Beyond delivery: How a birth plan can prepare you for all four trimesters

For expectant parents, navigating pregnancy, delivery and postpartum can raise a range of emotions. There are so many things to think about and prepare for, and knowing where to start can feel daunting.

That's why we suggest creating a birth plan.

"A birth plan is a tool for a birthing person to outline their wishes in not just their labor and birth, but their postpartum as well," says Tanya Smith-Johnson, a certified professional midwife. It's a one to two page document that you share with your birth team and anyone who's a part of your support system.

Birth plans empower parents to make informed decisions about what's happening to their bodies and their babies, according to Smith-Johnson, who also serves as the policy director for Hawaii's Healthy Mothers Healthy Babies Coalition.

Having this autonomy was top of mind for new mothers Chanel Tyler of Chicago, Ill., and Anasia Sturdivant of Baltimore, Md. Both Black women, Tyler and Sturdivant were mindful throughout their pregnancies of racial disparities in maternal health outcomes. According to the Centers for Disease Control and Prevention, Black women are more than three times more likely to die of childbirth related complications than white women, and 60% of these deaths are preventable. The cause: structural racism and implicit bias.

Creating a birth plan empowered both mothers. They had a firmer grasp of their care options, and were able to talk through what they'd prefer if something unexpected came up. All of this brought peace of mind to the process.

The research backs it up, too. A 2012 study in the Journal of Perinatal Education found that parents with birth plans had more positive feelings about their birthing experience and related to their child better than those who did not. Having a birth plan also influenced how parents in the study managed their postpartum period.

Start early

Miami-based full-spectrum doula Francesca Polanco says it's never too early to get started on your birth plan.

"If you're talking about having babies, you should be talking about your preferences and writing them down," she says. "It's super important because this is a way of managing expectations for you and your partner."

As far as what to write down, start with your prenatal care: decide if you want things like ultrasounds — and how often, or if you'd like to pursue things like glucose or genetic testing. Getting a head start on determining your preferences also gives you a chance to consider what kind of practitioner you want to work with, if you have that option. Remember just because you're assigned someone, doesn't necessarily mean they are the best fit for the type of birth experience you want.

As you get closer to your due date, add the name and address of your birth space, provider's contact information, preferences for pain management, blood type, important medical history, medications and your desires for feeding.

Feel free to add a soft or personal touch. For instance, Tyler and her husband Sheldon McIntosh brought palo santo, blankets and pillows to make their hospital stay feel more like home.

Determine who will play a role in your pregnancy journey — and how

Narrowing down your list of support persons can be difficult.

As the COVID-19 pandemic continues, the large family gatherings in the waiting room are a thing of the past. Be sure to check the policies at your hospital or birth center to see how many people they allow during your stay.

If you anticipate friction from a loved one, we suggest gentle language that affirms how important they are to you and the ways that you do want them to be involved in this special time. A message like, "While I'm birthing, I'd be so honored if you could make your famous stew for my first meal," can go a long way in both protecting your boundaries and fulfilling their desire to be involved.

Don't forget to include postpartum care in your plan

Postpartum, or the fourth trimester, is more than just newborn coos and cuddles. This delicate time is often overlooked, leaving many parents feeling completely overwhelmed. Tyler, a beauty strategy and partnerships lead at YouTube, says she regrets not doing more to prepare for life at home with her newborn, Madison. Looking back, she says she wished she'd considered things including meal prep, laundry, household chores and getting rest before making it home with her baby girl.

This time is also a great opportunity for your support system to step up and pitch in. As a single mom, Sturdivant really appreciated her friends bringing meals and groceries after she gave birth to her son, Isaiah. And as Tyler's husband's paternity leave wrapped up, he coordinated times for their family to watch the baby and help with household chores so that Tyler could rest and heal.

Ask for help

That list of things you think you'll be able to handle on your own after giving birth? Shave it all the way down. You're not superhuman and will need support as you adjust to caring for your little one, so don't be afraid to ask for it. If you're not sure of what to say, Smith-Johnson suggests being direct with loved ones about what you need. Try something like, "I would really love it if you could help out with laundry?" or "Could you come over to watch the baby for a few hours while I catch up on sleep?"

Realistically, you should plan for at least six weeks of support after delivery, but even two or three weeks is better than none. If you don't have a partner, or family or friends nearby, consider hiring a postpartum doula or even a night nurse if funds allow. It takes a village!

If at any point you find yourself in need of a pick me up, remember that you've got this. We'll leave you with an affirmation that lifted Polanco up during the birth of her child last summer: "My baby trusts me and I trust this process."

Martina Abrahams Ilunga and Gabrielle Horton are the hosts and executive producers of NATAL. You can listen to their podcast here.

The audio portion of this episode was produced by Andee Tagle.

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