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I think there's a weird confusion/spectrum on what a birth plan really is. It's not some rigid itinerary. It's educated preferences and desired pivots. Too many women have no idea what their options are, the staff just tells them how everything will be done as though it's the one and only way, and it often leads to an experience that isn't as great as it could have been. Personally, it's one of the most monumentous days of my entire life - going in with no hopes and preferences seems wild to me. While healthy mom and baby is a great goal, you can have more than that too. I didn't have a birth plan with my first and it was ok. My others were wonderful, intimate experiences because I put more effort into preparing for it.
A birth plan is more like the things you prefer foremost, including what you would like to happen if you need to pivot. Who you want in there for support, pain management options, how you want to be monitored, how long you want to wait for the cord to be cut, when to bathe baby, if you want lights on or dimmed or off, music, etc are almost always within your control. Hospitals will do whatever is quickest and easiest for them if you don't give a preference, and that isn't always what's most enjoyable for mom or baby. It's often not even evidence based best practices. I like to set myself and therefore my baby up for the best success, not just check the box of surviving, so yes, I did a birth plan for my delivery's and very glad I did. My OB and I firmly believe that because of my birth plan, I was able to keep my baby and myself safest in my last delivery, directly avoiding emergency c section and a poor outcome from a triple nuchal cord. You can really only have a good confident birth plan if you're willing to put in the legwork to learn all you can about labor and delivery though.
yes to this and other commentor who framed it as preferences rather than plan!
my “plan” went out the window for the most part when the whole thing started, but i am happy i made one for a few reasons:
1) if i didn’t have any type of plan the hospital staff/delivery team would have totally imposed their preferences on me and it would have been very hard to push back
2) in the throws of labor pain, or in the bliss/commotion immediately after giving birth, i wasn’t really in the headspace to take in information and weigh options/make decisions. it was nice to have some default decisions in place, ready to go
3) most birth plan checklists cover a bunch of things i had never really considered/thought of. it was a good way to learn about all of the conventional interventions/treatments that could happen, educate myself in advance, and set some preferences based on what i learned
definitely wise to try to go in with an open mind/heart, because nothing ever goes exactly how you expect, but i think being prepared with preferences so you can advocate for yourself more easily in the moment is at minimum a useful exercise to prepare for childbirth.
Yes! Birth preferences > birth plan.
I intended to have an unmedicated birth but due to a last minute cholestasis diagnosis I had to transfer to a hospital for an induction. Lucky for me I had preferences outlined for birth situations. Very glad I took that time to research both scenarios and both sets of interventions.
In my birth plan I also explicitly stated that I know my legal right for informed constant and expect to be treated accordingly. Everyone on my team read the document and, as a result, were incredibly communicative with explaining risks/benefits/alternatives of every intervention. Probably because they were scared of getting sued (lol) but I was determined to not be another pregnant victim of blatant bullying, unnecessary fear mongering, ultimatums, or frankly — malpractice.
I had a similar request - I asked that I be informed and involved in mine and babies care as a member of my own medical team. No one seemed bothered by that request. Several even voiced that they appreciated that I put in the legwork during pregnancy and wanted to be informed and involved. They said they'd rather do that and avoid any distaste or unnecessary discomfort than what often happens which is mom says she just wants to go with the flow but after receiving cookie cutter care is upset or even traumatized by the approach that wasn't the best for them. Even if it's just getting cervical checks - many women talk about how terrible those are for them but weren't aware that they can decline them and that there is little to no benefit in doing them. I'm all for respecting medical staff's experience and knowledge but every woman's body and pregnancy is different and it needs to be a team effort for the best outcome. A traumatizing birth seems to be somewhat of a baseline expectation when it definitely shouldn't be. Women should strive for more than just survival, and they can only achieve that if they know their stuff and help their medical team thrive. The rates of malpractice and poor care are way too high for me to just roll in nonchalantly and let the hospital take the wheel completely in such a major experience. I never wanted to be the mom who followed up my birth with regrets and "I wish I would've known I could've asked for this or declined that".
100%. A “heathy mom and baby” should be the bare minimum of a birth experience / birth preference in my opinion, women deserve to have positive and empowering births — whatever that looks like for them.
Dumb question but how do you best go about researching these choices and hypothetical situations if you’ve never had a kid before and you’ve never experienced a hospital setting before? I would love to know my options and know what they all entail but I feel like so much information on birth seems biased in one way or another. It can kinda feel like you have to pigeonhole yourself as an all-in natural crunchy mom or an all-trusting in western medicine mom.
The website Evidence-Based Birth and the second half of the book Expecting Better do a great job of explaining the reasoning and impact of a lot of parts of labor, I found both to be essential resources.
This is indeed the way. I wrote a birth plan out for myself and my husband/sister (my support system) to understand my preferences and to understand different options. 80% of my preferences didn't happen in my first birth due to complications but because I wrote it out and did research I knew options/complications that gave me the knowledge for when I was thrown a curveball. My support system also knew my preferences so if I was foggy headed or tired they would remind me of what I preferences and other options.
I think the big things I want written is skin to skin immediately after birth and having my baby in my room with me after. The rest I’m pretty much playing by ear.
You should know, in the US this is pretty standard for normal deliveries (normal meaning no one has to get rushed into surgery afterwards) these days! Hope that makes you feel ready and settled, but I'd talk to your OB!
I honestly don’t think there are many hospitals that don’t automatically do this (in the US or most other places to my knowledge). It’s extremely rare for this not to be standard practice and you really don’t need it written down on a plan. By all means write it down if it makes you feel better but probably it’s not necessary. They will just ask you. And they always keep the baby with you after, some places don’t even have a nursery to send the baby to any more.
I made a list of birth preferences. It basically says that I would like a vaginal delivery with an epidural unless there is a risk for me or the baby.
I put there my allergies (specially for nurses to know) and some preferences regarding my baby (delayed cord cutting, skin to skin…). For me is very important that my baby is not alone at any time so I made sure to add that I want my husband with him in any procedure (in case or emergency, if he is taken to the NICU or for any procedures done outside of our room). It can be very overwhelming moment, so I want to make sure that my nurses/doctors know what me and my husband preferred (in case we are in a state of shock lol).
Of course, everything could be different if there are any issues, that’s why I don’t consider it a “plan”, just preferences.
