It’s not a “Birth Plan” — they’re just “Birth Wishes” Why Birth Plans Cause More Anxiety Than Security in Expecting Moms

I hear it all the time, “I am anxious because my birth plan didn’t go to plan at all, and now I’m mad I even had it.”

Like many other things in the world of medicine, good intention, stupid rationale. “Birth plan” is a way for doctors to give expecting mothers some faux sense of control in the planning of their labor. It sounds empowering — a declaration that you’re prepared, informed, and ready to advocate for your body. But let’s be honest: birth rarely goes according to plan, and when it doesn’t, it often causes more angst and emotional upset than if there weren’t one at all.

When we call it a plan, we unconsciously attach expectations of control, sequence, and predictability — three things birth almost never offers. And when the process veers off course (as it often does), many women internalize that as failure, disappointment, or loss of agency.

In therapy, I hear this all the time:

“I didn’t stick to my plan.”

“It didn’t go the way I hoped.”

“I feel like my body failed me.”

“I feel like my doctor failed me by not honoring what we discussed in my birth plan.”

But what if it’s not the birth plan that’s the problem, but the language itself?

Why “Plans” Set Moms Up for Shame & Anxiety

A plan implies that you can direct every outcome. But birth is not linear — it’s primal, unpredictable, and deeply individual. When women are told to “make a birth plan,” it can sound like an instruction manual for control, rather than an invitation to stay present and adaptive.

When the plan doesn’t unfold as written — the epidural doesn’t take, the induction fails, or an emergency C-section becomes necessary — many women feel like they “didn’t do it right.” The emotional fallout can include:

• Guilt (“I didn’t do what I said I would.”)

• Shame (“I failed at natural birth.”)

• Disconnection (“My body betrayed me.”)

• Anxiety (“I’m worried about myself and the baby now that it won’t go as I planned”.)

In reality, birth is not a test of strength, it’s a surrender to process.

Shifting the Language: From “Plan” to “Wishes”

What if we reframed it as a Birth Wishes List instead of a “plan”?

Language matters — especially when it comes to how we experience our bodies. Calling it “wishes” gives space for flexibility, adaptability, and compassion.

Birth wishes say:

“I hope for this — but I will trust you as my doctor and the process if it changes.”

“I prefer this — but I am still going to be okay if it doesn’t happen this way.”

“I can be informed, empowered, and flexible at the same time.”

This subtle shift helps women reclaim emotional agency. You’re not failing if your birth doesn’t match your plan — you’re responding, adapting, and surviving something incredibly human and raw.

What This Has to Do with Sex Therapy?

As a sex therapist, I see how birth experiences can profoundly shape body image, sexuality, and intimacy postpartum. Many women carry unspoken trauma from “failed” birth plans into their sex lives — associating their body with disappointment or pain instead of power and awe.

By shifting language early — from plan to wishes — we plant a seed of self-compassion that can ripple into postpartum healing, self-trust, and sexual reconnection.

Your body didn’t fail. It did what it needed to do to bring life into the world. And that deserves reverence, not regret.

A Birth Wish Template to Try

Instead of writing “My birth plan,” try starting your document with:

My Birth Wishes:

These are my hopes and preferences for birth, understanding that things may change. My goal is a safe, supported, and empowered experience, no matter how it unfolds.

This wording keeps you grounded in your values while leaving room for reality.

Birth can be beautiful, chaotic, empowering, or all of the above — sometimes within the same hour. When we stop calling it a plan and start calling it wishes, we make space for both intention and grace.

Because birth isn’t a project to be managed — it’s an experience to be felt.

About Dr. Carli Blau

Dr. Carli Blau, LCSW, Ph.D., M.Ed., is a sex therapist and psychotherapist licensed in New York, New Jersey, and Florida. She helps women navigate intimacy, fertility, pregnancy, and postpartum transitions with compassion, humor, and honesty. She is certified in Women’s Hormone Health, Perinatal Mental Health and Mood Disorders, and is a published researcher in the field of Infertility.

Learn more or schedule a session at CarliBlau.com.