Your birth plan
Writing a birth plan gives midwives, doctors and your birth partner a clear idea of what’s important to you – during labour, birth and in the first few hours with your baby. We provide everything you need to get your birth plan ready.
- What is a birth plan?
- Tips for writing your birth plan
- What to include in a birth plan
- C-section birth plan
- Birth plan templates and examples
- Coronavirus and your birth plan
A birth plan outlines what you want to happen during the different stages of labour, through to the first hours with your newborn. The aim is to let the team taking care of you know what your ideal birth looks like, so they can work towards it while giving you the care you need.
In a recent study, the NCT suggested that birth plans help midwives to quickly establish rapport with the women they are caring for in a very short period of time.
Whether it’s a written guide, or a few principles that you have discussed with your midwife, a birth plan is about feeling prepared for what’s to come.
While it might not be the case that everything will go as planned, it’s your right to express your preferences and to discuss them with the team taking care of you.
Think of your birth plan as a rough guide that provides an overview of what you would prefer to happen. It’s a good idea to include details of what you want to happen if circumstances change.
If you’ve already considered these outcomes, you’re likely to feel more prepared as things happen, even if you don’t get the birth you had imagined.
Watch independent midwife Pauline Cooke explain why planning your birth matters:
Research is the key to a good birth plan. Taking on new information and making important decisions during labour can make things more stressful, so it’s better to familiarise yourself with the situations you may be confronted with so that you feel prepared and well informed on the day.
Putting a birth plan together can be as simple as writing up a few key points by hand, or you might want to use an existing birth plan template which can be found online.
The earlier you write your birth plan, the more time you’ll have to find out about local services and to speak to midwives about what’s important to you, so it’s recommended that you think about it throughout your pregnancy.
Some women prefer to go into a lot of detail, while others choose to give guidance on a few key aspects that are particularly important to them. It’s entirely up to you how detailed your birth plan is.
As a rough guide, aim to fit it onto a sheet of A4 paper, if possible, as your midwife may not have a lot of time to read it. However, the most important thing is to communicate all of your preferences clearly – so don’t fret if it does span out over a few pages.
The list below is by no means exhaustive. Cherry-pick what’s most important to you, or include other ideas to get everything down that matters to you during labour and birth.
To start with, list the names of the people who are going to be involved in the birth, and the roles you want them to play. Make sure you include:
- Your name
- Your birth partner’s name and their role
- The name of the person overseeing your medical care
- The name of anyone else who will be present – for example, your doula or other children.
Consider whether you want birth partners, friends and family members to stay with you in the event that a forceps or ventouse delivery is needed, or if you need to have a caesarean section, and include this in your birth plan.
If you need to stay overnight once you’ve had your baby you might want your partner to be able to stay with you. It’s worth knowing that not all units allow partners to stay overnight. If this would be important to you, check with your midwife what the policy is at your chosen maternity unit, so that you’re not disappointed if you have to stay on your own.
Where you want to give birth
Choosing where you want to give birth is an important decision. You’re likely to have a choice of planning to give birth in a hospital labour ward or at home, and in many areas there’s also the option of a birth centre.
What is best for you will be guided by how likely you are to experience complications during labour as well as your personal circumstances and your preferences.
If you haven’t made a decision yet, use our Where to give birth tool, which takes your individual situation and birth preferences into account to recommend the best place for you to give birth.
If you decide to plan a home birth or want to give birth in a freestanding birth centre, keep in mind that during labour you may need to be transferred to a labour ward. As a precaution, it’s good to make a note of the kind of birth you’d like to have there too, in case the situation changes on the day.
What pain relief you would like access to, and what you want to avoid, can sometimes determine whether a home birth, birth centre or labour ward is the best fit for you.
It’s worth doing some research into which forms of pain relief are available where you have decided to give birth. Gas and air, for example, is always available as it can be brought to a home birth by your midwife, whereas epidurals are only available in a labour ward.
You can find out more about different types of pain-relief options and what’s available in different birth settings in our guide to coping with pain in labour.
