Beginning in the early 1980s, childbirth educators and activists suggested that pregnant women make a list of the maternity options that they wanted. This newly-named "birth plan" would then be discussed with and signed by their doctors. As time went on, preprinted, "fill-in-the-blank" birth plan forms -- some that went on for pages -- became available.
Today, the best thing about birth plans is that you have to become knowledgeable about birth to write one. For many women, used to following someone else's lead and doing what they're told in medical matters, this is a wholly new idea.
Birth plans are written with great promise, but how often do they really deliver on that promise? Perhaps what you want is not routine for the doctor and hospital you've chosen. Sometimes a doctor or a nurse will go out of her way to accommodate you, but you can't count on it. These professionals will do what they think is best. Why should they act otherwise?
Be aware that birth plans often give false hope -- you may believe you will get what you want because you put it in writing, but the signatures of health care providers are not legally binding. Many women have discovered that their birth plans are not much more than wish lists. Still, you need to think about your options -- writing up a birth plan forces you to organize your preferences. After all, if you don't know your options, you don't have any.