Two weeks ago I went to play mahjong with a local parents group. Three of the four women at my table had children under age two, and we got to talking about our births. Their stories all had one thing in common: they deviated from the birth plan.

Every birth. Including mine — twice.

So if birth plans don’t survive contact with reality, why make one? That’s what this post is about. Because you *should* still make one – and reading this may change how you approach yours.

You’re not supposed to know how to do this from scratch — and it’s wildly inefficient for you to try

Birth planning is one of those areas where the mental load gets quietly handed from the expert to the amateur. Your doctor — who has delivered hundreds of babies — tells you to “go make a birth plan.” And now you, who have delivered zero babies, are supposed to figure out what belongs in one. It’s the same pattern that plays out across parenthood: every family solving the same problems alone, from scratch, when tools and systems already exist.

That’s exactly what happened to me. When I found out I was pregnant, I wanted to talk about labor during my first medical visit. (I knew the options for getting the baby out of me and they all seemed…bad.)

I was disappointed when my doctor told me to go home, make a birth plan, and we’d discuss it in a few months. But I trusted the process.

So I went home– and immediately realized I had no idea how to make one. The whole reason I had questions was that I had never given birth before. How was I supposed to plan for something I’d never experienced?

I Googled it. What I found was not helpful. Blogs where people mentioned the music in their birth plan (What does music have to do with giving birth?). Posts about how many people you want in the room (Am I even going to be aware of who’s in the room?). Nothing that gave me a framework — just other people’s random preferences, which raised more questions than they answered.

And even if I could identify a few obvious preferences — like hoping to avoid a C-section — I had no idea what else belonged in a birth plan.

This is the real problem with birth plans. You’re being asked to make informed decisions about something utterly outside your experience. It’s like asking someone who has never been on a plane to create a guide to navigating airport security.

Use a checklist — don’t start from a blank page

I am really good at internet research. So I went digging for a birth plan checklist — not a blog post, not someone’s personal narrative, but a systematic tool.

I found one and it changed everything.

The best way I can explain why: a checklist is like being handed a restaurant menu instead of being asked “what do you want to eat?” It gives you the universe of possibilities so you can form opinions, rather than staring at a blank page trying to invent categories you don’t know exist.

The checklist is organized into categories, headers, and options — pain relief, delivery positions, who’s in the room, what happens immediately after delivery. Instead of doing extensive research and trying to synthesize it all into something coherent, the checklist does the mental lift for you. You go through and check off what applies.

Is it the most direct and explicit thing to hand a nurse? Probably not. But that’s not the point. The point is that when you sit down to think about pain relief, you have a genuinely extensive list of options in front of you. When you talk to your doctor, you can have a precise conversation instead of groping around for information in real time.

The checklist turned me from a passive recipient of medical care into an informed participant in my own delivery. (I found a second exceptionally useful menu too — Penny Simkin’s Pain Medication Preference Scale – I linked both at the bottom.)

The plan won’t match reality. Make it anyway.

Here’s the thing: the ladies at mahjong weren’t anomalies. I don’t know a single person whose labor and delivery followed their birth plan. The baby takes over.

The real point of a birth plan is the making of it. It’s a process for getting aligned — with yourself, with your partner, with your provider, and with whoever ends up in the room when you deliver (which may not be the provider you planned with). You’re getting clear on what you want in an ideal situation. And then the baby does what the baby does.

I think of it like rehearsing for improv. You don’t rehearse to memorize lines. You rehearse so everyone understands the characters, the themes, and the boundaries — so that when the performance goes off script (and it will), everyone can improvise from a shared understanding of what matters.

That’s what the birth plan does. It’s not a prescription. It’s preparation for the improvisation.

My birth went off-plan immediately — and it was fine

I didn’t want to be induced. But my water broke and labor didn’t start, and my doctors advised Pitocin because too much time had passed. What we all want is a healthy baby and a safe delivery, so when you get medical advice like that, you typically follow it.

(For anyone worried about missing out on a natural labor experience by having an induction: I was induced with my first and went into labor spontaneously with my second. To me, it felt pretty much exactly the same.)

It’s not just biology that can change your plan

When people imagine their birth going off-script, they usually think about medical surprises — the baby is breech, labor stalls, an emergency C-section. But there’s another category of variable that can change your plan, and it has nothing to do with biology or medicine: the external environment in which your birth is happening.

