June 1, 2025
Making a Birth Plan? Here’s What You’re Probably Missing
Send us a text The birth plan has become a staple of pregnancy preparation, but most expectant parents are approaching it all wrong. What began as a revolutionary tool for restoring autonomy during the natural birth movement of the 1960s has too often devolved into a rigid checklist that sets birthing people up for disappointment and even trauma. I reframe how we think about birth plans, explaining that they were never meant to be a list of demands but rather a foundation for communication, ...
The birth plan has become a staple of pregnancy preparation, but most expectant parents are approaching it all wrong. What began as a revolutionary tool for restoring autonomy during the natural birth movement of the 1960s has too often devolved into a rigid checklist that sets birthing people up for disappointment and even trauma.
I reframe how we think about birth plans, explaining that they were never meant to be a list of demands but rather a foundation for communication, informed choice, and emotional preparation. Drawing on wisdom from pioneers like Sheila Kitzinger and Penny Simkin, I reveal why the most powerful birth plans focus not on controlling external events but on cultivating internal strength.
You'll discover the five most common birth plan mistakes and practical strategies for avoiding them—from treating the plan like an inflexible checklist to using it as a shield against your deepest fears. Through guided visualization exercises and nervous system training techniques, I introduce the concept of a "birth vision" that keeps you anchored in your power even when birth takes unexpected turns.
Perhaps most powerfully, I draw parallels between birth and athletic performance, explaining why elite preparation involves not just visualizing your ideal scenario but training for every possible challenge. Just as no professional athlete enters competition without a coach, I share why dedicated prenatal coaching helps birthing people show up with clarity, confidence, and the ability to stay grounded under pressure.
Whether you're preparing for your first birth or looking to heal from a previous experience that left you feeling powerless, this episode offers a revolutionary approach to birth preparation that honors both the unpredictability of birth and your capacity to lead your experience with strength and grace. Ready to transform how you think about birth planning? Book a free birth vision call at kellyhof.com and start preparing not just for birth, but for one of life's most profound transformations.
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Medical Disclaimer:
This podcast is intended as a safe space for women to share their birth experiences. It is not intended to provide medical advice. Each woman’s medical course of action is individual and may not appropriately transfer to another similar situation. Please speak to your medical provider before making any medical decisions. Additionally, it is important to keep in mind that evidence based practice evolves as our knowledge of science improves. To the best of my ability I will attempt to present the most current ACOG and AWHONN recommendations at the time the podcast is recorded, but that may not necessarily reflect the best practices at the time the podcast is heard. Additionally, guests sharing their stories have the right to autonomy in their medical decisions, and may share their choice to go against current practice recommendations. I intend to hold space for people to share their decisions. I will attempt to share the current recommendations so that my audience is informed, but it is up to each individual to choose what is best for them.
00:56 - Introduction to Birth Plans
10:28 - The History of Birth Planning
21:05 - Five Common Birth Plan Mistakes
31:27 - Creating Your Birth Vision
35:29 - Visualization Exercise
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Welcome back to the Birth Journeys Podcast.
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I'm your host, kelly Hoff, labor nurse, prenatal coach and mom of two.
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Today we're diving into one of the most important and often misunderstood tools in your birth prep toolbox the birth plan.
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But this episode isn't just about filling out a checklist.
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It's about avoiding some common mistakes that set you up for disappointment and missed communication.
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By the end of this episode, you'll understand that a birth plan is not like ordering your desired birth experience from a menu.
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You can't just say no Pitocin at the hospital like you'd say no pickles at a restaurant.
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In this episode, you'll learn the difference between a birth plan, what you hope will happen and a birth vision how you want to feel during your birth.
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Your birth vision won't control everything, but it will help you stay calm and think clearly, even if things don't go the way you expected.
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So let's talk about where the idea of a birth plan actually came from and what it was meant to be before it got boiled down into a checklist of do's and don'ts.
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The concept of a birth plan started gaining traction in the 1960s and 70s during the natural birth movement.
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This was a time when birth was becoming more and more medicalized, especially in hospitals, routine interventions like forceps, deliveries, episiotomies and automatic anesthesia were standard Birthing.
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People often had little say in what happened to their bodies during labor.
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It was very much lie back and let the professionals take over.
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So the birth plan?
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It wasn't originally about control, it was about agency.
