registered Nurse Liesel Teen is here to help us understand what actually needs to go into a birth plan, how to advocate for yourself, and what to do when labor doesn’t go as planned or your experience is particularly traumatic. 

What People Think A Birth Plan Needs To Include

“A lot of people think I need to put all this stuff on here, and if I don’t put all this on here, it’s not going to happen,” Liesel said.

“I recommend going to your provider and talking about your birth and things you’re thinking of putting in your plan,” she said. A lot of things people want to include in their birth plan are already standard practice for most hospitals.

But online birth plan templates often don’t take this into consideration. She gave the example of skin to skin contact right at delivery. This is important to a lot of moms, but it’s also standard practice for most hospitals unless mom or baby are unstable. You wouldn’t need to include it in your birth plan. Delayed cord clamping is another thing you probably don’t have to write into your birth plan for most hospitals.

“The other really good advantage of doing that is making sure you’re at a practice that aligns with the important things that are on your birth plan,” Liesel said. What if you want to do a home birth or go completely natural, but you’re at a practice that has a high c-section or epidural rate?

You might want to consider going to a different practice, but without having the conversation you wouldn’t know. Although in Canada, you do have less choice with providers. You still might be able to find a doula or birthing coach to make sure you get more of the experience you’re looking for. But if you want to go with a home birth or water birth, you’d need to choose a midwife.

And in Canada this is a decision you’d need to make up front. But if you’re later categorized as high risk, you’ll be under the care of both an OBGYN and a midwife.

What A Birth Plan Should Actually Include

When I got pregnant with my first child, none of my friends had kids. And as I was preparing to become a mother, they would ask me things like, “Do you have a push song picked out?” As a mom of three, this makes me laugh out loud now. Labor and delivery can sometimes become romanticized. This is how we end up focusing on the wrong things in our birth plan.

Liesel explained to us that important things to include in the birth plan are pain management for a vaginal birth, how you prefer to be monitored, and a good amount of after care. Things like if you want the baby to stay in your room for procedures, if you want baby to have vitamin K, and how you want baby to eat. You can also mention things like how soon you want baby bathed.

“A lot of this stuff we should be asking you when you’re coming in, and we should be talking to you as we’re doing things. But a birth plan is kind of like an insurance plan just in case you can’t voice everything,” Liesel said.

A birth plan is kind of like an insurance plan just in case you can’t voice everything.

Because sometimes you’re in so much pain that you might want to go for an IV pain or an epidural when this wasn’t a decision you wanted to make. It can be hard to advocate for yourself when your body is birthing a watermelon. Having a birth plan can help you do this.

When Labor Doesn’t Go According To Plan

“I hear from so many moms that say, ‘I ended up getting an epidural and I feel really, really guilty,” Liesel said. This is usually because they’ve read a book or taken a course on “natural births” and feel like they failed because they chose pain relief. Liesel emphasized using pain relief or having a c-section is totally okay. 

There are so many different options, but when we only see one scenario played out that’s the one we tend to assume is right. 

We only see one scenario played out that’s the one we tend to assume is right.

With my first child, I was determined to do it “right.” I labored 55 hours, and I wasn’t progressing. Finally, I was like “Give me an epidural before I go insane!”  It was okay. I wasn’t a failure. I just had less pain.

With my second child, I walked into the hospital and said, “No one’s touching me or breaking my water until I’ve had an epidural. I’ll hang out in my room until an anesthesiologist can come.”

Being able to make that decision from the start was empowering. That’s why I want you to have all the information.

For Moms Who Have Had Traumatic Birth Experiences

“Interview some providers and see if the provider is a good fit for you,” Liesel recommended. Again depending on where you are changing practices may be easier or harder, but that’s often a really important piece.

You can advocate for yourself, but if you feel like you’re not being listened to, it won’t accomplish much. “Find a good provider you align with,” she repeated.

If you feel like you’re not being listened to, it won’t accomplish much.

Something moms often tell me in sessions is that they were in so much pain and didn’t feel heard. They had no control over the situation, and no one would listen to them. We often think of traumatic births as mom or baby being near death, but it doesn’t have to be that. Whatever your feelings are, they’re valid.

Advocating For Yourself During Birth And Labor

“There are a lot of things you can’t have complete control of. But it is that lack of control that is so anxiety provoking and affects people so, so much,” Liesel said.

It is that lack of control that is so anxiety provoking.

If you’re coming in with a history of (birth) trauma—no matter how large or small that trauma was—you can tell your labor and delivery nurse. Liesel explained to us that if she’s aware a patient has had past trauma, she will over-explain everything to make sure the patient understands what’s happening and why. Communicating what you need allows the labor and delivery nurse to best support you during the birthing experience during the moments you can’t control.

Learning coping skills with a perinatal mental health specialist can also help you through the process. It gives you skills to lean on during moments you can’t control.

We can rewrite the story of our first painful birth. We can work with a therapist and learn to see that experience through a different lens. “It doesn’t just take having another child to redo what happened the first time,” Liesel said.

Okay, mammas, you’re doing great! Keep showing up.

You’ve got some good tips on what to think about for your birth plan today, but if you still feel a little lost or need more information, I’ve put together a practical mommy centered postpartum checklist that should cover just about everything. I put hours into this 20 page document and it’s available for free!