You could get stuck in traffic and end up delivering in your car (yes, this really does happen sometimes - it’s not just a TV plot point!). You could arrive at the hospital to discover that a resource you were counting on isn’t available because of who’s on shift that night. The world doesn’t pause because you’re in labor — and your birth plan checklist won’t have a section for any of it.

Here’s how it played out for me. I had planned to use a bathtub as a form of pain relief — not a water birth, just the counter-pressure of being in warm water to manage pain. My hospital had one available to women who requested it, so I requested it.

The doctor said no — through a nurse, not to my face — because my labor wasn’t far enough along. I pushed back. This was always part of my plan. Eventually the doctor agreed, but it was stressful getting her to say yes – and the whole time, it was all via messages from the nurse. I never even got to make the ask directly to the doctor myself.

The bathtub was heavy and could only be moved by specific staff with the right authorization. They had to find those people. But it was a Friday night. Four hours later — four hours of me at the threshold of what I could bear — there was still no bathtub.

I had a pain escalation plan — a sequence of interventions from least to most medical, with my preferred order mapped out in advance. The next step after bathtub was supposed to be nitrous oxide gas. But that also had to be brought to my room by hospital staff. And the hospital had just demonstrated that it couldn’t deliver resources in a reasonable timeframe. So I made a strategic decision: I wasn’t going to gamble another four hours on the gas never arriving, only to discover I’d waited too long for an epidural. You have to be able to hold still for that, and as the pain increased, I was running out of runway. I skipped it and went straight to the epidural.

Zero regrets. This was the right choice for me: once I was not in torturous pain, I could actually enjoy the experience.

The lesson: the bathtub wasn’t unavailable because it was broken or reserved. It was unavailable because it was a Friday night and the people authorized to move it weren’t around. That’s a staffing problem, not a medical one — and it’s the kind of external variable that no amount of medical preparation can account for.

This is why preparation matters: when you know your priorities and the universe of options that exist, you can adapt in the moment, even when the environment (or the baby, or the medical reality) doesn’t cooperate.

A Final Tip: If you want an unmedicated birth, get a doula

The only people I know who have successfully had an unmedicated birth either were doulas or had doulas. If that’s a high priority for you, a doula is worth serious consideration.

Even if your partner is committed, labor is relentless — after hours of providing counter-pressure, even the most devoted support person wears down. The birthing parent has no choice but to keep going; the supporting partner can falter. A doula is a professional who has accompanied many births, who can pace herself, and who can help you stick to what you said you wanted.

They can’t make decisions for you. But they’re a voice in the room whose only interest is your birth plan and your safety. They’re not influenced by billing, shift changes, or institutional dynamics. When my doctor denied the bathtub request through a nurse intermediary, a doula might have advocated differently than I could from a hospital bed mid-contraction.

Your birth plan checklist

1. Use a checklist, not a blank page. A birth plan checklist gives you categories and options so you’re not guessing at what to ask about. Pair it with Penny Simkin’s pain medication preference scale to get clear on your priorities. The point isn’t the document — it’s the education.

2. The plan won’t match reality. That’s a-ok. Making it means you show up informed. When you deviate, you’ll know what you’re changing and why — instead of having things happen to you.

3. You can’t control the environment, but you can ask about it ahead of time. There’s a difference between “we have a birthing tub” and “a birthing tub will be available to you at 2 AM on a Saturday.”

4. If unmedicated birth is your goal, having a professional advocate dramatically increases your odds. A doula is the only person in the room whose sole job is helping you stick to your plan.

5. Expect at least one thing to go off script — and you’ll have a better experience. At the end of the day, what matters is a healthy baby and a healthy parent.

You won’t follow your birth plan. But you’ll be a better improviser for having made one.

Resources:

- Bebo Mia Birth Plan Checklist

- Penny Simkin’s Pain Medication Preference Scale

The birth plan is one kind of preparation. But there’s a bigger preparation gap that almost nobody addresses: what happens to your life after the baby arrives. Most people prepare for one day of labor and not for the 18 years that come after. I cover that in The You Plan.

This post is from the subsection Preparing for Parenthood by The Third Shift.

The Third Shift begins the moment you’re pregnant. Suddenly, you’re juggling thousands of decisions about topics you know nothing about—baby gear, nursing logistics, postpartum mental load, partner delegation—without any framework for evaluating them. This section applies the same operational thinking we use for household management to the specific overwhelm of preparing for a baby.