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It was a way to say hey, I want to be a part of the conversation here, I want to understand what's happening and make choices that reflect my values.
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It was meant to restore autonomy, encourage informed decision-making and create space for collaborative communication.
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By the 1980s, doulas and childbirth educators began formalizing the idea.
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They used birth plans as tools to help expectant parents prepare not just physically but emotionally, and to make sure those preferences were talked about ahead of time.
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The goal was never to hand in a list of demands and expect the birth team to follow it to the letter.
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It was a starting point for reflection and consent.
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Now let's talk about some of the influential voices who helped shape this idea, because, like many parts of birth history, it's a mix of groundbreaking insight and problematic context.
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One early influence was Dr Grantley, dick Reed, who wrote Childbirth Without Fear in 1942.
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He's often credited with inspiring the natural birth movement by arguing that pain in childbirth was made worse by fear and that if women could relax and trust their bodies, birth would be less painful.
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But let's be honest, he was also a bit of a chauvinist.
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His views about women's roles were deeply rooted in outdated patriarchal ideas, and much of his writing doesn't exactly honor birthing people as full decision makers.
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So while he helped spark an important shift, we shouldn't put him on a pedestal.
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Thankfully, other pioneers carried the conversation forward in more empowering ways.
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Sheila Kitzinger, a British social anthropologist and fierce birth advocate, was one of the earliest and strongest voices for humanizing childbirth.
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She believed deeply in informed choice and saw the birth plan as a way to restore dignity and power to the birthing person.
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One of her most favorite quotes is birth isn't something we suffer, but something we actively do and exult in.
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She also said the way a woman gives birth can affect how she feels about herself for the rest of her life.
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And isn't that the truth?
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Penny Simkin, a doula and educator here in the US, took things a step further by helping to popularize birth plans as practical tools, but she emphasized that they weren't directives, they were conversation starters.
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She said the birth plan is a tool for communication, not control.
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Its value lies in the discussion it sparks between the mother and her caregiver.
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Its value lies in the discussion it sparks between the mother and her caregiver.
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She also reminded us that women remember their birth experiences all their lives and those memories can powerfully affect their self-esteem, relationships and parenting.
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Then there's Ina May Gaskin, the legendary midwife who founded the Farm Midwifery Center.
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She wasn't specifically tied to the birth plan movement, but she was a massive force in reclaiming birth as a normal, sacred and powerful life event, not a medical emergency waiting to happen.
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One of her most well-known lines is if a woman doesn't look like a goddess during labor, then someone isn't treating her right.
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And, of course, your body is not a lemon.
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You are not a machine.
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The creator is not a careless mechanic.
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Ina May's words are so affirming because they bring us back to what matters most trust in our bodies, in the process and in our right to be respected and heard.
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So when you hear the term birth plan, I want you to remember this it's not about controlling every detail, it's not about handing every detail.
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It's not about handing in a paper that your care team will magically follow, and it's definitely not about listing no Pitocin like you're saying.
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86 the pickles on a burger order.
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It's about thinking through what you value, understanding your choices and learning how to stay emotionally and mentally present so that you can lead your experience even when things don't go according to plan, because birth is unpredictable, but how prepared you feel, that's the part in your hands.
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So let's talk about why most birth plans miss the mark.
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The idea of creating a birth plan sounds empowering, and it can be.
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It's a way to explore your preferences, think through your options and communicate what matters most to you.
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But too often the birth plan becomes either a rigid checklist or an afterthought.
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When that happens, the very tool designed to center you in your birth experience can actually backfire.
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A birth plan isn't the magic script for a perfect birth.
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It's not a guarantee.
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It's a guide.
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When done thoughtfully, it helps you show up for your birth, feeling prepared, empowered and able to respond, not react when things change.
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Let's walk through five of the most common mistakes people make when creating a birth plan, why they're problematic and how to avoid them.
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Mistake number one treating the plan like a to-do list.
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One of the most common traps is approaching the birth plan as a rigid checklist, almost like a wedding itinerary.
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Everything is thought out scripted and timed.
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While planning can feel reassuring, this approach can set you up for emotional distress if labor veers off course and most labors do in some way.
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People often internalize deviations from their plan as personal failures which can leave emotional scars long after the baby arrives.
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Birth is unpredictable.
