Your birth plan

What is a 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.

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 and even if things don't go exactly to plan it's your right to express your preferences to the team taking care of you.

The charity Birthrights says that while a birth plan has no legal status, if it's been agreed with your midwives and doctors this should indicate that they are happy with it and are prepared to follow it - even if you've chosen care that isn't what they recommend they should still try to meet your wishes.

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 plan for a home birth, for example, you might need to be transferred to a labour ward, or if you plan for a vaginal birth you might end up needing a caesarean section.

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:

How to write a birth plan

There are many things to think about when you’re writing your birth plan. 

A birth plan is a way to let your medical team know what kind of labour and birth you’d like and what you’d like to avoid if possible. 

Your plan will be highly personal to you and is dependent upon so many factors including your medical history and what’s available at your maternity service. Some hospitals have a special birth plan form you can fill in but you can either just use a sheet of paper or download our template. 

Your midwife can help you fill it in, too.Remember - you don’t have to have a birth plan and you don’t have to stick to it. In fact, flexibility is key when it comes to giving birth because some of the things you may hope for may have to alter if the situation changes - for example, if you need an emergency c-section. 

Once you’ve written your birth plan, you can keep a copy in your hospital bag as well as giving one to your birth partner for safe keeping for when the day arrives

Here are some factors to consider when you're writing your birth plan. You can also download a birthplan template here to tick things off on and to write extra notes where required.

Where you'd like to give birth

Perhaps the first thing to think about is where you'd like to have your baby. 

Would you like to give birth at home, would you prefer a midwifery-led unit or would you prefer to give birth in a hospital? A 2019 survey of women's experiences of maternity care (released in January 2020) by the Care Quality Commission (CQC) found that just 10 per cent of women hadn't thought about where they wanted to give birth before the actual event.

Remember, you don't have to stick with this decision - and it may well be that circumstances ultimately leads your decision, such as the position of your baby as your pregnancy progresses - but it's good to clarify your mind at this early stage.

Your birth partner and their role

A birth partner could help you to cope with the ups and downs of labour and birth and the CQC survey certainly reflects this: in 2019, 97 per cent of women said that their partner or someone else close to them was involved as much as they wanted to be. 

As you're writing your birth plan, have a think about the role you'd like them to play at this important time.

Do you want them there throughout your labour and birth, and after you've delivered, or are there stages when you might prefer them to leave the room?

If you have a c-section, forceps or ventouse delivery, would you like your birth partner or companion to be there?

If interventions are suggested, would you want to talk about them with your birth partner in private?

You might also wan to think about whether you want - or are, indeed, allowed more than one birth partner (e.g. your mum as well as your birth partner)?

Positions for labour and birth

There is no 'right' position to give birth in - it's down to personal choice. You may like to think about the following as you prepare your birth plan:

Do you want to remain upright and moving around for as long as possible or would you like to be in bed with your back propped up with pillows while you’re in labour and give birth lying on the bed?

Would you prefer to lie on your side?

Do you want to be kneeling, standing, squatting, on all fours or are you not sure yet?

Monitoring your baby’s heart rate

Do you want your baby’s heart rate monitored continuously during labour? 

You don’t need electronic fetal monitoring (EFM) if your labour is going well although you can ask for it if you want to.

It may also be suggested in certain circumstances, such as if you’ve had an epidural, have high blood pressure, develop a temperature or are on an oxytocin drip to speed up labour.  

Medical students observing your labour and delivery

Trainee midwives, nurses and doctors need to observe women in labour as part of their training. 

If you don’t want this, tell your midwife. You are under no obligation to consent to this.

Birth interventions

Your labour might be slower than expected - for example, if your contractions aren't coming often enough or aren't strong enough.

As you're writing your birrth plan, you may like to think about whether you'd like interventions to speed it up again (such as with an oxytocin drip) or would you prefer to wait?

If you’re told you need help to give birth, do you want to avoid an episiotomy and to try other giving birth positions first?

Would you be happy to have a forceps or ventouse delivery or are you happy to see what’s recommended if and when that time arises?

Do you want to be able to use music or relaxation tracks during your labour and birth?

Birthing equipment

Do you want to use birthing equipment such as mats, beanbags or wall bars during labour or not and are these available where you’re planning to give birth?