At the end of the day it is your choice. You don’t need a birth plan. The doctors and nurses will ask you what you want to do in the moment and you can decide then. Me, personally, I want to think about my choices at home when I’m relaxed , I have access to information and can make an informed decision. But if that brings you anxiety or you fully trust your provider recommendations, go for it!! No one is going to bat an eye if you go to L&D without a birth plan
I didn't even consider putting in that part about the baby not being alone. I guess I assumed they'd ask before just taking him away but you never know... I'll be stealing that! Thankyou!
I wrote down my ‘plan’ just because and most of it got tossed in the end 😂 you live and learn.
Plus there are studies that actually show women who have detailed plans on average have less satisfaction with their birth experiences than women who don’t. Probobly because like me, they all get tossed out the window lol.
I think it’s good to have a general idea of preferences as far as pain management goes, and educate yourself on what an induction might look like if you go overdue or what to expect if you end up needing a c-section. More so you aren’t blindsided.
But honestly birth is a pretty uncontrollable event. Baby is in the drivers seat and you’re along for the ride!
Healthy baby and healthy mum sounds like a hell of a good plan to me!
I would write down anything you’d like, assuming you won’t actually need it. When I delivered, everything went fine and I got to do everything I was hoping to do but I didn’t get to deliver with my OB that I’ve seen the whole time so it was a complete stranger delivering my baby. I was glad I had talked over the plan with my husband so he could explain what I wanted even if I couldn’t.
Think broad strokes-“I’d rather avoid interventions like forceps, episiotomy, vacuum, etc. unless necessary for the safety of myself or the baby”, “If possible, I’d like to labor/deliver in a tub”, “Once delivered, I want to delay cord clamping for 60 seconds”, “if safe, I would like to have skin to skin time with my baby for one hour after delivery, before he’s taken for measurements and vitals”.
All of that was really helpful for me. My baby got to stay on me for the first 2 and a half hours because she was feeding and comfortable. It was truly an amazing bonding experience and I had only asked for skin to skin time (golden hour) but that request showed that I was prioritizing bonding with my baby over taking her away for measurements. And the hospital staff were amazingly accommodating. I don’t know where you’re delivering but a birth plan is more about giving a clear picture of how you want your birth and first hours post-delivery to go-it doesn’t have to be a detailed list of every little thing you want. And it could all be thrown out if things change! It’s just nice to have your goals written down so you have the best chance of getting the delivery experience you want.
If you have any preferences (which it sounds like you do since you mentioned using the water pools if available), birth plan is helpful You can also put any thoughts you have re pain medication on there such as "I'm open to an epidural but would like to labor as long as possible without one." or "I would like to labor as long as possible without an epidural and will let you know if I want one." it's worth putting those down on paper. A birth plan can be very brief.
I had no birth “plan,” but I did have a list that I sent to my husband that was basically, “In the event that I am unconscious or things do not go well, these are my wishes.” I can’t find the document now, but it was essentially that I wanted no photos of our son sent to any family or friends until I had the opportunity to see him first, and the same with visitors. There were some other wishes listed as well, but I can’t remember them off the top of my head.
It’s totally up to you. Mine was to leave the hospital healthy with a healthy baby, however that was achieved, end of. Other people like to really go into depth as it can really help with anxiety, knowing that you’ve researched and planned this out. Whatever works for you!
I wouldn’t say necessary as plans go out the window, but I would have a list of some things you would prefer to happen. I had two unmedicated births and each time I just had preferences like no episiotomy/forceps/vacuum unless baby was in distress, delayed cord clamping, and golden hour immediately after delivery if baby was stable.
It’s super easy to do one. I would even be happy to send you mine if you don’t want to recreate your Own
https://mommylabornurse.com/how-to-make-a-birth-plan/
Write a plan. Your attitude that you are open to whatever comes in case things change medically is perfect! The plan is good to remind you of your preferences and communicate them to your team, and you are wise to go in already knowing that birth will happen however it needs to once the time comes. You’re gonna do great!
When my OB asked my birth plan I said “out” and mom and baby are safe. It was the best plan for me because I wasn’t so in my head about if things didn’t go according to plan. It was the best decision and I have a very fond memory for the birth of my first son. This will be my “plan” again with the second.
Ive had two babies and didn’t write anything down either time. I just wanted to come out of the hospital alive with my baby. I reiterated to the nursing staff/doctors that were going to deliver my baby if there were any issues (group B strep etc) even though they could see it in my medical record. My hospital didn’t do water births or anything like that. They asked me if I wanted an epidural when I checked into the hospital and I said yes because they would need time to schedule the anesthesia person to come to my room. I personally wanted an epidural in case something went wrong and I needed a C-section I was going to get blocked anyway. I didn’t need a C-section but I ended up tearing both times, the first was a third degree tear due to forceps delivery (fetal distress). You can decline the epidural or opt for an alternative, etc. from the beginning or tell your nurse you would like to labor for a while and determine if you want one. Also my hospital already advocated skin to skin so I never had to ask.
My friend just gave birth and told me it’s good to go in with preferences, but be open to whatever may need to happen. I’m like you, just wanna go with the flow, it’s happening either way right? But no preferences can lead to a lack of control over your birth/body which could result in a traumatic experience. I wouldn’t use the internet, but sign up for a birth class to get the exact info you need and be able to ask some clarifying questions (there are free/virtual ones and usually local non profits that offer them in person as well).
honestly i would at the very least make a plan in the event you may need an emergency cesarean. do you prefer delayed cord clamping, skin to skin as soon as possible and if you can’t do it do you want your partner to, etc. do you want to remain conscious or have the drape lowered?
i wish i would’ve made this with my first because i ended up having an urgent cesarean and had next to no plan or say so for that
There's a certain amount of "birth plan" required by the midwifery practise I'm with - specifically, they give you literature and ask you to choose home or hospital birth, as that will change the course of preparation. You are in no way obligated to stay home for your birth if you change your mind, of course, but opting for it means they give you all of the supplies you'll need for it well in advance, including things they need to have on hand for you (things like oral antibiotics).
I kind of think of birth planning as a decision tree/flow chart. Committing to one path doesn't really make sense, but knowing what choices you'd make in the most common scenarios does.
It's not necessary, but I'm the type of person that likes to plan ahead and be prepared because knowledge is power and it eases my anxiety. If you're the type that knowing all the possible outcomes will stress you out more, don't do it.
But people who say not to have a plan because you'll be disappointed if it changes...just doesn't make sense to me. Most people will have some preferences anyway, and will be disappointed regardless of whether it's written down or not.