If you’re expecting, start here. If not, you can easily opt out of the “Preparing for Parenthood” posts — or stick around and share your wisdom in the comments!

You might also like…

Thanks for reading!

Jennifer

www.thethirdshift.co

My friend who works at a notoriously cutthroat private equity fund cried when she sat down to make her baby registry. So many decisions. About things she knew nothing about. What makes a good crib mattress? Do I need a “wipe warmer”? What is a nipple shield?!

It’s overwhelming because the decisions feel weightier than just buying gear. They feel like a referendum on your parenting ability. It’s the first brush with mom guilt: am I doing a good enough job? Am I buying enough things? The right things? Am I going to mess you up because I didn’t do enough research?

And if you’re a career-driven woman, you might also be thinking: This is so time consuming and you aren’t even here yet!! I have 3000 prenatal appointments. Am I going to completely ruin my professional life?

There’s more to say about baby gear, but for now, when it comes to stuff, just know this: if you have a child without health complications, all you really need is a way to feed your baby and some diapers. Everything else is potentially helpful, but not essential. It’s icing on the cake.

The essential preparation isn’t stuff.

The nursery, the gear, your hospital bag, perhaps a night nurse — these are obvious and tangible “nesting” steps you’re likely planning for. But there are other needs and changes less visible, also possible to anticipate and prepare for — thereby reducing your post-partum stress.

You’re focused on mitigating risks to ensure a healthy baby, a safe delivery, and having what baby needs. But you can also prepare for some common risks rarely discussed in advance: losing yourself, defaulting into an unequal partnership, and trying to do it all alone. Those might sound dismal, and perhaps that’s why no one talks about them — but you CAN prepare for these things (if you’ve been told they may be coming.)

Here are my top 10 non-obvious but absolutely critical things to do before the baby arrives to ease the transition from standalone human to parent:

Preserve your identity, even if you don’t think you need to

As a not-yet-parent, you might be blown away by this video from . In it, she notes that 67% of parents feel guilty taking time for themselves.

Yeah, it’s a thing. Parent-you might start convincing yourself that you really enjoy acts of service for your family — and maybe you do— but that’s not the same as time for you. You existed before your children did.

Let’s make sure you keep in touch with that.

(1) Document your hobbies and consider how you will continue them.

Here’s the exercise: imagine you have childcare obligations from 7am–9am and 5pm–8pm on weekdays and all day on Saturday and Sunday. Now think about everything you currently enjoy — yoga after work? Early morning runs? Reading a novel for 30 minutes before bed? — and figure out when you’ll keep doing it.

This is one of the most essential ways to preserve your “personhood” after giving birth.

Immediately postpartum, your newborn’s needs will necessarily be paramount, and that’s ok. You probably won’t even mind. But it’s easy to set up a pattern of perpetual self-sacrifice that you never course-correct because there will be no external event like birth that prompts you to snap back into living the way you lived before.

(Quite the opposite, in fact — you won’t ever live the way you lived before. You won’t be able to just walk out of your house, effortlessly, on a whim, for several years.)

Somewhere around the 6 month mark, I tend to hear from parents who kept waiting for the intense demands to subside and realized… they don’t. They evolve and you do get more sleep. But those parenting hours before and after work — they persist.

So: literally write down what you like to do for pure enjoyment. If you want to continue those between the hours of 7am and 8pm, you will have to coordinate childcare coverage. Or, do them before or after that (at home or while your partner is with your sleeping kids.)

“Childcare” could be your spouse or partner, but there’s a new coordination step you’ll need to take.

It’s good to anticipate this so you can proactively plan — this helps you avoid the trap of feeling lost in parenthood and unsure why. Believe it or not, you might feel guilty missing out on your future child’s bedtime if you don’t decide in advance that yoga twice weekly is what you need to be sane.

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Prepare to restructure your partnership, even if it’s already “equal”

(2) You will need better coordination with your partner; start with a family email account.

If you and your partner have been operating fairly independently to date — each managing your own schedules, your own logistics, your own lives — understand that you cannot keep doing that once you share a tiny, dependent human who is (in most cases) a fused version of you both.

A baby generates an astonishing volume of shared administrative work: pediatrician appointments, insurance claims, daycare applications, supply runs, feeding logs, developmental milestones. If you don’t consciously manage this before the baby arrives, all of this will default to one person — and by default, it will be the person with the longest parental leave — typically the birth parent. This is how inequity takes root, not through malice, but through inertia.

