A birth plan outlines your preferences for labour, pain relief, and the first hours after birth. Write it between weeks 28 and 34, keep it to one page, use "I would prefer" language, and share it with your midwife and birth partner. It is a conversation starter, not a contract.
A birth plan is a short document that outlines your preferences for labour, birth, and the first hours with your baby. It helps your midwife understand what matters to you without having to ask during contractions, and it helps your birth partner advocate for your wishes if you are unable to communicate them yourself.
Think of it as a set of preferences rather than a rigid script. Labour is unpredictable, and flexibility is important. The best birth plans use language like "I would prefer" and "if possible" rather than absolute demands. Your midwife wants to support your choices, and having them written down makes that easier, especially during shift changes when a new midwife takes over your care.
Most people write their birth plan between weeks 28 and 34. By this point you have attended antenatal classes (or at least started them), discussed your options with your midwife, and had time to think about what matters to you. Do not leave it until 39 weeks when you might be too tired or uncomfortable to think clearly.
Share a copy with your midwife at a late-pregnancy appointment so it goes into your maternity notes. Bring a spare copy in your hospital bag. And make sure your birth partner has read it and understands your preferences.
In the UK, you typically have three options, and your birth plan should state your preference:
Hospital labour ward. Full medical support available, including epidurals, continuous monitoring, and surgical facilities. Best for higher-risk pregnancies or if you want an epidural as an option.
Midwife-led birth centre. A calmer environment with midwife-led care, birth pools, and a more home-like atmosphere. Usually adjacent to a hospital for quick transfer if needed. Available for lower-risk pregnancies.
Home birth. Two community midwives attend you at home. Research shows that for second-time mothers with low-risk pregnancies, planned home births are as safe as hospital births. For first-time mothers, there is a slightly higher transfer rate. Discuss suitability with your midwife.
Your birth plan should outline which pain relief options you are open to and which you would prefer to avoid. Options available in the UK include:
Breathing and relaxation techniques. No side effects, taught in antenatal classes, used by almost everyone to some degree.
Water (birth pool or bath). Provides significant pain relief and relaxation. Available at birth centres and many labour wards.
TENS machine. Electrical nerve stimulation you control yourself. Most effective in early labour. Hire or buy from around week 37.
Gas and air (Entonox). Breathed in through a mouthpiece during contractions. Takes the edge off. Can make you feel lightheaded. You control the dosage.
Pethidine or diamorphine. Stronger pain relief given by injection. Takes 20-30 minutes to work. Can make you drowsy.
Epidural. Anaesthetic injected near the spinal nerves. Highly effective, most women report significant pain relief. Requires an anaesthetist (only available on labour wards). Limits mobility but can be topped up.
There is no medal for refusing pain relief. Your birth is not an endurance test. The goal is a safe birth where you feel supported.
Birth partners. Most hospitals allow one or two birth partners. State who you want with you.
Environment. Do you want dim lighting, music, your own pillow? Birth centres especially encourage you to personalise the space.
Monitoring. Intermittent monitoring (listening periodically) is standard for low-risk births. Continuous monitoring (a belt around your belly) is used for higher-risk situations.
Movement and positions. Do you want to move freely, use a birth ball, try different positions like kneeling or all fours?
Communication. How would you like to be kept informed? Some people want detailed explanations, others prefer minimal interruption.
Skin to skin. Most parents want immediate skin-to-skin contact. If you are having a caesarean, skin to skin is usually possible in theatre.
Cord clamping. Delayed cord clamping (waiting 1-3 minutes) is now standard NHS practice and allows more blood to flow to baby. State if you have a preference.
Feeding. Do you want to breastfeed straight away? Would you like support from an infant feeding specialist?
Vitamin K. Offered to all newborns to prevent a rare bleeding disorder. Most parents choose the injection (single dose). An oral alternative is available (three doses over several weeks).
Placenta. Some parents wish to see or keep their placenta. If this matters to you, include it. Otherwise it is disposed of by the hospital.
Include a section about what matters most if your plan needs to adapt. For example: "If a caesarean is needed, I would like to be told what is happening at each stage" or "My partner should be with me wherever possible" or "Please explain any interventions before they happen."
This section acknowledges that labour does not always go to plan, while ensuring your core values are still respected.
Keep your birth plan to one page. Here is a structure that works well:
About me: Name, due date, birth partner name, any relevant medical history or allergies.
My preferences for labour: Where I would like to give birth. Pain relief I am open to. Pain relief I would prefer to avoid. Environment preferences. How I would like to be supported.
My preferences after birth: Skin to skin. Cord clamping preference. Feeding plans. Vitamin K preference.
If things change: What matters most if plans need to adapt.
The most important thing is not what is on the paper. It is that writing it helped you think about what matters to you and gave you a way to communicate those preferences clearly.
Include your preferred birth location, pain relief options, birth partners, environment preferences, skin-to-skin and cord clamping wishes, feeding plans, and vitamin K preference. Keep it to one page and use flexible language.
Most people write their birth plan between weeks 28 and 34. Share it with your midwife at a late-pregnancy appointment and bring a copy in your hospital bag. Make sure your birth partner has read it.
No, it is not compulsory. But having one helps your midwife understand your preferences and helps your birth partner advocate for you. Even a short list of priorities is useful.
Options include breathing techniques, water (birth pool), TENS machines, gas and air, pethidine, and epidurals. Epidurals are only available on labour wards as they require an anaesthetist. Your midwife can help you understand each option.
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