• Rhiley Binns

Expecting the Unexpected: Birth Plans VS Care Guides

You may have noticed that as a doula, I don't tend to use the phrase "birth plan". It's not because I don't believe in thinking ahead or that I'm disorganized. It's because of the potential mental traps that can come with a planning mindset when it's applied to birth.


An endearingly cringey photo of Rhiley at the Smithsonian on said D.C. trip. Everything turned out fine- we can do it!

When I was in junior high, my family took a vacation to Washington D.C. For reasons I still don't fully understand, my parents let me plan out the entire trip by myself. Over the course of several months, I meticulously researched and scheduled our itinerary down to the LITERAL minute. I printed out tiny pages of each day's itinerary and created conviently fanny-pack sized notebooks for each family member (let it never be said that I'm disorganized or ashamed of a good fanny pack). When our plane landed in D.C., it took us over an hour to catch a shuttle out of the airport. In my mind, this placed my ENTIRE schedule disastrously behind. Within 30 minutes of landing, I was sitting on the curb inconsolably crying about how we might miss the Smithsonian. (Don't worry, we didn't, and I have a much healthier approach to planning today!)



Birth is inherently unpredictable. By saying that we have a birth "plan", we can be unconsciously telling ourselves that we have control over the process or outcomes of our birth. Just like 7th grade me unfortunately couldn't will a shuttle to appear at the airport, you can't change the innate nature of your labor and birth. The best of birth plans cannot dictate how long birth takes, how your body works through the process, or whatever things may happen or change along the way. While this loss of control can be scary, the good news is that you can shape and change your mindset towards birth in meaningful ways. One great way to do this is to reframe "birth plans" into "care guides".


A care guide, just like a birth plan, is an outlining of your ideal care during birth. Care guides encompass important questions such as:

  • Who would you like present at your birth?

  • What ways would you like to try to manage pain and discomfort during labor and birth?

  • How would you ideally like to give birth?

A care guide also helps you to work towards a personal philosophy of birth, rather than an implied itinerary. When I work with clients during prenatal meetings to develop their Birth Care Guide, we discuss their hopes, wishes, and fears for birth, outline a care guide from these and evidence-based sources, and then relate their Care Guide to a variety of potential birthing outcomes to reflect on how they can cope and work with different scenarios. My hope is to help clients embrace the unexpected moments in birth, rather than hold steadfast to a singular result.


By exchanging birth plans for care guides, we openly acknowledge that birth is changeable and out of own personal control. This means we can be at once deeply in touch with our individual needs and free to move and react within our experience. In the words of stoic philosopher Epictetus:

“Happiness and freedom begin with a clear understanding of one principle: Some things are within our control, and some things are not. It is only after you have faced up to this fundamental rule and learned to distinguish between what you can and can’t control that inner tranquility and outer effectiveness become possible.”

If you're interested in learning more about Care Guides or working together to develop your own,

contact me to schedule a no-cost, no-obligation meeting to see if I'm the right doula for you!

Rhiley Binns, Birth Doula ● rhiley@rbdoula.com ● (515) 218-2482