One concrete thing you can do right now: create a family email address. Something like TheJohnsons@gmail.com — whatever feels right. Use it for anything related to your child and your household: pediatrician communications, daycare enrollment, Amazon orders for baby supplies, subscriptions. This way, both partners have equal access to all information and neither is the sole gatekeeper.

This might sound small, but it’s foundational. It builds the habit of operating as a team on household management — and it means nobody has to “forward” anything or “catch the other person up.” You’re both already in the loop.

(3) Give the non-birthing partner (typically dad) two new things to fully own post-partum.

One household thing. This could be dinner. Groceries. Daily kitchen cleanup. Your daycare/nanny search.

One baby-care thing. Could be the dinnertime bottle. The evening bath. Diaper changes. (In our house, because I exclusively breastfed and all feeding was on me, my husband owned 100% of all diaper changes for the first 3 months. He actually loved this time to talk to and bond with our daughter!)

This supports the mother to heal, gives the non-birthing parent a clear contribution, and sets the groundwork for greater household management equality going forward.

If you’re unsure what dad can do, did a great post on it. Don’t read this and assign your partner something — read this together so you’re sharing ownership for planning and getting educated on parenthood from the outset.

By the way, I’m not saying dad should only ever own two things. This is merely a discrete step to take as you plan for postpartum; you’ll need ongoing recalibration.

Build your support network before you need it (then trim it later)

(4) Proactively identify support providers, even if you don’t plan to use them.

As a first-time parent, you expect to have lots of time on maternity leave, but in those early days, you will not. If you need to call upon critical service providers, it will be stressful to do the searching and research in your moment of need.

I assume you’ve got finding a pediatrician covered. Other great phone numbers to have in your back pocket: a night nurse, a lactation consultant, a pelvic floor physical therapist, a post-partum mental health provider, a post-partum doula, someone to provide sporadic or part-time household help (cleaning, making meals) and a babysitting service.

For the latter, I recommend Bambino because it is nationwide, so you can use it while traveling too. You can get a $10 credit by signing up with my code THETHIRDSHIFT. (They gave me this code because I sent them so many customers in my analog life — I am sincerely a raving fan.)

(5) Give yourself permission to spend more than you typically would on convenience, and set up outsourcing (even if you don’t think you’ll want it.)

What do you do at home that someone else could do? This might be a cleaning service every two weeks. A meal delivery subscription. A regular grocery delivery slot. A laundry service. Whatever your household’s version of “buying back time” looks like — get it operational now, while you have the bandwidth to research, compare, and onboard.

I say this because in the postpartum haze, the last thing you’ll want to do is evaluate cleaning services, schedule trial visits, or figure out your grocery delivery password. And yet these are precisely the things that pile up and make new parents feel like they’re drowning — not the baby, but the piles of laundry surrounding the baby.

Two things to prepare: one is giving yourself permission. Let yourself buy ease, at least temporarily (if it’s not going to put you into debt).

The other is to make the decisions now and set up accounts and orders. You want this running before you come home from the hospital, so your decisions after baby are to cancel X thing you don’t need, not start from scratch on finding something you do need. In the worst-case scenario, you have a little too much help. This is far better than the reverse.

Newborn life is a season. It’s fleeting (truly). It’s also very demanding. Remember that anything you do during this period to give yourself more bandwidth isn’t a lifestyle commitment. Hiring a cleaning service for 6 months is okay. Using a meal kit service just for 9 months, until you’re in a better routine, is okay.

Not only do you not have to commit forever, you also don’t have to accept the company’s default cadence. If weekly is out of budget, do it monthly. Calibrate to your budget and needs.

Even if you’re the kind of person who thinks that paying for cleaners is “bougie” or getting prepared meals delivered is “highway robbery” (hat tip to my grandmother) — this is the time to do it.

Trying these services is not a lifetime commitment, but it may be a critical lifeline. Especially if you are far from your family.

Think of it this way: you would never start a major project at work without making sure your operational basics were covered. This is the same thing. Your household is about to take on its most demanding project to date. Put your support team in place.

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(6) Identify a photographer if you want newborn photos.

