Writing a birth plan and deciding about pain relief

Should we write a birth plan?

Well, you don’t have to write a birth plan and it’s not clear yet whether birth plans can actually improve your birth experience (Cook and Loomis, 2012; Mirghafourv and et al, 2019). But you might find birth planning gives you both a handy framework for talking about and thinking through what you’d like to happen during the labour and birth (Cook and Loomis, 2012; NHS, 2017). 

It’s helpful if birth partners are aware of the mum-to-be's preferences because as labour gets going she might not want to talk about the fine details. In fact, don’t be too surprised if the mum-to-be actually stops talking as her hormones help labour to progress. She’s concentrating on what her body needs to do (NHS, 2017).

Discussing your birth plan can help you feel more prepared and confident about entering the world of giving birth. That way you know you’ve done as much as you can to get ready. And birth partners can focus on supporting the mum-to-be and embracing the amazing experience of becoming a parent (RCM, 2018).

Are birth partners part of the birth plan?

Writing a birth plan is also a chance for birth partners to put down what they’d like their role during labour to be. See our article about what it’s like for dads in labour and how birth partners can support labour for more ideas.

Birth plans will help birth partners in the thick of labour, as well as making the part they want to play clear to the midwife. The idea is that the midwife will then be able to help them fulfil this role. This can help birth partners feel more included in the birth (Machin, 2018).

What should the birth plan include?

You could also talk about your plans with friends and relatives and get tips from them as well as your midwives and doctors (Cook and Loomis, 2012). 

It’s worth considering all the nitty-gritty choices you’ll both have to make in advance, as labour can progress quickly.

Good questions the birth partner might like to think through beforehand could include:

• Do they want to take an active role, for example cutting the cord?
• How much do they want to see ‘down there’?
• Do they also want skin-to-skin contact with your baby after they’re born? 

How else can we prepare ourselves for the birth?

You might find it helpful to go on an NCT antenatal course to meet other local parents-to-be and to help prepare you for your baby's arrival. A course will help you to think about: 

• what happens in labour
• the role of the birth partner
• options for pain management
• communicating with your caregivers in labour
• making decisions and understanding when more support might be needed during birth
• practising birth positions 
• relaxation strategies in different birthing scenarios
• looking after and feeding a newborn 
• how your lifestyle might change in the early days of parenting.

(Birth Trauma Association, 2019)

You might also want to consider alternative choices for your next birth if you experienced a difficult birth last time (Ayers et al, 2006).

How do we write a birth plan?

Some midwives or hospitals have a birth plan template that can help get you started. The NHS has a useful template you can download here.

Unless you’re using a template, try and keep your birth plan to a single sheet of A4, typed in a large font to make it easy to read. The midwife present when the mum-to-be goes into labour might not be the one you've seen before, so try to keep the birth plan simple.

Attach one copy of the plan to the maternity records and have a copy for yourself and one for the midwife.

The important thing to remember is that a birth plan is not set in stone. Things may happen during labour that you hadn’t planned for, so it's good to be flexible. You should also both feel you can change your mind as labour progresses.

How birth partners can help to prepare for a home birth

A growing number of parents are choosing to give birth at home. Planned home births are safe for healthy women with an uncomplicated pregnancy; they're also relatively straightforward to organise (Broklehurst et al, 2011).

Your midwife will talk you both through what you need to do to prepare. As birth partners might be on home turf, they can help with lots of things at a home birth. These could be to:

• arrange soft lighting and music
• find some plastic sheeting to protect furniture or carpets
• get a bucket or bowl for the placenta
• keep the birth pack the midwife provides at around week 36 somewhere handy; it’ll contain sheets, pads and items the mum-to-be might need
• have a trial run at assembling and filling your birth pool beforehand if you’re using one
• pack an emergency bag and have it ready in case you need to go to hospital.

(Homebirth, 2008)

Various methods of pain relief to consider

An important point to include on your birth plan is what, if any, pain relief the mum-to-be plans to take. Many women use self-help methods to help them cope during labour, such as hypnobirthing. You might also want to discuss the medical options available, such as Entonox, remifentanyl, opioids, epidurals, TENS and sterile water injections.

Mums-to-be might change their wishes during labour and may want to try pain relief. So you could find that things change from what you've requested on your birth plan.

While the best laid plans can change during the birth, it is still a great idea to write a birth plan. A little thought, research and a good chat can help you both feel prepared for what happens during labour and birth.

This page was last reviewed in May 2019.

Further information

Our support line offers practical and emotional support with feeding your baby and general enquiries for parents, members and volunteers: 0300 330 0700.

You might find attending one of NCT's Early Days groups helpful as they give you the opportunity to explore different approaches to important parenting issues with a qualified group leader and other new parents in your area.

Make friends with other parents-to-be and new parents in your local area for support and friendship by seeing what NCT activities are happening nearby.