Birth Plan Choices To Know About: Your Options and Making Informed Decisions
Nothing in Birth Is Truly Required
One thing I talk about often with families is how many decisions in pregnancy or birth can feel set in stone when there is actually more flexibility than people realize when making birth plan choices.
A lot of people walk into a provider’s office without questions prepared.
Maybe they’ve not had time to research yet. Maybe they didn’t know there was anything to research. Maybe they’re simply going along with the standard of care that is in place because that is what feels normal in the moment. And honestly, that makes sense. Pregnancy comes with a lot of information, and most people are trying to take it in as they go.
But everybody is so unique and different in the things they want and the things they value. What feels reassuring to one family may not feel necessary to another. What one person wants more information about, another person may feel comfortable moving forward with it right away. That is why I think it is important for people to be given full information about the alternatives they may have during pregnancy, birth, postpartum, and even newborn care.
Birth Plan Choices, Guidelines, and Provider Boundaries
When I say that nothing in birth has to be required, I do not mean recommendations do not matter. They do. Recommendations are often there because there is evidence, experience, or a safety consideration behind them.
In my own practice as a home birth midwife, I have boundaries too. I do not love using the word “require” because I do not want to force somebody into something they do not want, but there are things I consider important within my own practice. I prefer to have initial labs drawn, including an OB panel, and then another set of labs around 28 weeks. That information helps us make decisions about whether the pregnancy is remaining low risk and ultimately whether home birth continues to be the safest place to deliver.
I also require an anatomy ultrasound around 20 weeks in my practice. In the home setting, we are limited to certain resources. If we do not know where the placenta is and it is covering the cervix, that is something I would not want to find out during delivery. I also think it is important to know how baby is doing, how they are developing, and whether there are any concerns that would need immediate care at the time of birth.
Those things are important to me. They are boundaries within my practice. At the same time, not every home birth midwife practices exactly the same way. Some may have different requirements or different boundaries. If somebody does not want labs or an anatomy ultrasound, for example, that may mean helping them find another provider who has different practice boundaries and can support them in a way that aligns more closely with what they are looking for.
That is part of informed choice too.
It is not always about every family making the same decision. Sometimes it is about understanding the recommendation, understanding the reason behind it, and deciding whether that provider relationship is the right fit.
Some Birth Plan Choices Are More Flexible Than People Realize
Understanding your birth rights in pregnancy does not mean declining every recommendation or questioning every decision. It means understanding what is being offered, why it is being offered, and having the opportunity to participate in the decision-making process.
There are many birth choices during pregnancy that people often assume are required because they are offered routinely.
Gestational diabetes screening is one example. Some people do the glucola drink that is usually provided through hospital labs. Some use the Fresh Test. Others choose finger pokes multiple times a day for a week or two. And some use a continuous glucose monitor. There is also the option to decline testing, while understanding the risks behind that and what would need to be watched for as pregnancy continues.
The same can be true for cervical checks and membrane sweeps. Cervical checks are often offered around 36 weeks and then weekly until delivery. For some people, that information feels helpful. For others, it does not feel necessary. Membrane sweeps can be used as a tool when needed or when desired, but they also do not need to be done if someone is not comfortable with that. That has to be a conversation between you and your provider.
Those are the kinds of decisions that can feel automatic because they are commonly offered. And sometimes they may be the right choice for someone. Sometimes they may not be something a person wants. Sometimes they simply need more information before deciding.
Birth and Newborn Care Have Choices Too
The same thing continues into labor, birth, and newborn care.
Do you want an IV placed in labor? Do you want continuous monitoring or intermittent monitoring? Do you want Pitocin after delivery to help reduce bleeding? Do you want to push lying on your back, or do you want to push in a different position? Do you want students in the room? What do you want the atmosphere to look and feel like?
Even delayed cord clamping can mean different things in different settings. Sometimes in the hospital, waiting 30 seconds to a minute is considered delayed. In my practice, I often encourage people to wait until the cord is white and limp, like a floppy noodle. That visual helps people understand what we are looking for, and it also opens up a bigger conversation about what they want after delivery.
Newborn care also includes decisions that some families do not realize are choices until they are right in front of them. Vitamin K, erythromycin eye ointment, circumcision, and the timing of the first bath are all examples. I often encourage people to wait several days or even up to a week before bathing baby, depending on what they want to do, because of the baby’s microbiome and not washing off all that good bacteria right away.
There are a lot of things in pregnancy, birth, postpartum, and newborn care that are options. And sometimes having so many options can feel overwhelming when you are unfamiliar with them.
That is why the provider relationship matters so much.
Having Someone You Can Talk With
I think one of the most important parts of care is having somebody you can talk with. Somebody who helps you understand your options. Somebody who does not assume they already know what you want. Somebody who can help you have a real conversation about the risks, benefits, alternatives, and what matters to you.
Because everything being a choice does not mean every decision feels easy. Sometimes it feels like a lot. Sometimes you do not know what questions to ask until later. Sometimes you hear a recommendation and go along with it because you did not realize there were other ways to approach it. Sometimes you want more information, but you are not sure how to start the conversation.
That is why I think it is so important to have a provider you trust and feel comfortable asking questions to. People deserve to understand what is being offered, why it is being offered, and what options they have available to them.
One of the most important birth rights in pregnancy is the ability to have informed conversations about your care and participate in decisions that affect you and your baby.
There are recommendations. There are guidelines. There are provider boundaries. There are safetyconsiderations. There are individual values. And somewhere in the middle of all of that, there should be room for a helpful conversation where you do not feel judged for asking questions or making a certain decision.
If you're looking for care that gives you time to ask questions, understand your options, and make informed decisions that align with your values, I'd love to connect!
Whether you're interested in a Birth Planning Call, Birth Doula Support, Home Birth Midwifery Care, or simply want help understanding your options and navigating decisions during pregnancy, we're here to support you through the conversation.
Family Focused Midwifery supports families throughout Milwaukee, Waukesha County, and Southeast Wisconsin with home birth midwifery care, birth doula support, and childbirth education.
If you're looking for personalized support, we're here to help you navigate pregnancy, birth, and postpartum with confidence.
Not local? You can still learn with us through Fearless Birth Academy, our online childbirth education program.
You don’t have to figure this out alone, and you don’t have to choose between safety and autonomy.