Even if you know which kind of pain relief you want to use, it’s good to read up on other options too, as a 2018 survey by the Care Quality Commission (CQC) found that four-in-ten women ended up using a different type of pain relief in labour than they had planned to beforehand.
Creating the right atmosphere
You’re likely to have ideas about the kind of atmosphere you want to create in the room you’re going to give birth. Below is a list of things you can often change to get the atmosphere that feels right for you, so look out for these things when researching local units.
- Using a birth pool
- Ability to control music and noise in the room
- Ability to adjust lighting
- Number of guests in the room
- Availability of aromatherapy
- Flexibility for freedom of movement
- Use of props and furniture, including mats and birthing balls.
You may have other ideas about ways you can make the environment as comfortable as possible. Be sure to contact the unit in advance to see what they offer to help you feel comfortable, and run what you want by your midwife so you aren’t disappointed when you arrive.
Foetal monitoring is the process of checking a baby’s heart rate during labour.
Your midwife will check your baby’s heartbeat for one minute, every quarter of an hour, using a Sonicaid or Pinard stethoscope. This intermittent monitoring is the recommended practice for women with uncomplicated pregnancies.
If health problems are spotted in the run-up to the birth or if your midwife is concerned about your baby’s heart rate during labour, they may recommend continuous foetal monitoring. Also known as CTG, continuous foetal monitoring is only available in labour wards (obstetric units) so if you’re in a birth centre or at home you will need to be transferred.
You can request continuous monitoring but this isn’t usually recommended if you’re having a straightforward pregnancy. Discuss it with your midwife and note any specific preferences in your birth plan.
Keeping active during labour
Some people prefer to have the freedom to continue moving around the room during labour. This can help speed up the process and provide some relief from pain.
You can use a birthing ball or chair to stay sitting upright. Swaying or rocking from side to side can be comforting and reassuring and can also help move your baby into the best position for birth.
If you feel up to it, standing up and leaning on your partner, or even leaning over the side of the bed can help things move along naturally too.
The types of pain relief you have will impact whether or not you’re able to move around during labour. For example, you can’t usually move around by yourself if you’ve had an epidural.
How you want your baby to be monitored during labour will also affect the positions available to you.
The 2018 survey by the CQC found that two thirds of women who didn’t have a planned c-section were able to move around and get into comfortable positions during labour most of the time.
Position during delivery
After considering movement and positions during labour, think about what kind of position you would like to be in when you give birth. Here’s a handful of positions to consider:
- On all fours
- Leaning on a birthing stool/bed
- Lying on your side
- Sitting up.
Practice getting into these positions beforehand, with the help of your birth partner, to find one that feels right for you.
If your baby is being monitored continuously, or if you have an epidural, this can limit the positions you can get into. If you feel like you need to move, discuss it with your midwife so that they can help you.
While thinking about how you’d like to give birth, also try to prepare yourself mentally for if things don’t go quite to plan. In the 2018 CQC survey, around a third of women reported giving birth with their legs in stirrups.
An episiotomy is the process of making a surgical cut in the area between the vagina and your bottom to widen the opening and allow the baby to be born more quickly.
Usually this is done to prevent extensive tearing, though it’s worth keeping in mind that the majority of women do tear to some extent when giving birth, and that routine episiotomies are no longer recommended.
Sometimes an episiotomy will need to be performed if the baby is in an abnormal position, or in order to speed up delivery if the baby’s health is at risk.
It’s a good idea to state a general preference in your birth plan, such as ‘I would prefer to tear naturally unless circumstances dictate otherwise’, or ‘I would prefer to have an episiotomy if required’.
Let the midwives or doctors know whether you have a preference for how you want your placenta (afterbirth) to be delivered.
Choosing a ‘physiological third stage’ means that the placenta will be delivered naturally, without any assistance or pulling on the cord. The other option is an ‘active third stage’, where your doctor or midwife will give you a hormone injection and then pull on the cord to help speed up the process.
Most hospitals are likely to opt for active management if you don’t give them a preference, as it can help to reduce the loss of blood.
Cutting the umbilical cord
The World Health Organization (WHO) recommends clamping the umbilical cord one to three minutes after the birth, which is referred to as delayed clamping.