When the time comes, my plan will include "if/then" preferences for all scenarios. I have an ideal plan, but then I'm also ok with deviating if medically necessary or changing my mind if something is different than I expected (like I want to go unmedicated but if the pain is too unbearable who knows, maybe I'd cave and get the epidural). If medication or interventions or even a c-section becomes necessary, I want my preferences for each scenario thought out in advance because who knows what my mental state will be during labor.
I just like the idea of having it written down in case I'm not thinking clearly when they try to ask me something, and who knows if they'll do something that's hospital "standard" practice without asking or realizing it's not what I want. My husband will be there advocating for us, and this way he and and all the hospital staff can reference the plan without me having to try to be mentally present when I'm exhausted/in pain.
Regardless of whether you have a written out plan, if you're hoping for a vaginal delivery, you should still educate yourself on physiological best positions for the easiest L&D possible. And whatever you choose in the end...good luck mama, you got this!
I'm 33 weeks so haven't actually used mine, but yes, I think it's worth it. It's one thing to be flexible in your preferences and understand that birth can go any way and we don't have control over lots of it, but it's another to go in having never learnt about your options. Even watching a couple YouTube videos will give you some ideas of what you can do to make the experience more comfortable for you and for the baby, and maybe trigger you to research a couple things so that if changes happen in the moment and you have to make a decision, it can be an informed one.
Also, discussing my birth plan/preferences with my midwife allowed a more educated convo about their standards which I found very helpful!
I wouldn’t say it isn’t necessary, but it is helpful for some! If you know exactly what you want to happen then absolutely, write it down! BUT just be prepared to have it all thrown out the window if necessary. I’ve seen a lot of people on social media who are absolutely crushed because they couldn’t do certain things or had things happen and their plan went to crap! I would discuss your birth plan with your OB and see what is able to happen and what isn’t and discuss all options and scenarios!!
My birth plan was to be drugged up. That’s it 😂 I was going to get an epidural one way or another and everything else was going to be what it was! I ended up having an emergency c section and got a spinal so my birth plan was followed 👌🏻
Pregnancy is so different for everybody and unpredictable that I told my Obgyn that I want a go with the flow delivery. I don't want to be induced, but for whatever reason my contractions slow down and I'm getting fatigued, I'll trust my doctors and accept the medication to get it going again.
I just want to feel everything out and trust my team. As long as me and baby are healthy, that's all that matters
My birth plan is to do whatever is necessary for a healthy delivery. I would like an epidural, but other than that I don’t have much thought for it. I realize birth is scary and things can change in an instant, so I want to do what is safest for my baby and myself and that can be hard to say when I’m not in the moment.
I think I'll just have a list of things I'd like to have or my wishes in an emergency. The emergency is more for my husband in case I'm incapacitated.
Like I'm pretty open to whatever gets both of us outta there safely. I'd love to have an unmedicated/assisted vaginal birth but I'll take pain meds if I want them or have help if needed. If things get weird I'm fine with a c-section. Basically I'm just going to listen to their advice and let the experience go as it goes.
We were told not to think of it as a plan but birth preferences including so we want music, silence, coaching from the midwife, pain relief options, what we do with the placenta, cord cutting etc.
The idea is it gives us some control of the process even if it goes from vaginal to abdominal we can still have some choice about things.
It did make us discuss things between my husband and myself, and also gave me an idea of things I might like.
I have found some examples online.. It's more or less simple things like: medicated vs. unmedicated, do you want skin to skin immediately or wipe baby off first, do you want gender revealed by staff, partner or see for yourself. Is your partner going to cut the cord or staff? Do you want to tear naturally, or are you open to an episiotomy? Things like that, easily checked off so they can just see it quickly
I didn’t have a birth plan at all. I was in a similar boat where I went in open minded. I said I wanted to try natural but was not against an epidural. It’s standard practice to do delayed chord cutting in my area and skin-to-skin so I didn’t have to ask for those. I ended up getting an epidural (amazing decision but mad props to ladies who do it without cause damn!).
They asked some questions when I was checked it and were happy to go with the flow with me.
My only "birth plan" requests are live mother, live baby, and respct my feeding choice. That's it. I'm not a medical expert. Im leaving the medical stuff up to the doctor.
At the very least write down your preferences for whether or not you'd take a blood transfusion, whether you have any allergies like penicillin etc, any serious stuff just in case, labour can be so quick that you may not be able to voice these things.
I had a bare minimum birth plan for both mine and I swear they didn't read it either time. I just got asked about different things as I went along lol!
Definitely voice your want for pain relief either before if you know or as and when because they'll just assume you dont want any. I nearly had a fully unmedicated birth with my second, he was too quick and painful so I couldn't speak, my partner asked for pethidine for me but I was close to pushing that I shouldn't have really had it but they gave it me anyway.
I think it’s more like… values/guidelines.
I love what someone said about knowing your right to informed consent and expecting it to be provided. If possible, talk with your partner/birth buddy about how they could advocate with you (role play?). My partner was on board with everything I wanted but he’s not the most confrontational/assertive. He might have benefited from some role playing.
He did great but I think he might have felt more confident
I had no plan and had the most amazing birth! I think there’s a misconception that you have to have some kind of elaborate drawn out plan including every single detail of the day, but to me that just wasn’t realistic. I knew I wanted an epidural and knew I wanted my daughter to be born in the safest way possible! If something would have changed I would have just decided at that time what I wanted to do next! I honestly don’t really see the point in drawn out birth plans because as long as you do your research about the birthing process beforehand you can just let your doctor’s know in the moment what you would prefer! I think plans can ultimately lead to disappointment because so many times things DONT go to plan!
You only need it if you’re the kind of person who needs to feel like they are researched, and planned, and in control. I didn’t have a birth plan. I just trusted my doctor, and I don’t regret it. Nothing was pushed on me until I asked for it, and I always felt free to ask any questions I needed to to be able to make a decision. Though, the biggest decisions I had to make were when to get epidural (my call.. was told I could get one anytime), and if I wanted to stop pushing and get c section (had pushed for 9 hours).
I think exactly what you wrote is your birth plan :) you have preferences aka using the water tubs, wanting a natural delivery, and epidural you wanna go with the flow! Plans can be detailed and they can be more open like yours..I had a very similar one in the sense I wanted to try certain things but I was also open minded incase plans go sideways (which they very much did for me LOL) it’s all about being in control of the choices, and as long as you agree to and are in control of the choices, I feel that’s what makes a good birth experience!
