A birth plan — increasingly referred to as a "birth preferences" document, which better reflects its nature — is a written summary of your preferences for labour, birth, and the immediate postnatal period. It is addressed primarily to the midwives and doctors who will care for you during labour, particularly if they have not met you before.
The most useful birth plans are clear, specific, concise, and realistic. They are not contracts and they do not guarantee particular outcomes — birth is too unpredictable for that. But they are an effective way to ensure your voice is heard even when you are in active labour and not best placed to articulate complex preferences.
The primary value of a birth plan is communication. During established labour, you may be managing intense pain, you may have had medication that affects your thinking, and you may simply be too focused on what your body is doing to conduct a thoughtful conversation about preferences. A clear written document means the midwife caring for you can quickly understand your priorities without needing to ask lots of questions at a difficult time.
It also serves a secondary, valuable purpose: the process of writing it forces you to think through your preferences, understand your options, and have important conversations with your partner and midwife before the day.
At the top, include your name, your due date, your partner's or birth companion's name, your group B strep status if known, and any relevant medical history (including any conditions the midwife would not know from a brief introduction).
Who do you want present, and what role do you want them to play? Some people want their partner to lead communication with midwives; others prefer to communicate directly themselves. If you have a doula, note this and clarify their role.
If you have a preference for a midwifery-led unit (MLU) versus the consultant-led obstetric unit, note it here. If you were planning a home birth that has been transferred, noting that context is helpful.
This is one of the most important sections to think through carefully. Options to consider:
You do not need to pre-commit to a specific approach. A statement such as "I am open to all options but would like to try water and gas and air first" is entirely reasonable.
The standard approach to fetal monitoring during labour in a low-risk pregnancy is intermittent auscultation — a midwife listens to the baby's heartbeat at regular intervals using a handheld Doppler device. Continuous electronic fetal monitoring (CTG) is recommended when there are identified risk factors or when concerns arise.
If you have preferences about monitoring, note them — for example, if you want to remain mobile (which continuous CTG makes more difficult, though some units offer wireless CTG).
Research consistently shows that upright, forward-leaning, or lateral positions during labour and birth are associated with shorter labour, reduced need for episiotomy, and less severe perineal tearing compared to the semi-recumbent position (lying on your back with legs raised). If you have a preference to remain upright or to use specific positions, note this.
Delayed cord clamping — waiting at least one to three minutes after birth before cutting the umbilical cord — allows a significant additional transfer of blood from the placenta to the baby, providing iron stores and stem cells. NICE guidance now recommends delayed cord clamping for at least one minute in all births unless there is a clinical reason not to (such as the baby needing urgent resuscitation). Include this in your plan if it is important to you, and note whether your partner wants to cut the cord.
You will be offered a managed third stage (an injection of oxytocin given after birth to help the uterus contract and deliver the placenta quickly, reducing bleeding risk) or a physiological third stage (allowing the placenta to deliver naturally). Managed third stage is generally recommended as it significantly reduces the risk of postpartum haemorrhage. If you prefer a physiological third stage, note this, but also note your understanding of the associated risk so that midwives know you have made an informed choice.
Immediate skin-to-skin contact after birth — placing the baby directly on your chest before drying, weighing, or wrapping them — supports temperature regulation, early bonding, and the initiation of breastfeeding. It can be done after vaginal and caesarean birth (with some adjustments for the latter). If this is a priority, note it explicitly.
Shortly after birth, your baby will be offered:
If you have preferences about any of these, including whether you want them delayed (to a certain extent) to allow for uninterrupted skin-to-skin time, note this.
Note whether you intend to breastfeed, bottle feed with formula, or are undecided. If breastfeeding, note that you would like support from the midwife to achieve a first latch.
If you know you will be having a planned (elective) caesarean, or if you want to note your preferences in case an emergency caesarean is needed, there are several things worth including:
The most important quality of a good birth plan is flexibility. The phrase "I understand plans may need to change" — or similar — somewhere in the document signals to your care team that you are realistic, which tends to make them more receptive to your stated preferences generally.
Plans can change due to the baby's position, the progress of labour, the baby's response to contractions, clinical concerns, or simply because you change your mind once labour begins. None of this is failure. The purpose of the birth plan is to communicate your default preferences, not to bind clinical staff.
Your midwife will read the birth plan at the start of your care, and should refer to it during discussions about your progress and options. Most experienced midwives welcome a clear, concise plan — it saves time and reduces the risk of miscommunication. The key word is concise: a one-to-two page document is considerably more likely to be read carefully than a five-page document.
Discuss your birth plan with your community midwife before your due date to make sure there are no preferences that need further discussion or that may not be feasible at your specific unit.
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