Beyond the Birth Plan: Your Guide to Setting Realistic Birthing Goals

For many expectant parents, preparing for labor and delivery includes outlining their preferences for the experience. Traditionally, this has been called a birth plan, but I prefer the term "birthing goals” as it is nearly impossible for everything during labor and delivery to go exactly as planned. Reframing this as setting goals can help parents have better expectations and a more positive experience. 

 What are birthing goals, and why are they important? 

Birthing goals are a way for parents to communicate their intentions for labor and delivery while understanding that flexibility is key. These goals provide guidance for the medical team and help parents be more prepared and involved in the process. By focusing on goals rather than rigid plans, parents can navigate unexpected situations with less stress. 

Key elements of birthing goals 

 Every birthing experience is unique, and goals should reflect what is most important to each family.  

 At The Birth Place at Southern NH Medical Center, many of our standard practices align with common birth goals. For example, skin-to-skin contact, delayed cord clamping, rooming-in, and early breastfeeding initiation all happen routinely. This knowledge allows parents to instead focus on additional preferences that matter most to them.  

 Some key elements may include: 

 Pain management preferences – Whether using epidurals, IV pain medication, or natural pain relief methods like breathing techniques or hydrotherapy, parents should consider what feels right for them. 

• Cultural or religious traditions – Some families have specific customs around birth, such as music, prayer, or family involvement. Sharing these with the care team ensures they are honored when possible. 
• Labor environment – Parents may want to adjust lighting, music, or support persons in the room to create a comfortable setting. 
• Medical preferences – These could include preferences for fetal monitoring, movement during labor, or interventions like induction or assisted delivery. 

 Balancing preferences with the unpredictability of labor 

 Labor and delivery are unpredictable, and medical needs may change quickly. Parents should view their birthing goals as a guide rather than a strict set of rules. Discussing different scenarios with your provider in advance can help manage expectations. For example, if a cesarean section becomes necessary, parents may still be able to have skin-to-skin contact and immediate breastfeeding. Staying open-minded helps ensure a positive experience, even if things don’t go exactly as envisioned. 

 Common misconceptions about birthing goals

 One of the biggest misconceptions is that having birthing goals means everything will happen exactly as outlined. In reality, labor is complex, and flexibility is essential. Another misconception is that parents must choose between an all-natural birth and medical interventions. The truth is, birth is not all-or-nothing—many parents can find a balance that works best for them. 

 Advocating for your birthing goals 

 Open communication with your healthcare team is key. Discuss your goals early in your pregnancy so your provider can offer guidance and address any medical considerations. Bringing a written list of priorities to prenatal visits can help structure these conversations. It’s also helpful to ask about hospital policies so you can align your goals with what is already standard of care. 

 During labor, consider having a supportive birth partner who understands your preferences and can help advocate for you when needed. Remember, your healthcare team wants you to have a safe and positive experience, so working together to adjust goals as needed will help everyone stay on the same page. 

 Setting birthing goals allows expectant parents to express their wishes while maintaining the flexibility needed for a safe and positive experience. By understanding what is already standard of care and focusing on what matters most, parents can approach labor and delivery with confidence. Open discussions with healthcare providers ensure that families feel informed, supported, and prepared for their baby’s arrival. 

The Birth Place is ready to welcome you and your baby! 

Learn More

 Laura Johnson is an APRN in practice at Foundation OBGYN.