Making Your Birth Plan: Go Natural, Medical or Something in Between?

In an excerpt from her book, Common Sense Pregnancy, our go-to labor nurse shares her suggestion for the perfect labor and delivery.

Pregnant Patient in Hospital Bed With Pillows
Some women are 100 percent sure they want an all-natural birth. No medications, no epidurals, minimal time in bed, maximum time on their feet, in a tub and using a birthing ball, and absolutely no C-section. Other women know for sure they want all the bells and whistles the hospital has to offer. If they could get an epidural during their last week of pregnancy, they’d be all for it. If they end up with a C-section, no problem. They want the full-meal medical deal. Most women fall somewhere in between, though some never give it any thought. Their plan is to do whatever their doctor or midwife says they should.

Making a plan

If you aren’t already leaning strongly toward either a natural or a medicalized birth plan, here’s how to determine what you want: Give yourself a comprehensive prenatal education; take into consideration your health history, medical conditions, your partner’s preferences, your providers’ recommendations, and your options for where to give birth; then go with your gut and remain flexible.

You probably already know if you have a high pain tolerance and a high level of trust in your own body’s ability to function normally.

Those are going to be huge factors in how you approach your birth. I know a few women who are scared to death of a labor without medical experts at their bedside. I also know women who are terrified that if they deliver in a hospital all the staff will be out to get them. Most of the women I know, however, aren’t that nervous, and they’re fine with a middle ground approach.

When plans fail

Going into labor set on a rigid all-natural, or an all-medical, or a following-orders birth plan isn’t such a great idea, because labor and childbirth rarely go exactly as planned. Every birth is a previously untested navigation between one mother’s body and one baby’s body, and babies never consult birth plans. Instead, I recommend women approach labor as naturally as possible and then adapt as needed. That’s why it’s important to learn what’s involved in births that veer away from your preferred birth plan.

Even if you want an epidural, you should learn how to relax and breathe into contractions, get into positions that facilitate labor, and participate in decisions made about your birth experience. In many hospitals, you can’t get an epidural until you’re about 4 centimeters dilated, and you might have to wait until an anesthetist is available. That could mean hours of contractions you’ll need to cope with. Even if you’re planning an all-natural birth, you need to know about other pain management options available at your birth facility in case you change your mind mid-labor. Believe me, that happens a lot.

I think the best birth style and plan is this: Aim for a natural birth with the least amount of medical intervention whenever possible. Be flexible. Trust your body and your health care providers and go with the flow. If everything goes as planned, excellent; but if plans have to change, so be it.

Common Sense Pregnancy is available everywhere books are sold, including at and