What’s Your Birth Plan?

Sarah Rae Easter, MD,
Division of Maternal Fetal Medicine,
Division of Critical Care Medicine
Brigham and Women’s Hospital
Assistant Professor, Harvard Medical School

Many of my patients ask me whether or not they should have a birth plan. The reality is my birth plan for all of my patients is the same: healthy mom, healthy baby, and vaginal delivery. That plan comes with two important footnotes. First, if that third goal of vaginal birth compromises the health and safety of mom or baby it is the first part of my plan to go. Second, the details of my “birth plan” are based on my knowledge of medicine and clinical experience which may be inadequate for some patients. Though I like to think of myself as a good doctor, my obstetric skillset isn’t always equipped to deal with the complexity patients face in their lives.

When I say ‘healthy mom’ that means not only physical but mental health. While I try to get to know all of my patients as people during prenatal care, developing that kind of relationship takes time. This is where a birth plan can be helpful. Your birth plan can be a place to share medical or personal preferences or highlight what is important in your birth experience. For patients with a history of anxiety, trauma, or distrust with the medical system this can be a clear way to communicate goals of care without having to relive negative experiences on such an important day.

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