The Best-Laid Plan

By Hillari Dowdle

My birth plan when I was pregnant with my son, Truman, was this: I had no plan. I knew I wanted a hospital delivery, so I selected one that had a birth center known for family friendliness and an OB-GYN with a reputation for erring on the side of safety. Beyond that, I just packed my iPod in my hospital bag, let my doctor know that I'd rather skip the C-section, thank you, and trusted that somehow the process of giving birth would take care of itself.

My friend Lynn was shocked by my nonchalance. "Oh, my God!" she said. "You have to have a birth plan!" Lynn had wanted—and, after 51 hours of labor, got—a completely natural delivery. She firmly believes that her no-detail-overlooked birth plan helped her enjoy the childbirth experience she wanted. "If you don't have a birth plan," she warned me, "you forfeit control of this beautiful, natural process to the medical system."

Oh no! Just as I started to panic—and cobble together a detailed birth plan at 38 weeks—my friend Jeanette, an ultrapractical mother of four, offered another point of view. "Don't bother," she advised. "Birth plans don't work. Something always goes wrong, and you'll just have to trash the whole thing anyway. Why set yourself up for failure?"

So who was right? Turns out, both—and neither. "Birth plans are useful because they help couples think through the process together and decide what's most important to them," says Sharon Phelan, M.D., an OB-GYN who practices at the University of New Mexico in Albuquerque. "Some women like a high-tech birth; others have a Pearl Buck image of motherhood. Either way is fine, but it helps to have those expectations expressed so everyone understands what the goal is." But Phelan also warns that while you can try to guide it, childbirth is something you simply can't fully control, so don't even try. Here are some additional tips from Phelan and other experts for making your birth plan work for you.

Start shopping early

Create your birth plan early in your pregnancy, use it to "shop" for a care provider whose vision most closely matches yours and make sure that person knows about any special concerns you may have, suggests Cynthia Flynn, C.N.M., Ph.D., an associate professor of nursing at Seattle University in Washington and president of the American Association of Birth Centers. "When you show up in the delivery room with a birth plan, you're saying that you don't trust your provider to do it your way," Flynn maintains. "Why not just find someone who normally does it your way?"