Do you want to use a birth pool at hospital or in a midwife-led unit or are you planning to use one at home?

Would you like to give birth in it or is it for pain relief

Would you like to use it to deliver the placenta?

Caesarean section 

The CQC survey found that out of 16,895 respondents, 13 per cent had had a planned caesarean while 16 per cent had had an emergency one.

In the event that you either choose to have a caesarean or find that circumstances mean you end up having one, you can put in your birth plan whether you want the medical screen lowered or no screen at all so you see your baby being born.

You can also choose to not see past the screen.

Some caesareans, such as crash caesareans, are carried out under a general anaesthetic so these options won't be relevant.

Pain relief

What kind of pain relief would you like to try? Although the 2019 CQC survey found that the most common method of pain relief used was gas and air (used by 79 per cent of women surveyed), natural methods such as hypnosis, breathing or massage were used by 34 per cent.

There are a number of options you can choose for your labour and birth, including: 

• breathing and relaxation
• being in water during labour and/or birth 
• massage, acupuncture or a TENS machine
• gas and air (entonox)
• pain-relieving injections 
• epidural
• other pain relief methods
• trying to manage without pain relief.

Coping with the unexpected

Sometimes things don't go according to plan when you've given birth.

In the event of an c-section, 

If your baby needs to be taken to special care while you need stitches or to recover from a c-section, do you want your partner or companion to go with your baby?

Or would you rather they stayed with you?

Finding out your baby’s sex

When your baby is born, chances are someone else will see what sex it is before you do.

Would you like to be told the sex of your baby by someone else or would you want to find out for yourself (if you don’t already know) or for your birth partner to tell you.

Put this information into your birth plan so that it's clear.

Skin-to-skin

After the birth you can have your baby lifted straight onto you for skin-to-skin contact before the cord is cut. 

Unicef UK says that skin-to-skin contact 'helps parents bond with their baby and supports better physical and developmental outcomes for the baby.'

When you give birth, would you like your baby to be delivered straight onto your tummy, cleaned before they’re given to you or given to your birth partner?

Third stage of labour (delivering the placenta)

Do you want an active third stage, where you have treatment such as a syntometrine injection to make it happen faster, or would you prefer a physiological third stage, where you have no treatment and it happens naturally?

Who do you want to cut your baby’s umbilical cord and do you want delayed cord clamping?

NICE (the National Institute for Health and Care Excellence) recommends that the umbilical cord shouldn't be clamped and cut until at least 1-5 minutes after the birth so that blood from the placenta can continue to flow into your baby to help with their growth and development. 

Pregnancy and birth charity Tommy's says: 'Delayed cord clamping should be practised everywhere, but you should still include this in your birth plan.'

Special requirements

There may be factors that impact your pregnancy and birth, such as a disability. If so, what will help you - for example, do you need a sign language interpreter?

Do you have any religious needs and how can these be catered for?

If English isn’t your first language, do you need someone present who speaks your first language?

Maybe you need a special diet during labour and after the birth, whether it's for religious, cultural, ethical or health reasons?

Have you had a past experience that may affect your labour or birth - for example, a previous stillbirth?

Feeding your baby

Although research shows that breast milk gives babies the best start in life, it's not always possible to breastfeed or you may actively choose to bottle feed from the start. 

Whatever your circumstances, you shouldn't feel guilty (or be made to feel guilty by others).

Tommy's says: 'It's your right to choose how to feed your baby and you can change your mind along the way if you want.'

You may want to think about how you are planning to feed your newborn and putting your thoughts on your birth plan:

Would you like to breastfeed your baby?

Would you like to bottle feed your baby?

Would you like to try a mixture of breastfeeding and bottle feeding?

Will you wait to decide once your baby is born?

Vitamin K for your baby

It may be suggested that your baby needs vitamin K to help the blood clot properly and to prevent a rare bleeding disorder called Vitamin K Deficiency Bleeding.

In this instance, would you prefer it was given to your baby orally, by injection (in their thigh in the first day of life) or not at all?

It should be explained to you that if your baby has oral vitamin K, they'll need more doses as the absorbtion of the whole drug can't be guaranteed in the same way as if it's given as an injection.

You can include your preferences for vitamin K in your birth plan.

Coronavirus and your birth plan

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 02/03/21. Please check the Royal College of Obstetricians and Gynaecologists website for the latest updates.