Beyond the Birth Plan: How Birth Preferences Can Support a More Flexible and Empowered Birth Experience

Why We Plan for Birth

The idea, concept, and thought of giving birth can feel scary, overwhelming, and quite frankly, terrifying—especially for those experiencing it for the first time. These emotions, often rooted in a fear of the unknown, can contribute to feelings of anxiety surrounding the birthing experience.

So, how do we naturally respond to anxiety?

We look for what we can control.

Boosting our sense of control can increase confidence, provide a sense of preparedness, and decrease the feeling that we are simply floating in the unknown.

And this is where the birth plan comes in.

Birth plans come in all shapes and sizes. The internet is filled with casual, cute one-page documents, highly detailed birth plans spanning 10+ pages, and everything in between. Each one is created with a similar goal in mind: to help increase a birthing person's sense of control and preparedness in the birthing room, suite, tub, or wherever their birth unfolds.

The Challenge with Birth Planning

It's great to have a plan, right? After all, a plan helps us organize information, think through our options, and make decisions ahead of time about how we hope something will unfold.

The challenge with birth planning, specifically, is that birth rarely goes exactly according to plan. Birth, and babies, tend to have their own agenda, regardless of how much we prepare.

As a perinatal therapist, I genuinely hope every birthing person has the positive, empowering birth experience they envision. Unfortunately, the reality is often more complex. In my clinical work with postpartum parents, I rarely see births that go 100% according to plan.

When we enter birth with a concrete plan and something changes or shifts (as it often does), it can be difficult for our brains to engage the flexibility needed to adapt to what is happening in the moment. Instead, many people find themselves grieving the birth they perfectly planned for while simultaneously struggling to process the birth they are actually experiencing. That emotional mismatch can contribute to feelings of disappointment, guilt, failure, or even trauma, despite everyone ultimately being healthy and safe.

The issue isn't that birth plans are inherently bad. In fact, thinking through your options and advocating for your preferences can be incredibly empowering. The challenge arises when a plan begins to feel like the only acceptable outcome. That's where shifting from a birth plan to birth preferences can make all the difference.

Shifting Toward Flexibility

Am I saying you should throw away any and all preparation for your birth experience? Absolutely not!

In fact, I think it can be incredibly empowering to take the time to research your options and develop a clear idea of what you would like to happen (or not happen) during your birthing experience.

What I am suggesting is a shift toward flexibility: moving away from something that feels very concrete, like a birth plan, and instead creating birth preferences.

The key is in the word: preferences. Preferences allow an individual or couple to identify what they would like to happen while also leaving room for flexibility if the unexpected arises. Rather than viewing changes as a failure of the plan, birth preferences encourage adaptation while still honoring what matters most to you.

Approaching birth with this mindset can make it easier to pivot in the moment and may reduce the likelihood of experiencing intense feelings of grief, failure, or trauma if your birth unfolds differently than expected. Will it completely eliminate the possibility of having complex emotions about your birth experience? No. Birth is a deeply personal, unpredictable, and often emotional process.

What this approach can do is create a stronger foundation for navigating whatever your birth experience brings, allowing you to hold onto your values and priorities without feeling defined by whether every detail went according to plan.

Controlling the Controllables

The truth is, there is a lot you won't have control over during the birthing process. When labor begins. How long labor lasts. How much your baby weighs. The intensity of contractions. Whether additional medical interventions become necessary.

I'm not sharing this to increase anyone's anxiety around an already anxiety-provoking experience. I'm sharing it to validate something many expecting parents already know: birth can feel scary, overwhelming, and unpredictable.

But here's the good news.

We've already made the shift from a birth plan to birth preferences, helping your brain move into a more flexible mindset if something unexpected happens. And while there are aspects of birth that are outside of your control, there are also many things that are within your control.

I encourage my clients to focus on what I like to call the controllables. Focusing on the controllables can increase your sense of agency during labor and birth, which can help reduce anxiety and create a greater sense of safety throughout the experience. One of the factors that can contribute to birth trauma is feeling as though all control has been taken away. While we can't control everything that happens, we can intentionally hold onto the areas where choice is still possible.

So... what is controllable when it comes to birth? The answer will look different for everyone, but here are a few ideas that come to mind.