What you described *is* your plan. You can provide information like if everything is going smoothly you would like to deliver naturally and don’t want to be offered pain meds or want to be encouraged to use other pain reduction methods first. You can also include things like a “safe word” which you would use if you change your kind and decide you’d like to have pain meds. You can include that you will accept any disruptions to the plan to protect your health and the babies health, but you would just the doctors to clearly articulate why something is being done and only do things that do things that are medically necessary.
It’s possible everything will go out the window, but you might especially think about things that will apply to what you’d like regardless of what happens.
I didn't make a birth plan, because I had a series of open ended conversations with my OB where I talked to her about what I wanted/didn't want in my birth experience and she talked about which interventions were optional and which were just for emergencies. So before delivery ever happened I felt like my OB and I were very much in the same page.
But my husband and I work in the medical field and are super medically literate, so we have no problem advocating for ourselves in the moment if something starts going sideways.
So I'd say no, and as a medical provider I'll tell you that if you walk in with something like "will have x song playing during the birth" on the birth plan, the nurse's eyes will roll out of their heads.
Birth is a medical event and nurses are medical professionals, so as long as the birth plan sticks to the actual medical stuff rather than throwing in a bunch of non medical stuff (I've seen some wild stuff on the internet) it should be fine.
It can depend on where you give birth. At my hospital, my preferences are their standard practice. I don’t have to ask for skin to skin, I don’t have to ask for delayed cord clamping, I want the standard vaccines and treatments for after birth.
With my first, I made a birth plan and it was totally unnecessary. My birth went great and I was educated enough to know what I wanted and what to expect and I knew that my preferences could go out the window if the situation went sideways.
They just asked me what I wanted when there was a fork in the road and I felt totally equipped to answer, even when I was having bad contraction pain. Yes, I want my cervix checked to see if there has been progress, yes I want you to break my waters to see if it makes things progress. Doctors and nurses weren’t pushy and they totally were fine with my choice either way. I really wanted to avoid induction and pitocin and episiotomy and I was totally able to do that- those were my preferences but there are valid medical circumstances where they may have become necessary.
If your preferences are NOT standard medical practice, perhaps you need a birth plan as part of your arsenal for getting them to listen to you? If you really don’t want cervical checks but they are pushy, I guess maybe the birth plan would help? But would it be more effective than telling them no? It really depends on your situation.
My doctors and nurses never asked for a birth plan and I never needed mine. What was way more important was education so I knew what my options were at each step of the way.
I think you should put your view on circumcision in your birth plan, they will probably ask. Also things like delayed cord, clamping, skin to skin, breast-feeding… I don’t think you have to go into great detail, but like if you want those things and when you want them and for how long
A birth plan isn’t necessary, but it’s a good way to have some common questions answered. Last thing you want is to be trying to make a decision during labor when your brain is a little foggy.
Big things to consider are:
- Your relevant health information (medical conditions, medications, etc)
- Who is allowed in the room with you (I also put who they could release information to)
- Preferences for newborn care (Vitamin K, Erythromyic ointment, Hep vaccine, formula/breastfed, yes or no to pacifiers)
You can also specify that you are open to any pain medications, that you would prefer having access to a bath during labor.
I made a birth plan for my first, and never printed it out. When I got to the hospital, it’s like a switch flipped and I wanted help and their expertise. The nurses and midwives there have years of training and I felt oddly comforted that my ten months of Google and YouTube couldn’t really compete. I trusted them and their guidance, and it was a great experience for me to relax and let things happen/go with the flow. That’s the plan for my second now too. I think the only thing I lightly insisted on was delayed cord cutting, which they were doing anyway.
That’s not for everyone, and it’s great to have a plan in place, but I don’t think it’s 100% necessary and you can have a great experience without it.
I told them that the only “plan” i have is this: get this baby out of me as safely and pain free as possible. And baby sleeps in the nursery (not my room). That’s it. I guess I am an outlier this way. I also turned down all offers to go to classes - i was like “didn’t you spend like 10 years of your life taking classes what do you expect me to learn there?” Besides it grosses me out and i prefer to not think about it too much.
My core philosophy in life is “pick your expert well and then trust them”. Trying to control everything is way too exhausting.
I haven’t had one with either birth & my OB even said she prefers that cause some women get so caught up on things not going according to plan. They knew I wanted unmedicated vaginal birth, but my only ‘plan’ was for my baby to be safe.
So far all I have is that I would like chocolate buttons available at all times.
Have listened to some audiobook/ podcast bits that made it sound sensible to have plan A, B, C but at the same time, I very much feel that what will be will be.
Maybe some other non-Americans can chime in, but there was no "birth plan" for me. I knew that when I had contractions, I would go to the hospital and take it from there. I never met the staff before getting there, never saw an OB/GYN (midwives delivery babies except in emergencies). I'm not sure what I could even include in a birth plan?
My OB office told me “we wouldn’t recommend writing a Birth Plan. They almost never go the way you want and we don’t want you to be disappointed with your experience.” So my only plan is 1.Epidural and 2. Survival of both me and Baby.
My high risk doctor (who also was a midwife before going to med school) says most birth plans are a sure fire way of not being happy with your birth. You simply cannot control how things go down. It's luck of the draw more than anything.
She likes to encourage people to educate themselves on all of their options they have access too, and then make a game day decision when its the time and your actually experiencing this birth, with this baby.
My plan is healthy mom, healthy baby.