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Even the most beautifully written plan won't account for every curveball.
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If your cervix doesn't dilate on schedule or if the epidural becomes necessary after hours of unmedicated labor, it doesn't mean you failed.
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It means your body and your baby are doing something unique and your job is to respond with love, flexibility and informed choice.
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To avoid the common mistake of treating your birth plan like a to-do list.
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Focus on birth preferences rather than a fixed plan.
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Use language like I prefer or, if possible, instead of absolutes like I will or I won't.
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This subtle shift helps you stay anchored in your values without becoming attached to a specific sequence of events.
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It also gives your medical team room to collaborate with you in real time, not just follow instructions from a static document.
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Real time, not just follow instructions from a static document.
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Mistake number two using the plan to avoid what scares you.
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Some people use the plan to declare what they don't want, while it's important to know what you hope to avoid.
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This strategy can sometimes come from a place of unprocessed fear.
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Instead of working through anxiety, the plan becomes a form of denial, like if it's on paper it won't happen.
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But unacknowledged fear doesn't disappear.
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It often surfaces in labor, when your thinking brain goes offline and your body is flooded with adrenaline.
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That's when you might feel panic freeze or feel like you're spiraling, if something you swore wouldn't happen becomes necessary.
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And in those moments you'll need coping tools and a mindset that can hold space for the unexpected, not just a plan that says no.
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Instead of avoiding your fears, get curious about them.
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Why does the thought of an IV or a C-section bother you?
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What past experiences or stories are influencing that fear?
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Working with a prenatal coach, doula or trauma-informed provider can help you unpack those layers and make peace with possibilities you hope to avoid.
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You may still list your preferences, but you'll do it from a place of clarity, not panic.
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Mistake number three Assuming the medical team will just follow it.
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Some people hand over their birth plan expecting it to be followed like a Starbucks order.
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But birth is not a transaction.
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It's a dynamic, collaborative event.
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Your provider isn't fulfilling an order.
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They're a clinical decision maker with their own training, concerns and constraints.
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The assumption that your birth plan will be followed to the letter can lead to deep disappointment.
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You may feel dismissed or blindsided if a provider recommends something that's against the plan.
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It also doesn't account for team-based care.
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Your provider may not be the one on call, and nurses, midwives and residents may all play a role in your care.
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The fix Treat your plan as a conversation starter.
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Bring it to a prenatal visit and say I'd love to talk through some of my birth preferences with you.
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Ask open-ended questions like how do you typically approach X, y or Z, or what would make this plan more workable from your perspective.
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That way, your team becomes a part of the process.
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This will also help you practice having a conversation about your preferences in a relaxed environment so that if you have to have a similar conversation when the pressure is high, you already feel comfortable doing so.
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Mistake number four skipping the plan entirely and just trusting your provider or doula.
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On the flip side, some people go in the opposite direction.
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They don't make a birth plan at all.
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Maybe they feel overwhelmed, or maybe they really like their provider and just want to go with the flow.
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And, while trusting your provider is important.
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Blind trust can be risky, especially if you haven't had clear conversations about your values, communication preferences or how decisions will be made during labor.
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Equally risky is expecting your doula to be your voice.
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Your doula is there to support you emotionally and physically, not speak for you.
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And, most importantly, your doula isn't you.
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You're the one who built the relationship with your provider.
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You are the one who gets to ask the questions, express your needs and make decisions.
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When a doula takes over that role, it can actually create confusion or even concern within your birth team.
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It may give the impression that you're not capable of advocating for yourself or, worse, that you're being pressured into choices that aren't your own.
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Without preparation.
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It's easy to freeze in the moment.
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You might nod along or agree to something you didn't fully understand, just to keep things moving, and that's how birth trauma can happen, not necessarily because something went medically wrong, but because you felt powerless or like things were being done to you and not with you.
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To avoid that, focus on building informed trust, not passive trust.
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Ask your provider how they typically handle common interventions.
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Talk to them about how they communicate in high-pressure situations.
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Use a birth plan not as a script, but as a tool to share your values and start those conversations.
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Early Birth will always hold some surprises, but when you're mentally and emotionally prepared, you're more likely to feel grounded, respected and fully present, no matter how things unfold.
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Mistake number five letting the plan replace communication.