Bring familiar comforts.

Do you have a favorite water bottle? Bring it with you. Staying hydrated during labor is important, and something as simple as using your favorite water bottle can provide a small sense of familiarity in an unfamiliar environment.

Have a fuzzy blanket you can't sleep without? A pillow that's just the right combination of firm and soft? Bring those too. Familiar comfort items can help make a hospital or birthing center feel a little more like your own space.

Create an environment that feels calming.

Hospital rooms aren't always known for being cozy. Bright overhead lights, unfamiliar sounds, and constant activity can feel overstimulating during labor.

If it feels right for you, consider bringing a small bedside lamp or battery-operated twinkle lights (if your hospital allows them). Soft lighting can completely change the atmosphere of a room and help it feel more peaceful and grounding.

Plan for your recovery, too.

After birth, your focus naturally shifts to recovery. Pack your favorite shampoo, body wash, face wash, lotion, or other self-care items that help you feel refreshed and cared for. These small rituals can be a meaningful way to show yourself compassion after accomplishing something truly incredible.

Talk with your support person ahead of time.

If your partner, family member, or another support person will be with you during labor, have a conversation before the big day. What feels supportive to you? Maybe you want them to hold your hand, rub your back, advocate for your preferences, remind you to breathe, or simply sit quietly beside you. Having these conversations beforehand allows everyone to enter the birth experience with a shared understanding of how to best support you.

Think about how you'd like to spend your labor.

Labor often involves waiting. Would you like to binge-watch your favorite show? Listen to a carefully curated playlist? Try aromatherapy? Bounce on a birthing ball? These choices are yours to make and can help create an environment that feels more calming and personal.

Bring things that make you feel like yourself.

Maybe your best friend bought you maternity pajamas that remind you how loved you are. Maybe there's a cozy robe or hospital gown you've had your eye on. While you will likely wear a hospital gown during labor, you'll have opportunities afterward to change into something that feels comfortable and familiar. Those little choices matter.

Remember that you have a voice.

One of the most important things you can bring into the birthing room isn't something you can pack in your hospital bag; it's your voice.

If the situation isn't an emergency, you can ask questions before making a decision. You can ask your medical team to explain what's happening in a way that makes sense to you. You can ask for a few moments to process new information before responding. You can change your mind if something that felt right during pregnancy no longer feels right in labor. And if advocating for yourself feels difficult in the moment, your support person can help advocate alongside you.

None of these choices guarantee that birth will unfold exactly as you hoped. But they can help preserve something incredibly important: your sense of agency throughout the experience.

This list is by no means exhaustive. These are simply some of the strategies my clients have shared with me over the years that helped them feel more grounded and in control during their birth experiences (and, truthfully, several are things I chose to do during my own birth as well).

Every person is different, and every birth story is unique. So take what resonates, modify what doesn't, and create a list of controllables that feels meaningful to you. Preparing for birth isn't about controlling every outcome. It's about identifying the choices that remain yours, even when the unexpected happens.

How Anchor Point Can Help

Preparing for birth is about so much more than packing a hospital bag or writing down your preferences. It is also about preparing emotionally for one of the biggest transitions of your life.

At Anchor Point, we understand that the journey into parenthood can bring up a wide range of emotions: excitement, joy, fear, uncertainty, disappointment, grief, and everything in between. Our goal is to provide a space where you can explore those feelings, process your experiences, and develop the tools needed to navigate pregnancy, birth, postpartum, and the transition into parenthood with greater confidence and support.

Whether you are feeling overwhelmed by the unknown, processing a previous birth experience, navigating changes in your expectations, or simply wanting support as you prepare for this major life transition, you do not have to do it alone.

Birth is unpredictable. Parenthood is transformative. Having support along the way can make all the difference.

At Anchor Point, we are here to help you feel more grounded, more prepared, and more connected to yourself throughout your journey into parenthood.

Often, the hardest step is the first one: reaching out. You don't have to navigate the emotional complexities of pregnancy, birth, and parenthood alone. The clinicians at Anchor Point are here to walk alongside you with compassion, support, and a deeper understanding of your unique journey.

With warmth & compassion,

Michelle at Anchor Point

MA, LMFT, PMH-C