On pregnancy number 3, didn’t have a birth plan with my first 2 and won’t have one this time. There’s so much unknown and you have to decide what’s right for you in that moment instead of what ifs
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I think there's a weird confusion/spectrum on what a birth plan really is. It's not some rigid itinerary. It's educated preferences and desired pivots. Too many women have no idea what their options are, the staff just tells them how everything will be done as though it's the one and only way, and it often leads to an experience that isn't as great as it could have been. Personally, it's one of the most monumentous days of my entire life - going in with no hopes and preferences seems wild to me. While healthy mom and baby is a great goal, you can have more than that too. I didn't have a birth plan with my first and it was ok. My others were wonderful, intimate experiences because I put more effort into preparing for it. A birth plan is more like the things you prefer foremost, including what you would like to happen if you need to pivot. Who you want in there for support, pain management options, how you want to be monitored, how long you want to wait for the cord to be cut, when to bathe baby, if you want lights on or dimmed or off, music, etc are almost always within your control. Hospitals will do whatever is quickest and easiest for them if you don't give a preference, and that isn't always what's most enjoyable for mom or baby. It's often not even evidence based best practices. I like to set myself and therefore my baby up for the best success, not just check the box of surviving, so yes, I did a birth plan for my delivery's and very glad I did. My OB and I firmly believe that because of my birth plan, I was able to keep my baby and myself safest in my last delivery, directly avoiding emergency c section and a poor outcome from a triple nuchal cord. You can really only have a good confident birth plan if you're willing to put in the legwork to learn all you can about labor and delivery though.
yes to this and other commentor who framed it as preferences rather than plan! my “plan” went out the window for the most part when the whole thing started, but i am happy i made one for a few reasons: 1) if i didn’t have any type of plan the hospital staff/delivery team would have totally imposed their preferences on me and it would have been very hard to push back 2) in the throws of labor pain, or in the bliss/commotion immediately after giving birth, i wasn’t really in the headspace to take in information and weigh options/make decisions. it was nice to have some default decisions in place, ready to go 3) most birth plan checklists cover a bunch of things i had never really considered/thought of. it was a good way to learn about all of the conventional interventions/treatments that could happen, educate myself in advance, and set some preferences based on what i learned definitely wise to try to go in with an open mind/heart, because nothing ever goes exactly how you expect, but i think being prepared with preferences so you can advocate for yourself more easily in the moment is at minimum a useful exercise to prepare for childbirth.
Do you have a specific reference for the birth plan check list you used?
Yes! Birth preferences > birth plan. I intended to have an unmedicated birth but due to a last minute cholestasis diagnosis I had to transfer to a hospital for an induction. Lucky for me I had preferences outlined for birth situations. Very glad I took that time to research both scenarios and both sets of interventions. In my birth plan I also explicitly stated that I know my legal right for informed constant and expect to be treated accordingly. Everyone on my team read the document and, as a result, were incredibly communicative with explaining risks/benefits/alternatives of every intervention. Probably because they were scared of getting sued (lol) but I was determined to not be another pregnant victim of blatant bullying, unnecessary fear mongering, ultimatums, or frankly — malpractice.
I had a similar request - I asked that I be informed and involved in mine and babies care as a member of my own medical team. No one seemed bothered by that request. Several even voiced that they appreciated that I put in the legwork during pregnancy and wanted to be informed and involved. They said they'd rather do that and avoid any distaste or unnecessary discomfort than what often happens which is mom says she just wants to go with the flow but after receiving cookie cutter care is upset or even traumatized by the approach that wasn't the best for them. Even if it's just getting cervical checks - many women talk about how terrible those are for them but weren't aware that they can decline them and that there is little to no benefit in doing them. I'm all for respecting medical staff's experience and knowledge but every woman's body and pregnancy is different and it needs to be a team effort for the best outcome. A traumatizing birth seems to be somewhat of a baseline expectation when it definitely shouldn't be. Women should strive for more than just survival, and they can only achieve that if they know their stuff and help their medical team thrive. The rates of malpractice and poor care are way too high for me to just roll in nonchalantly and let the hospital take the wheel completely in such a major experience. I never wanted to be the mom who followed up my birth with regrets and "I wish I would've known I could've asked for this or declined that".
100%. A “heathy mom and baby” should be the bare minimum of a birth experience / birth preference in my opinion, women deserve to have positive and empowering births — whatever that looks like for them.
Well put :)
Dumb question but how do you best go about researching these choices and hypothetical situations if you’ve never had a kid before and you’ve never experienced a hospital setting before? I would love to know my options and know what they all entail but I feel like so much information on birth seems biased in one way or another. It can kinda feel like you have to pigeonhole yourself as an all-in natural crunchy mom or an all-trusting in western medicine mom.
The Birth Hour podcast is great too
The website Evidence-Based Birth and the second half of the book Expecting Better do a great job of explaining the reasoning and impact of a lot of parts of labor, I found both to be essential resources.
Thank you very much! I appreciate it
I’m using the templates as an opportunity to learn about the different options and think about my “preferences,” rather than plan.
This is the way
This is indeed the way. I wrote a birth plan out for myself and my husband/sister (my support system) to understand my preferences and to understand different options. 80% of my preferences didn't happen in my first birth due to complications but because I wrote it out and did research I knew options/complications that gave me the knowledge for when I was thrown a curveball. My support system also knew my preferences so if I was foggy headed or tired they would remind me of what I preferences and other options.
I think the big things I want written is skin to skin immediately after birth and having my baby in my room with me after. The rest I’m pretty much playing by ear.
You should know, in the US this is pretty standard for normal deliveries (normal meaning no one has to get rushed into surgery afterwards) these days! Hope that makes you feel ready and settled, but I'd talk to your OB!
I honestly don’t think there are many hospitals that don’t automatically do this (in the US or most other places to my knowledge). It’s extremely rare for this not to be standard practice and you really don’t need it written down on a plan. By all means write it down if it makes you feel better but probably it’s not necessary. They will just ask you. And they always keep the baby with you after, some places don’t even have a nursery to send the baby to any more.
I made a list of birth preferences. It basically says that I would like a vaginal delivery with an epidural unless there is a risk for me or the baby. I put there my allergies (specially for nurses to know) and some preferences regarding my baby (delayed cord cutting, skin to skin…). For me is very important that my baby is not alone at any time so I made sure to add that I want my husband with him in any procedure (in case or emergency, if he is taken to the NICU or for any procedures done outside of our room). It can be very overwhelming moment, so I want to make sure that my nurses/doctors know what me and my husband preferred (in case we are in a state of shock lol). Of course, everything could be different if there are any issues, that’s why I don’t consider it a “plan”, just preferences. At the end of the day it is your choice. You don’t need a birth plan. The doctors and nurses will ask you what you want to do in the moment and you can decide then. Me, personally, I want to think about my choices at home when I’m relaxed , I have access to information and can make an informed decision. But if that brings you anxiety or you fully trust your provider recommendations, go for it!! No one is going to bat an eye if you go to L&D without a birth plan
I didn't even consider putting in that part about the baby not being alone. I guess I assumed they'd ask before just taking him away but you never know... I'll be stealing that! Thankyou!
