Should I write a birth plan? - Why language matters.

What is a "birth plan?"

• A birth plan is a written document given to your birth team (doctor, midwife, doula, nurses, partners, etc.) that spells out the choices you've made regarding your labor and the birth of your child. 

Shouldn’t it be “birth preferences" or "birth wishes?"

• Short answer: No, I don’t believe so. 

• Long answer: Let’s not mince words. When you hire a wedding planner, what is their job? Generally, a wedding planner's job is to walk you through all your options and have an open dialogue with you about your budget, the size of your guest list, what traditions you want to honor, etc. When you “plan” your wedding, for example, you expect it to generally go pretty close to what you planned, right? Why? Because you know your budget, you know your team (family, friends, fiance, wedding planner, yourself, etc.). You’ve discussed all this with your wedding planner, your officiate, your wedding party, your family, and your fiance. You've made your wedding plans based on all these factors. Not on some random ideal. The best wedding plans and wedding planners will also have you make and discuss one or more contingency plans. This way even if something arises and the original plan needs to change, you already know what everyone will do and you trust the day will still go as well as possible given the new circumstances. If you’re having an outdoor wedding, for example, you’ll have a plan for if it rains. There’s nothing wrong with plans and, as you can see, flexibility is an inherent part of planning. 
• A more extreme example: Let's say I hire a contractor to build me a house. If I presented the contractor with a document called, "my building preferences" or "my building wishes," what do you think s/he would learn from this document? Maybe the contractor will be confused and need to ask me a lot of follow up questions about what it is I really want. Perhaps s/he will assume that I don't care all that much about how my building turns out, just so long as it gets built. If I present my contractor with a building plan and they see an area where there may be some difficulty, a good contractor will tell me that immediately and discuss their suggested alternatives. This allows me to make the decision, allows me to decide how my house gets built, and builds trust between myself and the contractor. By presenting a contractor with clear communication, there is no doubt what I expect and there is a clear path for open communication. I am not leaving the house I am going to live in to open to assumptions and interpretation. But, I also expect my plans to change based on materials available, cost and budget changes, and the expert advice of my contractor (or I can decide to hire a different contractor!).

The bottom line is: 

• Calling it a birth plan does not mean it is rigid or inflexible. A good care provider will be like the contractor and have this discussion with you, but will ultimately leave all decision making up to you. A good doula will be like the wedding planner and help guide you through the process of preparing for multiple outcomes while also doing everything you can to have your desired experience. 
• I encourage you to insist on using words like "plan." Adults use such words as they command respect and convey authority. Children use "preference" or "wishes" as they defer to someone else's authority. As the mother, you are the one with the most authority in the labor and delivery room.