There are many templates for birth plans…

Over on our Nottingham Maternity Research Network pages, I’m currently publicising some work we’re doing around women’s use of birth plans.

In the UK, birth plans are a ‘normal’ part of antenatal care.  Many women’s handheld notes include a section where they can express preferences for such things as pain relief, positions for labour, and environmental comforts such as music, lighting and which people they might like to be present during labour and birth.

However, I’ve been having a little look at forums such as Mumsnet and Netmums, and birth plans are often a cause of intense debate: women sometimes question whether it’s worth writing one.  Can you really ‘plan’ for labour and birth?  Do midwives and obstetricians even take any notice of what you’ve written down?  And what happens if it all goes a bit awry when you’re in labour – where’s the sense of control if your birth plan goes flying out of the window?

There’s also a lack of consensus in the literature: in some studies, healthcare professionals have been shown to hold quite negative views of birth plans, and there’s a mistaken perception that completing one actually makes obstetric complications more likely.  Meanwhile, women report that the act of completing a birth plan antenatally can be a positive, empowering experience, highlighting the opportunity to effectively communicate wishes and desires and learn about choices and possibilities – but in labour, things often don’t seem so positive: choice is limited to what’s available locally, and sometimes healthcare professionals pay little attention to what women have asked for.

All this means that there are clearly some problems around birth plans, particularly in relation to a disjoint between constructing one and then using it during labour.  Ultimately, we’d like to look at whether there’s a ‘best’ scenario for birth plans: what’s the ideal time and place to write one?  Should it be a specific antenatal ‘event’ between a woman, her birth partner and the midwives who will be caring for her?  What can we do to help midwives regard birth plans positively?  And why is there such a range of opinions among healthcare professionals about the value of birth plans?  Questions, questions…

Interested in joining this conversation?  Visit our Notts Maternity page to read more about the kind of questions we’re asking, access the participant information sheet, and see the links to the questions we’re asking at Mumsnet and Netmums.  I’m also publicising this work via our Facebook page, so you can access the links from there if you prefer.  Whichever route you choose, I’d love to hear opinions about birth plans!