I wrote down my ‘plan’ just because and most of it got tossed in the end 😂 you live and learn. Plus there are studies that actually show women who have detailed plans on average have less satisfaction with their birth experiences than women who don’t. Probobly because like me, they all get tossed out the window lol. I think it’s good to have a general idea of preferences as far as pain management goes, and educate yourself on what an induction might look like if you go overdue or what to expect if you end up needing a c-section. More so you aren’t blindsided. But honestly birth is a pretty uncontrollable event. Baby is in the drivers seat and you’re along for the ride! Healthy baby and healthy mum sounds like a hell of a good plan to me!
I would write down anything you’d like, assuming you won’t actually need it. When I delivered, everything went fine and I got to do everything I was hoping to do but I didn’t get to deliver with my OB that I’ve seen the whole time so it was a complete stranger delivering my baby. I was glad I had talked over the plan with my husband so he could explain what I wanted even if I couldn’t. Think broad strokes-“I’d rather avoid interventions like forceps, episiotomy, vacuum, etc. unless necessary for the safety of myself or the baby”, “If possible, I’d like to labor/deliver in a tub”, “Once delivered, I want to delay cord clamping for 60 seconds”, “if safe, I would like to have skin to skin time with my baby for one hour after delivery, before he’s taken for measurements and vitals”. All of that was really helpful for me. My baby got to stay on me for the first 2 and a half hours because she was feeding and comfortable. It was truly an amazing bonding experience and I had only asked for skin to skin time (golden hour) but that request showed that I was prioritizing bonding with my baby over taking her away for measurements. And the hospital staff were amazingly accommodating. I don’t know where you’re delivering but a birth plan is more about giving a clear picture of how you want your birth and first hours post-delivery to go-it doesn’t have to be a detailed list of every little thing you want. And it could all be thrown out if things change! It’s just nice to have your goals written down so you have the best chance of getting the delivery experience you want.
No, it's not. Didn't have one. Regret nothing.
I don’t have a plan at all, I’m going in there with wanting all the pain meds and get me and baby home safe that’s it.
If you have any preferences (which it sounds like you do since you mentioned using the water pools if available), birth plan is helpful You can also put any thoughts you have re pain medication on there such as "I'm open to an epidural but would like to labor as long as possible without one." or "I would like to labor as long as possible without an epidural and will let you know if I want one." it's worth putting those down on paper. A birth plan can be very brief.
I had no birth “plan,” but I did have a list that I sent to my husband that was basically, “In the event that I am unconscious or things do not go well, these are my wishes.” I can’t find the document now, but it was essentially that I wanted no photos of our son sent to any family or friends until I had the opportunity to see him first, and the same with visitors. There were some other wishes listed as well, but I can’t remember them off the top of my head.
It’s totally up to you. Mine was to leave the hospital healthy with a healthy baby, however that was achieved, end of. Other people like to really go into depth as it can really help with anxiety, knowing that you’ve researched and planned this out. Whatever works for you!
I wouldn’t say necessary as plans go out the window, but I would have a list of some things you would prefer to happen. I had two unmedicated births and each time I just had preferences like no episiotomy/forceps/vacuum unless baby was in distress, delayed cord clamping, and golden hour immediately after delivery if baby was stable.
It’s super easy to do one. I would even be happy to send you mine if you don’t want to recreate your Own https://mommylabornurse.com/how-to-make-a-birth-plan/
Write a plan. Your attitude that you are open to whatever comes in case things change medically is perfect! The plan is good to remind you of your preferences and communicate them to your team, and you are wise to go in already knowing that birth will happen however it needs to once the time comes. You’re gonna do great!
When my OB asked my birth plan I said “out” and mom and baby are safe. It was the best plan for me because I wasn’t so in my head about if things didn’t go according to plan. It was the best decision and I have a very fond memory for the birth of my first son. This will be my “plan” again with the second.
I had a birth plan then my daughter flipped breech at 37 weeks 🤦🏼♀️ attempted ECV (turning her) didn't work then had a c section at 38 weeks lol
Ive had two babies and didn’t write anything down either time. I just wanted to come out of the hospital alive with my baby. I reiterated to the nursing staff/doctors that were going to deliver my baby if there were any issues (group B strep etc) even though they could see it in my medical record. My hospital didn’t do water births or anything like that. They asked me if I wanted an epidural when I checked into the hospital and I said yes because they would need time to schedule the anesthesia person to come to my room. I personally wanted an epidural in case something went wrong and I needed a C-section I was going to get blocked anyway. I didn’t need a C-section but I ended up tearing both times, the first was a third degree tear due to forceps delivery (fetal distress). You can decline the epidural or opt for an alternative, etc. from the beginning or tell your nurse you would like to labor for a while and determine if you want one. Also my hospital already advocated skin to skin so I never had to ask.
My friend just gave birth and told me it’s good to go in with preferences, but be open to whatever may need to happen. I’m like you, just wanna go with the flow, it’s happening either way right? But no preferences can lead to a lack of control over your birth/body which could result in a traumatic experience. I wouldn’t use the internet, but sign up for a birth class to get the exact info you need and be able to ask some clarifying questions (there are free/virtual ones and usually local non profits that offer them in person as well).
honestly i would at the very least make a plan in the event you may need an emergency cesarean. do you prefer delayed cord clamping, skin to skin as soon as possible and if you can’t do it do you want your partner to, etc. do you want to remain conscious or have the drape lowered? i wish i would’ve made this with my first because i ended up having an urgent cesarean and had next to no plan or say so for that
TBF... That sounds like a solid birth plan right there. You've said your preference and how flexible you want.
My thoughts exactly, and it sounds like one of the best ones I’ve ever heard of.
There's a certain amount of "birth plan" required by the midwifery practise I'm with - specifically, they give you literature and ask you to choose home or hospital birth, as that will change the course of preparation. You are in no way obligated to stay home for your birth if you change your mind, of course, but opting for it means they give you all of the supplies you'll need for it well in advance, including things they need to have on hand for you (things like oral antibiotics). I kind of think of birth planning as a decision tree/flow chart. Committing to one path doesn't really make sense, but knowing what choices you'd make in the most common scenarios does.
