Birth plans catch a lot of flack. And sometimes, it's for good reason. Like, when a parent hands over a two-pager (front and back) to the hospital nurse, or when a birth plan is intended as an impossible play-by-play script for the big day. Birth plans also can be immensely helpful when they are used as a tool intended to inform and educate parents, and open up a discussion between parent and provider. That said, there is a lot of variation in what parents include on their birth plan.
When a birth plan is used as a tool for parents to better understand all of the choices available during birth, it helps to list out things like "play music, dim lights, change positions." However, when a birth plan is used to communicate with the hospital or birth center staff the most critical preferences, things like lighting only serve to clutter and interfere with the most important messages. Here's the thing: not everything you prefer to have during birth should be on your birth plan. Some things you can just do without permission or discussion. Let's take a look.
Things You Don't Need to Include on Your Birth Plan
The following items may be very important and helpful for you, but they do not need to be disclosed to the hospital or birth center staff, or your care provider.
Room atmosphere - Dim lights, battery-operated candles, music in the background, keeping the room door closed -- none of these need to be included on your birth plan. You, your birth partner, and/or your doula are in charge of creating the ideal environment for your birth, so you can just go ahead and do it!
Wearing your own clothes - This is like asking for permission to brush your teeth -- you just don't need to do it. If you prefer to wear your own clothes, you can!
Natural pain relief items - Use of aromatherapy, massage, visualization tracks, etc., can be used freely without needing to let anyone know.
Things You Shouldn't Include on Your Birth Plan
This is something you shouldn't include because it won't help you or your support team and staff better understand your preferences.
Items incompatible with each other - This is where taking a good childbirth class comes in handy. It's important to know how interventions work together. For example, you can't request "no routine IV fluids" if you plan on having an epidural. Similarly, freedom of movement also is more difficult to achieve during an induction or with the use of an epidural.
Things You May Not Need on Your Birth Plan
You may want to include these items in order to discuss them with your care provider and place of birth (hospital or birth center) to learn the rules and regulations, but you may not need to include them if a) the rules are in your favor or b) you choose to act in accordance with best evidence for a safe and healthy birth, despite the hospital's rules.
Eating and drinking - Many, many hospitals still restrict eating and drinking despite research and recent recommendations that determine its safety. If your chosen birth place restricts eating and drinking (you can find out on a hospital tour, which is invaluable for first-time parents!), consider how this might impact your birth and if/how you plan to go against policies.
Changing positions and moving around - It's less typical for care providers and hospital staff to restrict a laboring or birthing person from moving around changing positions, which is why this item isn't as critical to include on your birth plan. If you want to change positions or get up and move around -- do it! That said, it may help to put this on an earlier or more lengthy version of your birth plan (the one you use to open up a discussion about your birth with your doctor or midwife) to see how your provider responds. If you're greeted with a warm, reassuring "absolutely!" when it comes to your preference of moving around and changing positions (including pushing and giving birth in positions other than on your back), then it's a good sign with you're with a great provider and you can remove this from your birth plan. If, on the other hand, your provider responds less than enthusiastically about his/her flexibility with this choice, you may want to dig deeper to find out if you're with a provider who practices according to best evidence for a healthy, safe birth.
For a short and simple, evidence-based birth plan template, check out this one from Lamaze. What do you plan to put on your birth plan?