How to choose a birth plan that’s right for your family

If you’re an expectant mom, you might feel overwhelmed when it comes to your birth plan. Maybe you’ve always imagined a hospital birth, but you saw an article on unnecessary interventions and C-section rates that have you questioning your original plan. Maybe you’ve always wanted a home birth, but there’s no midwives in your area. 

No matter what your situation is, there are choices for your family. Here’s what to know when planning for your little one’s arrival.

1. How to research

If you want to do a lot of research, opt for reading books over exclusively following personal birth accounts online or listening to podcasts. Unfortunately, online content can often lean towards extremism and fear-mongering in order to boost views. It happens on both ends of the medical spectrum, whether it’s OB-GYN media accounts implying that homebirths will result in unnecessary infant deaths or pro-home-birth accounts discouraging women from ever going to a hospital, even in extreme circumstances. Because books aren’t written “for the algorithm,” they tend to give more even-handed information.

One of the best books for moms-to-be is Made For This: The Catholic Mom’s Guide to Birth. Drawing on Pope Saint John Paul II’s Theology of the Body, the book offers guidance, encouragement, and discernment for moms and their little ones.

Another excellent resource is the Evidence Based Birth website, which includes information about various birth choices, including hospitals, homebirths, and pain management, all backed up with research. 

2. What provider do you want?

There are two main options for providers that can help you give birth: OB-GYNS and midwives. OB-GYNS, or obstetrician-gynecologists, are doctors who specialize in female reproductive health, pregnancy, and delivery. They are trained in surgery and are thus equipped to perform cesarean sections, and can manage both high-risk and low-risk pregnancies. They attend hospital births.

Midwives are trained medical professionals who can manage low-risk pregnancies and deliveries, and they can work with OB-GYNS for high-risk patients. Midwives can assist at home births and birthing centers and are trained in alternative pain management during birth, helping mothers avoid unnecessary medical interventions. They are also a part of some hospital practices. 

3. Location

a. Hospital births

Hospital births are by far the most common choice for American women, with around 98% of births occurring in the hospital. With a hospital birth, you will have access to pain management like epidurals, doctors who can perform caesarean sections, and usually access to a neonatal intensive care unit (NICU) in the case of complications. They also have medications and technology available to safely induce babies. 

Access to these resources make hospitals the safest choice for high-risk pregnancies, and offer peace of mind to moms who prefer access to more powerful pain medication and emergency care if needed. 

There are a few disadvantages to hospital births. Staff are not always trained in alternative pain management, like massage or water births. Hospitals also have much higher rates of interventions like inductions and C-sections (a 31% C-section rate compared to the 5% C-section rate of home births), which leaves some mothers concerned about whether these C-sections are always medically unnecessary. 

b. Birth centers

Birth centers are a middle ground between hospitals and home births. Typically attended by midwives, birth centers offer alternative pain management and are more likely to encourage moving around into different positions during labor, rather than laboring in a bed. However, they rarely offer medical pain relief besides nitrous oxide, and, in the case of an emergency C-section, the patient must be transferred to a hospital. They also have more limited resources to care for babies who end up in distress during or after labor and delivery, which may require transfer to a hospital.

Birth centers try to create a home-like atmosphere to boost oxytocin, the “love” hormone that pushes labor along. They may offer to lower the lights and put on an essential oil diffuser or music. Most birthing centers do not offer vaccines for the baby. They also make sure that the baby stays in the same room with the mother as she recovers from birth. 

c. Home births

Home births offer the least amount of intervention and, for some women, the most relaxing atmosphere to give birth. The laboring mother has a lot of freedom in the course of her birth, and a midwife helps her give birth. In the case of a medical emergency, the mother has to transfer to a hospital, and epidurals and C-sections are not an option. 

Women who have home births often say that they love the privacy and low-stress environment of birthing at home. After the midwife makes sure that mom and baby are healthy, parents can ease into their new role without having nurse check-ins at night or the other sights and sounds of a hospital. Mom doesn’t have to leave home at all during labor, and the baby comes into the world in the same place he or she will be leaving. Parents also do not have to deal with the pressure of unwanted interventions, like medications, vaccines, or circumcision, if they have decided against them.  

Very few women choose to have totally unattended “free births” with no medical professional present. These births can end tragically since most parents are not trained to detect or treat emergencies. 

Creating your birth plan

Once you have an idea of the different options available, you should create a birth plan (BabyCenter offers a helpful template). It’s ideal to have this written down and shared with your husband, provider, doula if you have one, and any other person who will be supporting you during birth.

When making your birth plan, ask yourself questions like: 

• How do I want to manage pain?  
• Do I want an elective induction or C-section, or would I prefer these only under specific circumstances? 
• If I need an induction, what methods am I comfortable with?

You should also think about how you want to labor.

• Do you want to move around or prefer to have a hospital bed? 
• Are you interested in a water birth? 
• Are there any ambiance preferences you have, like music or dimmed lights?

The other important aspect of your birth plan is your requests for your baby. 

• Do you want to delay cord clamping or bank your baby’s cord blood? 
• Which vaccines do you want your baby to receive?
• If you have a boy, do you want him to be circumcised? If yes, do you want it done at the hospital or somewhere else later?
• How do you prefer to feed your baby — breastfeeding or bottles?

While a doula can be helpful in guiding you through birth and advocating for both your preferences and needs, don’t be scared to lean on your husband as an advocate for you. He isn’t the one working through contractions, so his head will be clearer and he can articulate what you want to the doctor or midwife. The Bradley Method offers specific guidance for husbands coaching their wife through labor. 

Expect the unexpected

The last thing to keep in mind is that birth doesn’t always go as expected, whether you’re at home or the hospital, which is why a list of non-negotiables versus preferences is so important. Maybe you really wanted to give birth at home, but you spike a fever and need to go to the hospital. Maybe you really wanted an epidural, but you labor too quickly and there isn’t enough time. Either way, communicate to your husband, doula, and provider what you prefer ahead of time, and what you are willing to let go of for you or your baby’s health. 

The grace of parents

The birth of new life is an incredible time to rely on prayer and sacramentals. Maybe you have a rosary or a relic you’d like to bring with you as a tangible reminder of God’s grace. Or maybe there’s a prayer or Scripture verse that you can repeat during contractions. God invites mothers to participate in the sacred act of creation and to offer their own body up for another. He is there with you to sustain you with His grace and love.  

Ultimately, you as a mother are the one in charge of your birth. Together with your husband, you can research, pray, and discern where the best place for you to give birth is, and a trusted medical provider can guide you as well. God has given you the grace as a parent to choose what is best for your child, and even if birth doesn’t go according to plan, He is still with you and your little one the whole way.