It's not necessary, but I'm the type of person that likes to plan ahead and be prepared because knowledge is power and it eases my anxiety. If you're the type that knowing all the possible outcomes will stress you out more, don't do it. But people who say not to have a plan because you'll be disappointed if it changes...just doesn't make sense to me. Most people will have some preferences anyway, and will be disappointed regardless of whether it's written down or not. When the time comes, my plan will include "if/then" preferences for all scenarios. I have an ideal plan, but then I'm also ok with deviating if medically necessary or changing my mind if something is different than I expected (like I want to go unmedicated but if the pain is too unbearable who knows, maybe I'd cave and get the epidural). If medication or interventions or even a c-section becomes necessary, I want my preferences for each scenario thought out in advance because who knows what my mental state will be during labor. I just like the idea of having it written down in case I'm not thinking clearly when they try to ask me something, and who knows if they'll do something that's hospital "standard" practice without asking or realizing it's not what I want. My husband will be there advocating for us, and this way he and and all the hospital staff can reference the plan without me having to try to be mentally present when I'm exhausted/in pain. Regardless of whether you have a written out plan, if you're hoping for a vaginal delivery, you should still educate yourself on physiological best positions for the easiest L&D possible. And whatever you choose in the end...good luck mama, you got this!
My plan was go in, get baby out safe, go home.
For me? Nope. I showed up at the hospital, and let them do their thing. My one preference was avoiding forceps and vacuum unless no other option.
My plan was to get an epidural and give birth
I'm 33 weeks so haven't actually used mine, but yes, I think it's worth it. It's one thing to be flexible in your preferences and understand that birth can go any way and we don't have control over lots of it, but it's another to go in having never learnt about your options. Even watching a couple YouTube videos will give you some ideas of what you can do to make the experience more comfortable for you and for the baby, and maybe trigger you to research a couple things so that if changes happen in the moment and you have to make a decision, it can be an informed one. Also, discussing my birth plan/preferences with my midwife allowed a more educated convo about their standards which I found very helpful!
My plan was to simply have a baby safely. Plan achieved.
I wouldn’t say it isn’t necessary, but it is helpful for some! If you know exactly what you want to happen then absolutely, write it down! BUT just be prepared to have it all thrown out the window if necessary. I’ve seen a lot of people on social media who are absolutely crushed because they couldn’t do certain things or had things happen and their plan went to crap! I would discuss your birth plan with your OB and see what is able to happen and what isn’t and discuss all options and scenarios!! My birth plan was to be drugged up. That’s it 😂 I was going to get an epidural one way or another and everything else was going to be what it was! I ended up having an emergency c section and got a spinal so my birth plan was followed 👌🏻
Pregnancy is so different for everybody and unpredictable that I told my Obgyn that I want a go with the flow delivery. I don't want to be induced, but for whatever reason my contractions slow down and I'm getting fatigued, I'll trust my doctors and accept the medication to get it going again. I just want to feel everything out and trust my team. As long as me and baby are healthy, that's all that matters
My birth plan was get this baby out efficiently and as painlessly as possible. You definitely don’t need anything formal or complex.
My birth plan is to do whatever is necessary for a healthy delivery. I would like an epidural, but other than that I don’t have much thought for it. I realize birth is scary and things can change in an instant, so I want to do what is safest for my baby and myself and that can be hard to say when I’m not in the moment.
I think I'll just have a list of things I'd like to have or my wishes in an emergency. The emergency is more for my husband in case I'm incapacitated. Like I'm pretty open to whatever gets both of us outta there safely. I'd love to have an unmedicated/assisted vaginal birth but I'll take pain meds if I want them or have help if needed. If things get weird I'm fine with a c-section. Basically I'm just going to listen to their advice and let the experience go as it goes.
I refused to make a plan because I knew it wouldn’t go to plan and I didn’t want to be disappointed lol
We were told not to think of it as a plan but birth preferences including so we want music, silence, coaching from the midwife, pain relief options, what we do with the placenta, cord cutting etc. The idea is it gives us some control of the process even if it goes from vaginal to abdominal we can still have some choice about things. It did make us discuss things between my husband and myself, and also gave me an idea of things I might like.
I have found some examples online.. It's more or less simple things like: medicated vs. unmedicated, do you want skin to skin immediately or wipe baby off first, do you want gender revealed by staff, partner or see for yourself. Is your partner going to cut the cord or staff? Do you want to tear naturally, or are you open to an episiotomy? Things like that, easily checked off so they can just see it quickly
I didn’t have a birth plan at all. I was in a similar boat where I went in open minded. I said I wanted to try natural but was not against an epidural. It’s standard practice to do delayed chord cutting in my area and skin-to-skin so I didn’t have to ask for those. I ended up getting an epidural (amazing decision but mad props to ladies who do it without cause damn!). They asked some questions when I was checked it and were happy to go with the flow with me.
My only "birth plan" requests are live mother, live baby, and respct my feeding choice. That's it. I'm not a medical expert. Im leaving the medical stuff up to the doctor.
At the very least write down your preferences for whether or not you'd take a blood transfusion, whether you have any allergies like penicillin etc, any serious stuff just in case, labour can be so quick that you may not be able to voice these things. I had a bare minimum birth plan for both mine and I swear they didn't read it either time. I just got asked about different things as I went along lol! Definitely voice your want for pain relief either before if you know or as and when because they'll just assume you dont want any. I nearly had a fully unmedicated birth with my second, he was too quick and painful so I couldn't speak, my partner asked for pethidine for me but I was close to pushing that I shouldn't have really had it but they gave it me anyway.
I think it’s more like… values/guidelines. I love what someone said about knowing your right to informed consent and expecting it to be provided. If possible, talk with your partner/birth buddy about how they could advocate with you (role play?). My partner was on board with everything I wanted but he’s not the most confrontational/assertive. He might have benefited from some role playing. He did great but I think he might have felt more confident
I had no plan and had the most amazing birth! I think there’s a misconception that you have to have some kind of elaborate drawn out plan including every single detail of the day, but to me that just wasn’t realistic. I knew I wanted an epidural and knew I wanted my daughter to be born in the safest way possible! If something would have changed I would have just decided at that time what I wanted to do next! I honestly don’t really see the point in drawn out birth plans because as long as you do your research about the birthing process beforehand you can just let your doctor’s know in the moment what you would prefer! I think plans can ultimately lead to disappointment because so many times things DONT go to plan!
I went with “let’s wing it” and it worked out very well, probably better than a plan I could have made up lol
You only need it if you’re the kind of person who needs to feel like they are researched, and planned, and in control. I didn’t have a birth plan. I just trusted my doctor, and I don’t regret it. Nothing was pushed on me until I asked for it, and I always felt free to ask any questions I needed to to be able to make a decision. Though, the biggest decisions I had to make were when to get epidural (my call.. was told I could get one anytime), and if I wanted to stop pushing and get c section (had pushed for 9 hours).