If you imagined sleepy baby photos, those have to happen in the first 10 or so days post-partum. After that, baby gets a bit more alert. You can still take wonderful photos then. But either way, in those early days, you’ll be quite busy — busier than you are now, unbelievably, but true — and tired, and learning about breastfeeding and other weird aftermath of giving birth, and it will be difficult-to-impossible to schedule phone call consultations because you’ll be living according to the baby’s unpredictable sleep schedule. You have 9 months to plan. Do your photographer search in advance and save yourself the postpartum stress. Tentatively schedule for 10 days after your due date.

Front-load critical education & bookmark these resources (even if you think you’ll have more time later)

(7) Learn about baby feeding schedules and sleep.

For some reason, all the baby prep courses I could take (and I took several) covered bathing, car seats, choking — critical safety. But not much about actual day-to-day routines and care.

There are a lot of opinions about this and myriad books you can read, courses you can take, and people you can hire. I personally liked and have recommended to others The Baby Whisperer. Not everyone likes it, and as a writer I disliked the folksy tone, but I thought it was the most tactical, practical guide for real questions I had on a daily basis during the first 10 days. If you prefer directive: at minimum, just read this.

But it’s not about the method you choose. Just start to learn before you’re holding your baby. Because you’ll be tired and basking in love, but also if you’re unsure about things, perhaps a bit anxious and panicked after the baby comes. It’s not the best time to start amassing information, and you’ll be especially vulnerable to spending money on “quick fixes” instead of entering the market as a confident and informed consumer.

(8) If you plan to breastfeed, watch this video of a baby latching.

It’s like, really hard to find truly helpful breastfeeding latch-related content because you need to be able to see the nipple. This video is it. Save it to your home screen for easy reference in the early days — it might even save you a lactation consultant visit.

(Note: the best breastfeeding advice I got was “try it for at least two weeks before making any decisions.” A lot of issues can be sorted in that time, so if you want it to work, don’t give up before then.)

(9) Order a breast pump.

You probably won’t need it right away, but you might. Your insurance pays for it, but it can be confusing to find out where to buy them since to be fully covered they may have to come from DME distributors and each insurer seems to have a unique set of partners. Do the administrative work of figuring this out with your insurer before the baby comes.

The brands people use most often are Spectra and Medela. If your office has a pump in it, get the same brand so you can use the same parts at home and at work.

By the way, in case you’re wondering, breast pumping doesn’t hurt — it looks alarming but the mechanics aren’t painful. (It looked painful to me and I couldn’t find a clear answer about this online, so here you go.)

Make sure you won’t walk this road alone (even if you’re partnered and have great friends)

(10) Find your people: join a mom community before (or right after) birth.

This one catches people off guard, because it doesn’t feel like “preparation” — it feels social. But having even 2–3 people who are going through what you’re going through at the same time is a game changer. For getting advice. For referrals to providers. For feeling less alone at 3am when you’re asking ChatGPT whether your baby’s rash is normal.

Look for local mom groups, neighborhood listservs, WhatsApp groups, Facebook groups. There are organizations that literally match and form “moms groups” based on your due date and neighborhood. Your hospital may run one. Your birthing class may become one.

If you can’t find them, ask other moms — they know where the groups are. Or create your own: the women you meet in birth prep classes or prenatal yoga or maternity workouts are all about to go through the same experience. Exchange numbers. Start a group text. You will be so glad you did.

The particular magic of a new-mom community is that it normalizes everything. Your baby won’t sleep? Neither will theirs. You cried for no reason on Tuesday? So did she. You’re not sure if you’re doing this right? Nobody is. That shared experience is more valuable than any expert advice — because it reminds you that the hard parts are not evidence of your failure. They’re just part of becoming a parent.

Did I miss anything? Leave it in the comments!

I walk people through a version of all of this — and more — as part of my “Prepping for Parenthood” workshop, which includes creating your own YOU Plan. You can register for it in-person in DC or virtually.

This post is part of the subsection Preparing for Parenthood by The Third Shift.

The Third Shift begins the moment you’re pregnant. Suddenly, you’re juggling thousands of decisions about topics you know nothing about—baby gear, nursing logistics, postpartum mental load, partner delegation—without any framework for evaluating them. This section applies the same operational thinking we use for household management to the specific overwhelm of preparing for a baby.

If you’re expecting, start here. If not, you can easily opt out of the “Preparing for Parenthood” posts — or stick around and share your wisdom in the comments!

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Thanks for reading!

Jennifer

www.thethirdshift.co