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It's easy to assume that a birth plan will just speak for itself, but the truth is handing over a sheet of paper and expecting your birth team to read and know how to follow it, especially during a busy shift, isn't really realistic.
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If you haven't talked through what's on the plan, ideally before labor begins, it can actually hurt communication instead of helping it.
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For example, a nurse might skim your plan and assume that if you're experiencing a lot of pain and you wrote no cervical checks, they may avoid offering one, even if knowing your dilation or the baby's position could really be helpful in the moment.
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Or they might misunderstand a bullet point because there's no context and when things are moving quickly, misinterpretation can lead to missed opportunities for care that aligns with your true preferences.
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To avoid this, think of your birth plan as a living tool, not a final set of instructions.
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Share it early with your provider so you can talk through it together.
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Review it with your birth coach, support person or doula and practice how you'll talk about your preferences in real time.
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Think of it as less of a handout and more like talking points that you learn to speak from.
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That way, you're not just handing over your wishes, you're owning them.
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When used this way, your plan becomes a bridge to better communication, not a wall that shuts it down.
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So now that we've talked about how to use the birth plan the right way as a living, flexible communication tool, you might be wondering but what about all the things I can't plan for?
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That's where your birth vision comes in.
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Unlike a birth plan, which focuses on what you hope will or won't happen, a birth vision is about how you want to feel during your birth experience Calm, confident, connected, supported, even if things don't go exactly as expected.
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It's a powerful way to anchor yourself emotionally.
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So you're not just making decisions from a list, but from a place of inner clarity and strength.
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Let's talk about what that looks like and why it may actually be the most important part of your preparation.
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So when's talk about what that looks like and why it may actually be the most important part of your preparation.
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So when we talk about creating a birth vision.
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We're not just imagining a dream birth for the sake of wishful thinking.
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We're doing something much more intentional.
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We're laying the emotional groundwork for how you want to show up during your birth experience, no matter what path it takes.
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But here's the really fascinating part there's actual science behind why this works.
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Visualization isn't just a mind trick.
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It's a proven psychological technique that athletes, performers and even trauma survivors use to prepare their minds and bodies for high-stress or high-stakes moments, and it can be just as powerful during birth.
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Let's take a look at the psychology behind visualization and how practicing your birth vision can literally train your brain and your nervous system to stay calm, focused and grounded when it matters most.
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Visualization works because the brain doesn't fully distinguish between real experiences and vividly imagined ones.
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When you mentally rehearse something in detail, especially with emotional and physical cues, you activate the same neural pathways used in real-life experiences.
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This technique has been proven in sports psychology, trauma therapy and performance coaching, and it's just as powerful in birth preparation.
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When people visualize themselves moving through labor, feeling safe, grounded, calm and in control, they're wiring those emotional and physiological responses into the body.
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It's like giving your nervous system a muscle memory of strength and steadiness to access when birth begins.
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So when you repeatedly visualize yourself moving through labor, feeling safe, calm and in control, you're not just daydreaming.
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You're building real emotional muscle memory.
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You're giving your nervous system something to return to when the intensity of labor kicks in.
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But for that vision to truly support you in birth, it needs to be grounded, not in things that you hope others will do, but in things that you can control your mindset, your breath, the way you respond to challenges.
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That's what keeps the vision strong, even when things around you shift.
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Challenges that's what keeps the vision strong, even when things around you shift.
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Let's talk about how to create a birth vision that stays anchored in your power.
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So, no matter what's happening in the room, you are still the one leading your birth experience.
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Unlike a birth plan, which often focuses on external details and logistics, a birth vision is about your internal experience.
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It's not about scripting what everyone else will do to create your ideal birth experience.
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It's about training your body and mind to return to a feeling of emotional safety, no matter what's happening around you.
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When creating this vision, focus on what you can control your breathing rhythm, the mantras or affirmations.
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You repeat the mental image of your body opening with each contraction, moving into positions that are comfortable for you and help your baby move through the birth canal.
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Affirmations you repeat the mental image of your body opening with each contraction, moving into positions that are comfortable for you and help your baby move through the birth canal, the sense of warmth, focus or strength within your body, and communicating clearly with your birth team.
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And, most importantly, let's talk about your protective bubble.
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The bubble is your imagined boundary, an emotional and energetic shield that allows you to stay grounded and calm in your internal world.
