Birth Plan

YOUR BIRTH PLAN: WHAT IT IS AND WHAT IT ISN'T

A good birth plan is less about creating a “perfect” delivery and more about helping your care team understand your preferences, priorities, and concerns. The best ones are clear, flexible, and easy to skim during labor.

Side note: For a mom with gestational diabetes, there are a few specific things your birth plan should include that most generic birth plan templates don't cover. We cover that below!

Here are practical tips moms often find helpful:

Keep it short

Aim for 1 page if possible.

Use:

• Bullet points
• Simple headings
• Clear preferences

Focus on what matters most

You don’t need to include every possible scenario. Prioritize:

• Pain management preferences
• Labor environment
• Communication wishes
• Medical interventions
• Pushing and delivery preferences
• Newborn care

Be flexible

Labor can change quickly. Instead of rigid demands, use language like:

• “I prefer…”
• “If medically possible…”
• “I’d like to avoid… unless necessary”

That helps your team support you while still responding safely if plans change.

Include your top priorities first

Put the most important things near the top, such as:

• Delayed cord clamping
• Epidural preferences
• Minimal cervical checks
• Skin-to-skin after birth
• Partner involvement

Think through common decisions ahead of time

Some helpful areas to consider:

Labor environment

• Lights dimmed?
• Music?
• Limited visitors?
• A quiet room?

Pain management

• Unmedicated?
• Open to epidural later?
• Nitrous oxide?
• Mobility during labor?

Interventions

• Induction preferences
• Continuous fetal monitoring vs intermittent
• IV/hep lock preferences
• Preferences around breaking water or Pitocin

During delivery

• Preferred pushing positions
• Mirror to watch birth?
• Who cuts the cord?
• Immediate skin-to-skin

Cesarean preferences (important even if planning vaginal birth)

Consider adding:

• Partner present
• Clear drape if available
• Skin-to-skin in OR
• Delayed newborn procedures when possible

Include postpartum and newborn preferences

Examples:

• Breastfeeding support
• Formula supplementation preferences
• Pacifier use
• Rooming-in
• Circumcision preferences
• Golden hour after birth

Share it before labor

Review your plan with:

• OB or midwife
• Doula
• Birth partner

That gives you time to clarify what’s realistic at your hospital or birth center.

Bring multiple copies

Have:

• Printed copies in your hospital bag
• A digital copy on your phone
• One for your support person

Remember: the goal is communication

A birth plan is not a test or contract. Even when labor goes differently than expected, having your wishes known can help you feel more informed, respected, and involved in decisions.

THE GD SECTION OF YOUR BIRTH PLAN

State your GD history clearly at the top.

"I have been managing gestational diabetes throughout my pregnancy. Please monitor my blood glucose during labor." Don't assume it's in your chart and that everyone will read it. Say it out loud when you arrive. Put it in writing.

Know your glucose target for labor.

For most GD moms, the goal during active labor is to keep blood sugar between 70 and 100 mg/dL. Ask your OB or midwife before your due date what your specific target range is, and write it down. Bring it with you.

Ask about your hospital's IV glucose protocol.

Some hospitals routinely give laboring moms an IV drip that contains glucose (dextrose). For a GD mom — especially one managing with insulin — this can cause a significant blood sugar spike. It's completely reasonable to ask: "Does my IV contain glucose? If so, can we use a saline drip instead?" Many hospitals will accommodate this without hesitation. You just have to ask.

If you use insulin, tell your team about your doses.

Bring a written summary of your current insulin regimen — what you take, when you take it, and what your correction doses are. During the intensity of labor, medication details get lost. A written summary gives your nurses something to reference.

WHAT LABOR DOES TO YOUR BLOOD SUGAR

Here's something that surprises a lot of GD moms: labor is one of the most metabolically demanding things your body will ever do.

Your muscles are contracting hard, for hours. They are burning through glucose the way a long run burns through fuel. This means that for many moms — especially those managing GD with insulin — blood sugar can actually drop significantly during active labor, not rise.

This is especially true if you haven't eaten in many hours (most hospitals restrict food once active labor begins), if your labor is long and intense, or if you're on insulin and your dose isn't adjusted for the demands of labor.

Low blood sugar during labor — called hypoglycemia — can make you feel dizzy, shaky, confused, or exhausted on top of everything else. It can also affect your baby's blood sugar in the hours after birth. This is why GD moms are typically monitored more closely during labor, and why your care team needs to know your history.

WHAT TO EAT BEFORE YOU GO IN

If you are having a scheduled induction or C-section, you will likely be told to stop eating at a certain time the night before. Follow those instructions — they exist for your safety.

But in the hours before that cutoff, eat a real meal. Not a snack. A meal with protein, healthy fat, and complex carbohydrates that will release glucose slowly and keep your blood sugar stable as long as possible going into the experience ahead. Think: eggs and whole grain toast, a bowl of oats with nut butter, chicken and rice, Greek yogurt with berries.

If you go into labor spontaneously at home, eat something small and protein-rich before you head to the hospital if you can — and if your labor is still early enough that eating feels manageable. Once things get intense, that window closes.

THE CONVERSATION THAT CHANGES EVERYTHING

Of all the things in this post, this is the most important one.

When you walk into that hospital or birth center — whenever that day comes — say these words to whoever receives you:

"I have gestational diabetes. I'd like my blood sugar monitored during labor. Can you tell me what's in my IV?"

That's it. Three sentences. They will set the tone for everything that follows. They signal that you are informed, that you are advocating for yourself, and that your care team needs to be paying attention to your glucose alongside everything else.

You have spent 36 weeks managing this condition with care and intention. Labor day is not the day to stop.

You've got this. And we've got you.