Do I really need to write a birth plan?

What are pros and cons of writing a birth plan? Is it even worth doing one at all? Here's what you need to know...

pregnant woman writing a birth plan

No, you don’t need to write a birth plan – although it’s absolutely fine if you do want to write one. Or, rather than a detailed plan, maybe just a short list that indicates your preferences about your labour and birth.

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Gone are the days when midwives routinely encouraged every pregnant woman to write a long document about how we wanted our birth to be (what kind of pain relief we’d like, who we’d like with us, who gets to hold the baby first, and so on).

Now there’s an acknowledgement that doing this isn’t right for everyone: maybe long written statements aren’t your thing or maybe you just don’t see the point in ‘planning’ something you can’t really control. After all, you may want a candlelit waterbirth but it’s quite possible your baby may end up arriving some other way entirely…

So, should I write a birth plan or not?

It’s completely up to you – and what you think would make you feel best prepared for your labour and birth.

“Some women like to plan their birth and some don’t,” says Lia Brigante, Quality & Standards Adviser at the Royal College of Midwives (RCM), “and it is entirely up to the woman if she writes a plan down or not.

“What is important is that you discuss your pregnancy and birth with your midwife, and ask questions, so that you can make the decisions that are right for you – and this will of course be different for everyone.”

What are the advantages of writing a birth plan?

There are so many choices you can make during labour and birth (everything from preferences on the different types of pain relief to who gets to cut the umbilical cord) that, sometimes, writing things down can help you narrow what you’d prefer, if circumstances allow.

Writing a plan worked out well for GoldenShades on our forum, for example, who’d realised, as she went through the process, that she wanted to aim for as a natural a birth as possible.

“My plan was to be as mobile, upright and as natural as possible,” she says, “with TENS and gas and air, no pethidine and an epidural only if necessary. I also wanted to stay at home as long as possible.

“To be honest, I probably stayed at home too long but the rest all went with the plan.”

The key thing, says Lia at the RCM, is to know that even the best-laid plans may have to change – or that, once labour starts, you may realise your plan isn’t actually what you want after all.

“It is important to note that things can change in pregnancies and births,” she says. “and it is useful to be flexible.”

That’s certainly what Tigerlily on our forum found: “I wrote a plan but it went out the window when I arrived at the hospital as there was already someone in the [birthing] pool!

“I’d recommend just being open to anything, as you don’t really know what will happen or how you’ll feel when it all kicks off!”

What are the disadvantages?

A birth plan might not be right for you if you think writing down your ‘perfect’ birth scenario might set you up for disappointment if things don’t go exactly as you’ve planned.

And it does happen. One of our mums in our Bump Project research group was actually told by her midwife not to bother with a written birth plan for this very reason.

Louise tell us, “The midwife just said, ‘Oh don’t worry about that, we don’t do that anymore. It stresses the mums out more than anything else.’

“She said people beat themselves up if their birth plan doesn’t go right. Whereas if you don’t write a plan down, you’ve got nothing to beat yourself up over.”

Writing a birth plan is probably also not for you if you think you might treat the wishes expressed in it as things you must stick to, particularly around pain relief. It’s a plan, not a list of must-dos – and no one should feel under pressure to, for example, refuse an epidural just because it’s in their birth plan that they don’t want one.

“Whatever’s on your birth plan, you can change your mind about what you want at any point,” says Lia, “and your midwives will support you in this.”

What are birth preferences or birth choices?

Birth preferences and birth choices are just a fancy name for a less rigid, more list-y birth plan – a kind of birthplan lite. Instead of filling a couple of sides of A4 with a long, detailed statement, you can just write down the things that matter to you most.

As Margotmumdrum on our forum explains: “[Jotting down] birth preferences acknowledges that it may not always go to plan, and sticks to the important stuff, such as whether you want to try the water if the pool is available or how you want to feed”

Fellow forum mum trueman agrees. “The only 2 things I wrote down were: ‘I do not wish to breast feed’, and ‘I refuse to have an epidural (I’d heard it can sometimes slow labour down)’.”

And this, of course, is just fine, says Lia, as long as you’ve taken time to ask your midwife questions and think through what feels right for you. “This is your pregnancy and birth, ” she says. Talk to you midwife about your wants, your worries and your needs.

Still keen on a birth plan?

If you’re still like the idea of a birth plan, we’ve got a downloadable template and some great advice on what to include.

Pics: Getty

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