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It protects you from disruptions, a harsh tone, chaotic energy in the room or your provider's rushed demeanor.
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You remain calm, centered and safe in your bubble unless and until you need to come out of it to make a decision that truly matters.
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That moment is intentional, not reactive, and that's where your protective bubble becomes a game changer.
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It gives you a safe space to return to over and over again, no matter what's going on around you.
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You don't have to absorb the stress in the room or react to every shift in energy.
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You stay centered and you only step out of that bubble when a clear decision needs to be made.
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But let's be real Birth is full of surprises, so the next step is learning how to carry that same calm, grounded feeling from your ideal birth vision into situations you didn't plan for, because the real power of this work isn't controlling what happens.
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It's in preparing your nervous system to stay steady and clear when things don't go according to plan.
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Let's talk about how to apply your birth vision in those moments so that you can stay in your power even when birth takes an unexpected turn.
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The power of visualization doesn't come from picturing a perfect birth.
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It comes from training your nervous system to stay in that internal calm bubble when things don't go as planned.
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This is where your vision becomes a tool for flexibility, not fantasy.
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You can practice carrying your bubble with you into less than ideal scenarios.
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Visualize yourself calmly breathing through a cervical check while staying inside your bubble.
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Imagine your body staying soft and steady, even as a provider offers an intervention you didn't expect.
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Picture yourself maintaining your composure, using your rehearsed phrases to ask clarifying questions while still anchored in that safe internal space.
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When you've mentally rehearsed these responses, they become more accessible when you need them.
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You're not just hoping you'll stay calm, you've trained for it.
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So why does this help you show up for yourself in birth?
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Labor can be unpredictable.
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When you've done this kind of internal work, creating a vision based on your emotional regulation, not external control, you're more likely to feel empowered, not overwhelmed.
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You can adapt, advocate and participate in the process without losing yourself in fear, panic and confusion.
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This is how you truly show up for yourself in birth Not by making everything go exactly as imagined, but by anchoring yourself so deeply in your power and peace that, even when birth surprises you, you don't lose yourself in the process.
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Now I want to take you through a quick reflection exercise.
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If you're driving or multitasking, just listen along and come back to this when you can sit quietly.
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But if you're in a space where you can pause and really focus, go ahead and close your eyes.
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Take a deep breath in through your nose and let it out slowly through your mouth Again, in and out.
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Let your shoulders soften, unclench your jaw, let the tension melt down your neck into your arms, your fingertips down your back into your hips and thighs and all the way through your feet.
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Let your breath move easily now.
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No effort, just being.
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Now.
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Bring your awareness inside Now.
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Bring your awareness inside into the still quiet space of your body and imagine there's a wiser part of you, a deeper part of you, your higher self, the part of you that already knows how to do this, the part of you that holds deep wisdom, deep strength and deep calm.
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You ask this part of yourself one gentle question Show me my birth.
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You don't need to force anything, you don't need to make sense of it, you're just observing what comes up.
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You may see colors, images, people, light.
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You may not see anything at all, and that's okay.
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Let yourself feel whatever wants to rise.
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There may be no context, just presence.
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Observe it with softness and curiosity.
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No judgment, no fear, just witnessing.
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Let your vision unfold.
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What is the energy of the space around you?
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Are you still?
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Are you in motion?
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What are you feeling?
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What is your body doing?
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Is there a rhythm, a sound, a sense of connection?
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Let it all play out gently before you.
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This is your experience, guided by your inner knowing.
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No right, no wrong, just truth.
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Now hold that image softly in your mind, let it imprint into your heart, as if you're placing a bookmark in your soul, and slowly, gently, begin to return.
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Bring your awareness back to your breath, notice your body again, wiggle your fingers, your toes and, when you're ready, open your eyes.
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Now take a moment to reflect Gently.
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Ask yourself what specifically do I want from this experience?
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Why is that important to me?
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Or try this what is the highest purpose of that for me?
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That's a lovely question that my mentor, neary Life Choma, asks.
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I love that question.
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Another question what's one small step I can take to move closer to this vision?
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Who needs to be on board with this?
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What resources do I already have?
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Knowledge, support or inner strength?
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Is this vision achievable?
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Do I know others who've done it?
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Is this vision achievable?
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Do I know others who've done it?
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