Writing Your Birth Plan (Birth Preferences)

A birth plan, many midwives prefer to call it your birth preferences, is simply a way of telling the people caring for you what matters to you. It isn't a contract, and birth has a way of taking its own path, so think of it as a starting point for conversation rather than a script. Writing one helps you learn your options and feel more in control, whatever happens on the day.

Start with the basics: who you'd like with you, where you hope to give birth (home, a midwife-led unit, or a labour ward), and anything that helps you feel calm, dim lighting, your own music, freedom to move around, or quiet. Note any cultural, religious or personal needs, such as who can be present, modesty preferences, or food and drink. These details help your team look after you as a whole person, not just a labour.

Next, think about pain relief. You don't have to decide everything now, but it helps to know what's available, from breathing, movement and a birth pool, through gas and air (Entonox) and pethidine, to an epidural. You might write something like "I'd like to try the pool first and keep an epidural as an option." Keeping your wording open gives you room to change your mind, which is completely your right at any point.

Consider the birth itself: positions you'd like to try, whether you want a mirror or to touch your baby's head as they're born, and your wishes for the moment of birth, for example delayed cord clamping, immediate skin-to-skin, and who cuts the cord. Think too about the placenta (you can have an injection to help deliver it, or a more natural approach) and your preferences for feeding your baby in the first hour.

It's wise to include a short note on what you'd want if things change, for instance if you need an assisted birth or a caesarean. You might say you'd still like skin-to-skin in theatre if possible, or that your partner stays with you. Knowing your preferences for the unexpected means you've already thought it through, so decisions feel less frightening in the moment.

A note on advocacy, which matters deeply. Sadly, in the UK, Black and Asian women and birthing people are more likely to feel unheard during birth, and outcomes are not yet equal. You have every right to ask questions, to ask for a second opinion, to say "stop, explain that to me," and to bring someone to speak up for you. Writing "please keep me informed and involved in every decision" on your plan is completely reasonable. Your voice belongs in the room.

Finally, keep it to a page if you can, share it with your midwife at an antenatal appointment, and pack a copy in your hospital bag. Talk it through with your birth partner so they can speak for your wishes if you're busy concentrating. And hold it lightly, a different birth from the one you planned is not a failure. A plan that flexed to keep you and your baby safe did exactly its job.