How to Write a Birth Plan the NHS Way
The most useful birth plans are short, specific, and written knowing plans can change. Here’s a practical structure to follow.
A birth plan is a written record of your preferences for labour and birth, shared with the team looking after you — not a binding contract, and not a document that guarantees any particular outcome. The most useful ones are specific enough to be actionable on the day, and short enough that a busy midwife can read them in under a minute.
What the NHS suggests including
- Where you want to give birth — labour ward, midwife-led unit, or home birth, and any preferences if plans change (e.g. you're transferred from a midwife-led unit).
- Who you want with you, and whether you want them present throughout or only at certain points.
- Pain relief preferences — which options you'd like to try first (gas and air, water, TENS), and whether you're open to an epidural if needed, or want it avoided unless medically necessary.
- Mobility and positions — whether you want to move around and use different positions during labour, or use a birthing pool if available.
- Preferences after the birth — delayed cord clamping, immediate skin-to-skin, who cuts the cord, and feeding intentions.
- What you'd like if things don't go to plan — preferences around assisted delivery or caesarean, which many people find useful to think through in advance rather than for the first time in the moment.
Why "hold it loosely" is the most important instruction
Labour is genuinely unpredictable, and the single most common piece of advice from midwives is to think of a birth plan as your starting preferences, not a fixed script. Circumstances — how labour progresses, baby's position, your own pain tolerance on the day — change plans for a large proportion of people, and that isn't a failure of planning, it's how birth works. A plan written with flexibility in mind ("my preference is X, but I understand this may change") tends to leave people feeling more at peace afterwards than a rigid one.
Keep it short
A one-page plan, in bullet points, gets read. A multi-page document with lengthy explanations often doesn't get read in full during a busy or fast-moving labour. Focus on the handful of preferences that matter most to you rather than trying to cover every possible scenario.
Discuss it with your midwife before the day
Most antenatal appointments in the third trimester include time to discuss your birth plan directly with your midwife, who can flag anything that isn't possible at your specific unit (not every hospital has a birthing pool on every ward, for instance) and help you think through anything you haven't considered.
Share copies
Bring at least two printed copies in your hospital bag — one for your notes, one to hand directly to the midwife looking after you on the day, since staff change over during longer labours and each new person benefits from seeing it quickly.
Mentioned in this guide
Frequently asked questions
What if I don’t want to write a birth plan at all?+
That’s a completely valid choice — some people prefer to discuss preferences verbally with their midwife on the day rather than writing anything down in advance. There is no requirement to have a written plan.
Can I change my birth plan during labour?+
Yes, at any point. Your birth plan reflects your preferences going in, but you can ask for different pain relief, change your mind about positions, or request anything else as labour progresses.
What happens if my birth doesn’t go according to my plan?+
This is common and not a failure on your part — midwives are used to adapting care as circumstances change. Many units offer a "birth reflections" service afterwards if you want to talk through how things went compared to what you planned.
Sources
Written by
Sepehr
Software engineer, soon-to-be dad, uncle to four — the tech-obsessed half of the two of us testing this stuff. Currently building this site with my wife, ahead of our own baby arriving.