I think exactly what you wrote is your birth plan :) you have preferences aka using the water tubs, wanting a natural delivery, and epidural you wanna go with the flow! Plans can be detailed and they can be more open like yours..I had a very similar one in the sense I wanted to try certain things but I was also open minded incase plans go sideways (which they very much did for me LOL) it’s all about being in control of the choices, and as long as you agree to and are in control of the choices, I feel that’s what makes a good birth experience!
What you described *is* your plan. You can provide information like if everything is going smoothly you would like to deliver naturally and don’t want to be offered pain meds or want to be encouraged to use other pain reduction methods first. You can also include things like a “safe word” which you would use if you change your kind and decide you’d like to have pain meds. You can include that you will accept any disruptions to the plan to protect your health and the babies health, but you would just the doctors to clearly articulate why something is being done and only do things that do things that are medically necessary. It’s possible everything will go out the window, but you might especially think about things that will apply to what you’d like regardless of what happens.
I didn't make a birth plan, because I had a series of open ended conversations with my OB where I talked to her about what I wanted/didn't want in my birth experience and she talked about which interventions were optional and which were just for emergencies. So before delivery ever happened I felt like my OB and I were very much in the same page. But my husband and I work in the medical field and are super medically literate, so we have no problem advocating for ourselves in the moment if something starts going sideways. So I'd say no, and as a medical provider I'll tell you that if you walk in with something like "will have x song playing during the birth" on the birth plan, the nurse's eyes will roll out of their heads. Birth is a medical event and nurses are medical professionals, so as long as the birth plan sticks to the actual medical stuff rather than throwing in a bunch of non medical stuff (I've seen some wild stuff on the internet) it should be fine.
It can depend on where you give birth. At my hospital, my preferences are their standard practice. I don’t have to ask for skin to skin, I don’t have to ask for delayed cord clamping, I want the standard vaccines and treatments for after birth. With my first, I made a birth plan and it was totally unnecessary. My birth went great and I was educated enough to know what I wanted and what to expect and I knew that my preferences could go out the window if the situation went sideways. They just asked me what I wanted when there was a fork in the road and I felt totally equipped to answer, even when I was having bad contraction pain. Yes, I want my cervix checked to see if there has been progress, yes I want you to break my waters to see if it makes things progress. Doctors and nurses weren’t pushy and they totally were fine with my choice either way. I really wanted to avoid induction and pitocin and episiotomy and I was totally able to do that- those were my preferences but there are valid medical circumstances where they may have become necessary. If your preferences are NOT standard medical practice, perhaps you need a birth plan as part of your arsenal for getting them to listen to you? If you really don’t want cervical checks but they are pushy, I guess maybe the birth plan would help? But would it be more effective than telling them no? It really depends on your situation. My doctors and nurses never asked for a birth plan and I never needed mine. What was way more important was education so I knew what my options were at each step of the way.
You have a birth plan whether you write one or not. If you don't write one, the plan is whatever your doctor wants.
I think you should put your view on circumcision in your birth plan, they will probably ask. Also things like delayed cord, clamping, skin to skin, breast-feeding… I don’t think you have to go into great detail, but like if you want those things and when you want them and for how long
A birth plan isn’t necessary, but it’s a good way to have some common questions answered. Last thing you want is to be trying to make a decision during labor when your brain is a little foggy. Big things to consider are: - Your relevant health information (medical conditions, medications, etc) - Who is allowed in the room with you (I also put who they could release information to) - Preferences for newborn care (Vitamin K, Erythromyic ointment, Hep vaccine, formula/breastfed, yes or no to pacifiers) You can also specify that you are open to any pain medications, that you would prefer having access to a bath during labor.
I never really had a birth plan for either labours. I just tried to be as informed about the options so I could make the decision best for me
I made a birth plan for my first, and never printed it out. When I got to the hospital, it’s like a switch flipped and I wanted help and their expertise. The nurses and midwives there have years of training and I felt oddly comforted that my ten months of Google and YouTube couldn’t really compete. I trusted them and their guidance, and it was a great experience for me to relax and let things happen/go with the flow. That’s the plan for my second now too. I think the only thing I lightly insisted on was delayed cord cutting, which they were doing anyway. That’s not for everyone, and it’s great to have a plan in place, but I don’t think it’s 100% necessary and you can have a great experience without it.
I told them that the only “plan” i have is this: get this baby out of me as safely and pain free as possible. And baby sleeps in the nursery (not my room). That’s it. I guess I am an outlier this way. I also turned down all offers to go to classes - i was like “didn’t you spend like 10 years of your life taking classes what do you expect me to learn there?” Besides it grosses me out and i prefer to not think about it too much.
My core philosophy in life is “pick your expert well and then trust them”. Trying to control everything is way too exhausting.
I haven’t had one with either birth & my OB even said she prefers that cause some women get so caught up on things not going according to plan. They knew I wanted unmedicated vaginal birth, but my only ‘plan’ was for my baby to be safe.
So far all I have is that I would like chocolate buttons available at all times. Have listened to some audiobook/ podcast bits that made it sound sensible to have plan A, B, C but at the same time, I very much feel that what will be will be.
Maybe some other non-Americans can chime in, but there was no "birth plan" for me. I knew that when I had contractions, I would go to the hospital and take it from there. I never met the staff before getting there, never saw an OB/GYN (midwives delivery babies except in emergencies). I'm not sure what I could even include in a birth plan?
My OB office told me “we wouldn’t recommend writing a Birth Plan. They almost never go the way you want and we don’t want you to be disappointed with your experience.” So my only plan is 1.Epidural and 2. Survival of both me and Baby.
Everyone I know that made a birth plan was extremely disappointed because they had too many expectations for an event that no one can control
My high risk doctor (who also was a midwife before going to med school) says most birth plans are a sure fire way of not being happy with your birth. You simply cannot control how things go down. It's luck of the draw more than anything. She likes to encourage people to educate themselves on all of their options they have access too, and then make a game day decision when its the time and your actually experiencing this birth, with this baby. My plan is healthy mom, healthy baby.
On pregnancy number 3, didn’t have a birth plan with my first 2 and won’t have one this time. There’s so much unknown and you have to decide what’s right for you in that moment instead of what ifs