Birth plans have become an increasingly popular part of the preparation ritual for expectant mothers, but many women struggle with what to include in their plan, and worry about whether or not medical staff will support it.

Despite the growing popularity of the birth plan, it remains somewhat controversial, with plenty of debate among mums-to-be and professionals alike, about whether or a not a plan improves or hinders the birthing experience.

To help clear things up, we asked three midwives and a doula what they really think about birth plans.

Are birth plans a good idea?

Liz Wilkes, Managing Director of My Midwives
They are a good idea for women who are having care with someone they don’t know. It is important to understand all that a plan does not mean you are setting out what will happen – I think probably calling it a preference list or similar makes it clearer and sets the level of expectation where it should be.

Lisa Hamilton, Doula at Birth Mama
Absolutely. Planning for the birth you want is a womans sacred birth right and her responsibility. Does it mean that everything is going to go 100% exactly the way we want? Of course, not for two reasons.
1. Because that's not always how life works and
2. Because there is more than one person involved in the process - baby has to come to the party as well!

Belinda Joyce, midwife and author of Survive and Enjoy Your Baby.
I think birth plans are a fantastic idea as they prompt birthing women and their partners and support people to learn about and consider the different options that may be available.
Birth plans can even be helpful with a planned caesarean birth- there are still some choices available depending on your hospital and doctor or obstetrician, such as support people, music playing, how much you would like to see, maternal assisted birth and more.

Debra Wakefield. Midwife and Founder of Empowered to Birth
A good idea? – Yes.
If done correctly – yes.
If done poorly – No.


What should be included in a birth plan?

DW: A good birth plan is a basis on which couples can start conversations with their care providers about their deepest fears and their greatest desires for birth. A great birth plan is flexible to meet the changing circumstances they might find themselves in as labour and birth take unexpected twists and turns.

LW: It should include the things you can definitely control – saying something like “I would prefer my baby is handed immediately to me” or “I would prefer my husband or I are the first people to touch or catch the baby”.  Both these things can be catered for with the right care provider regardless of whether the birth is a vaginal birth or caesarean section. 

LH: Simply anything that is important to mum!
Some key details I do see included however are things like specific requests for their birth environment (think lighting, noise levels etc) as well as requests around medicalisation e.g. their preferences around interventions, being offered pain relief, fetal monitoring, cord clamping, skin to skin, breastfeeding etc.


What shouldn’t be included in a birth plan?

BJ: If the birth plan is too rigid or uses language such as “No pain relief from drugs” but if the mother feels she needs some pain relief, it can make her feel like a failure later. Try to keep the language flexible to consider your wishes whilst also allowing for the unexpected.

LW: Saying something like “I will not have a caesarean section” or “I must have an epidural” is not particularly helpful.  If a birth is heading into a challenging space, it is important to know that you may actually need a caesarean for the safety of you or your baby.  Putting these into a plan is less useful than choosing a care provider that will lead you in the direction you want in your birth and will try to steer you away from the things you don’t want to happen

LH: Nothing! Anything that is important to mum should be included and her birth team should do their best to facilitate her wishes.


Is there such a thing as too much information in a birth plan?

BJ: Again, it really depends on the sort of information you are including, if the extra information takes into account a change in the plan such as the need for an emergency caesarean and your wishes in this scenario then that could be helpful. But if the information is very rigid and detailed giving no leeway for the unexpected then it could be detrimental.

LH: I am yet to see a plan with too much information on it.

DW: Yes, a thesis style format for a birth plan will not be read by a busy midwife, it will be ignored and disregarded. In today’s hospital system where midwives are busier than ever; with the ever-increasing amount of documentation, there is barely time to cover the basics in labour, let alone read an essay of a birth plan.


Can birth plans lead to unrealistic expectations?

LW: I don’t think the plan leads to unrealistic expectations – but I think the process of writing it can.  If women are not discussing honestly with a care provider what they want and the care provider is not on the same page then it gets very problematic.  Women need to recognise birth can change in a second and they need to list preference that take into consideration any change and any possibility.  They need to have discussed this and ensured everyone, partners, family, care providers are on the same page.

DW: Yes, if the belief is that because it is written, it will happen. Then it is quite likely that the birth might not unfold according to what is written on paper. Therefore, leading to Birth Trauma, from unmet expectations. However, when a Birth Plan is written, based on a couple’s own research and understanding of hospital policies and protocols. Taking into account her own personal medical situation and discussed with care providers well in advance of labour, then it is quite likely that a couple’s desires can be facilitated. As such, a birth plan can be crafted with realistic expectations in mind.

LH: Absolutely not. I am a huge advocate for birth plans as through the creation of it, women have the opportunity to learn more about themselves, their body and birth itself.

BJ: Yes, birth plans can lead to unrealistic expectations. You must consider the unexpected and how you will cope then. Flexibility in a birth plan is key.


What do pregnant women need to keep in mind when making their birth plan?

BJ: Keep in mind your birth attendants, place of birth such as a hospital will have their own policies. Try to make the birth plan with your team, support people and birth attendants. This way everyone is on the same page and can discuss any wishes that may not be possible.

LW: They really need to keep in mind that there needs to be honest dialogue between them and their care providers about everything they are considering. 

DW: When writing a birth plan, a couple should understand the policies of the hospital they are birthing at, and the limitations of that facility.  As well as her own personal health status and that of her unborn baby.