I've had a birth plan for each of my three children. First one was about not having any medication for pain, and to break my water if progress stalled. I presented it hand-written on notebook paper, in pencil. Folded about eight times. It was given about as much consideration as any high school student's wishes on important topics they are unqualified to really know about. I was 22 and married. Ended up with two epidurals and pitocin
Second was not to offer pain meds; I would ask for them. Lots of walking and changing positions and to break my water if I stalled out. No vaccinations or prophylactic treatments for diseases I don't have once the baby was born. My nurse really got it. Helped a LOT that I typed it up and printed out copies so anyone who needed it could have one. When I stalled at 8+, she really helped me to work through it. When I requested pain meds, she took her time telling us about an option, flipping me to another position and leaving to let us think about what we wanted to do. Anesthesiologist arrived just as I was complete. It was exactly the birth I wanted.
Last time my birth plan was very similar, except I added that I didn't want anyone counting during delivery. My water had already broken and the progress was really slow. Ended up on pitocin without pain meds. Couldn't walk around, except to the bathroom, because she was still up too high. Nurse would walk in and ask, "You ready to push yet?" I had to remind her I didn't want any counting during pushing. It was the worst of my labors. Some of it was just the circumstances. Some, obviously, was the nurse. The nurse, in the long run, was a minor annoyance.
One thing I've heard about birth plans is the longer and more detailed it is, the less likely it is to happen.
My advice: Clarify what's *really* important, present your wishes clearly, have copies for everyone (I took five and came home with one each time) and understand that you may or may not have everything happen according to your wishes. Ultimately, it's a wish list, not something you can guarantee.
Best wishes for the labor and delivery of your dreams and a healthy baby to snuggle after it's all said and done.
:+)