A birth plan isn't a contract — it's a communication tool. Here's what to include, how to phrase it, and why you need a caesarean section section even if you're not planning one.
A birth plan isn't a contract and it won't make your birth go a particular way. What it does is help your care team understand your priorities — and give you a framework for making decisions under pressure.
A midwife or doctor who picks up your birth plan during a busy shift will read a single page. They will skim two pages. They may not read three. Brevity is kindness to the people caring for you — and to yourself, because a clear short document is easier to advocate from than a long one.
The goal is to capture your most important preferences, not to document every possible scenario. Prioritise what matters most. Leave out what you'd accept in a range of circumstances.
Birth plans written as lists of refusals — 'I don't want X, I don't want Y' — can create an adversarial tone before anything has happened. Rephrasing to what you do want works better: 'I'd like to try the pool/ball/movement before considering pain relief' rather than 'I don't want to be pressured into an epidural.'
One exception: your absolute refusals should be stated plainly. If there are specific interventions you are refusing for considered reasons, say so directly. This is your right under the law of consent, and it should be clear.
There's no point including things that will happen regardless — everyone gets their blood pressure taken. The value of a birth plan is in the areas where there's genuine choice. Focus on these six:
Pain relief: your current thinking and your openness to changing it.
Monitoring: intermittent vs continuous CTG (continuous monitoring limits movement).
Environment: lighting, music, who is present, photography.
Pushing: directed vs breathing baby down yourself.
Cord clamping: immediate vs delayed (delayed is now the NHS default — worth confirming).
After birth: skin to skin, feeding intentions, vitamin K for the baby.
Around 1 in 3 births in the UK are by caesarean — some planned, many unplanned. Having thought through your preferences for a caesarean in advance means that if the situation arises, you're not making decisions for the first time under stress.
For a caesarean, the things worth including: whether you want the screen lowered for a 'gentle' or 'natural' caesarean (where the baby emerges slowly and you can see the moment of birth), who will be with you in theatre, skin to skin on the table if you and the baby are well, and whether your partner will stay with the baby if it needs to go to the neonatal unit.
A planned caesarean birth plan is a slightly different document — see the full guide for this.
Give a copy to your midwife at your 36-week appointment. Put a copy in your hospital bag (several copies — one for each shift change). Email it to your birth partner so they have it on their phone. If you're planning a home birth or birth centre, confirm who will have it.
Your birth partner's job is to advocate from your plan when you are absorbed in labour and not in a position to speak for yourself. Brief them specifically on your most important preferences and on what to do if they feel something is going ahead without your consent. The phrase 'I'd like a moment to discuss this' can pause most clinical decisions.
Every decision in your maternity care is yours to make. You have the right to accept or refuse any intervention — including after labour has started. The WiseMama guide to your rights in maternity care covers informed consent, the right to refuse, and how to advocate for yourself. Read: Your Rights in Maternity Care →