If you have a preference, describe how long you want to wait before the umbilical cord is clamped and then cut. Many people prefer to wait until it stops pulsing to ensure that their baby receives the maximum amount of oxygen and nutrient rich blood from the placenta.
Another thing to consider and add to your plan is whether you want your partner to be the person to cut the umbilical cord.
Having your baby on your bare skin straight after birth can help you and your baby bond. It can also help to naturally encourage breastfeeding.
It can be more difficult to have uninterrupted skin-to-skin contact immediately after birth in certain situations – for example if the baby is delivered by c-section. If you feel very strongly about this, include it in your plan so that those caring for you can make sure you have skin-to-skin contact as soon as possible.
Breastfeeding sometimes occurs quite quickly and naturally after birth, but for many women it’s not as easy or straightforward. One thing you can include in your birth plan is whether you want help to start breastfeeding as soon as possible after birth.
You can also specify requirements around how your baby should be fed, for example whether you’re happy for them to receive supplementary formula, bottled water or glucose water.
Also think about whether or not you want them to be able to use a dummy immediately after birth.
Doctors recommend that as a precaution, vitamin K should be given to babies shortly after birth to reduce the likelihood of a rare bleeding disorder.
If you don’t want your baby to have an injection so soon after birth, vitamin K can be provided as an oral supplement. Taking it orally is known to be slightly less effective, so your baby will need additional doses.
If you have strong feelings about the use of vitamin K, or how it’s administered, discuss this with your doctor or midwife and include your preference in your birth plan.
Having an elective c-section doesn’t mean that you don’t get to make any choices about how you experience birth. You may still like to write a birth plan and consider if you want:
- your own music to be played during the birth
- dimmed lighting
- the curtain lowered so you can see your baby being born
- the hospital staff to be quiet when your baby is born, so yours is the first voice they hear
- photos to be taken during the birth, or someone to film when your baby is born
- to discover the sex of your baby for yourself
- immediate skin-to-skin contact and breastfeeding.
You can talk about all of these things at your antenatal appointments with your consultant or midwife if you’re planning to have an elective c-section, to come up with a plan for the birth which feels right for you.
If you’re planning for a vaginal birth, it’s still a good idea to write about what you would like to happen if circumstances change and you need to have a caesarean section, as more than one-in-ten births are emergency c-sections.
Who can I talk to for help with my birth plan?
If you have concerns or questions when you’re putting your birth plan together, talk to your midwife. They’ll be able to explain what you need to include and provide information on any aspects of labour and birth you’re interested in or concerned about.
Antenatal classes are another great opportunity to discuss your birth plan. Teachers will often set aside time to discuss it and it can be really useful to ask questions and share ideas with other mums-to-be.
If you have a friend or family member who has given birth recently, ask them about what they included in their plan and whether there was anything they’d have been keen to include in hindsight.
It’s good to involve your partner when you’re thinking about your birth. Not only is it useful for them to understand your wishes so they can support your decisions confidently during labour and childbirth, but it can also help to get another person’s support with research when you’re making decisions about what you do and don’t want to happen.
There are many different templates and sample birth plans you can use to help you get started, like this one from the NHS:
You can either put your answers in online to generate a personalised birth plan before printing it out – or you can print the blank document and fill it in by hand.
An RCOG (Royal College of Obstetricians and Gynaecologists) spokesperson says: ‘Having a birth plan during pregnancy is an important factor in helping women prepare for labour and ensuring maternity staff can support women and their babies in the best way possible.
‘The coronavirus pandemic does not change the importance of this, and women are still being encouraged to create a birth plan with their maternity team in the usual way.
‘Maternity services continue to work tirelessly to ensure that women’s choices are respected but it is important to know that some options – like a home birth – may temporarily not be available in certain parts of the country while units navigate the pandemic and continue to prioritise keeping women and their babies safe.
‘This will be communicated at the earliest possible opportunity and suitable alternatives and advice offered.’
Page last updated 03/06/20. Please check the Royal College of Obstetricians and Gynaecologists website for the latest updates.