Birth plan for two: what it is for, what to put in it, how to discuss it with your team

What is a birth plan for?

In France, the national health authority defines a birth plan as the meeting point between the aspirations of the woman and the couple and the local offer of care. It can cover how medical care is organised, birth preparation, the way of giving birth and follow-up after the birth (HAS, 2005). The NHS describes it as a way of letting your midwife, nurses and doctors know what you want to happen during labour: where you want to give birth, who will be with you and what facilities you would like to use (NHS, 2026).

A national quality directive published in France in 2023, drawn up under the aegis of Audipog and the users’ collective CIANE with the learned societies of perinatal care (including the CNGOF and the national college of midwives), spells out the spirit. A birth plan has been recommended in France since 2005 and is a right for every pregnant woman or couple. More than the expression of a dream birth, it is a communication tool between parents and professionals, which aims to build trust between you, your companion and the people at your side (Audipog et al., 2023).

It is not compulsory: women are not required to put forward a birth plan, nor to have an opinion on every topic (Audipog et al., 2023). It is still a little-used step: in metropolitan France in 2021, 10.2% of women had written a birth plan (3.7% in 2016) and 70.1% said they had no particular request, without the survey being able to say whether this reflects trust in the team or not daring to ask (ENP, 2021).

When to write it

Ideally well before the due date, in stages, in a continuing dialogue with the professionals following your pregnancy: preparing the plan helps you identify what you want to share with the team, your strengths, your vulnerabilities and your needs (Audipog et al., 2023).

Several appointments are suited to it. In France, the early prenatal interview (entretien prénatal précoce), individual or as a couple, is a time for talking and listening to take stock of your birth plan; it is advised from the 4th month, but it is never too late (Assurance maladie, 2026). The NHS advises talking through your choices with your midwife while you write, so that they understand them and can advise you (NHS, 2026). Our guide to preparing for childbirth covers what is available in France.

The plan can change throughout pregnancy and labour (Audipog et al., 2023). There is no need to wait until it is perfect: a first version written together, even incomplete, opens the conversation.

What a birth plan can contain

The 2023 French directive suggests eight main parts, to be used freely: you can fill in only some of it, use it as a simple basis for discussion or add other topics (Audipog et al., 2023):

• getting to know you: your resources and strengths, what the team should know of your story, your fears or needs around birth (if the fear is intense, our article on tokophobia can help you talk about it);
• how labour begins, whether spontaneously, induced or with a planned caesarean;
• support during contractions: what puts you at ease (light, music, a bath or shower) and how you imagine moving (walking, positions, a ball);
• the pushing phase: atmosphere of the room, your companion’s place, position, protecting the perineum;
• the people you want at your side;
• just after the birth: cutting the cord, the placenta, welcoming the baby and skin-to-skin contact, newborn care, feeding;
• the days that follow: support, visitors, skills to learn, extra support for yourself;
• anything else you want to raise.

What women ask for most often

In the 2021 national perinatal survey for metropolitan France, among women who had particular requests for their birth, the most frequent were skin-to-skin contact with the baby (67.3%), being able to walk or change position (60.1%) and limiting medical acts such as episiotomy, caesarean or oxytocin (52.2%). Among them, 38.2% asked to give birth without an epidural (ENP, 2021).

The NHS checklist also asks about where to give birth, who will be with you (including if forceps, a vacuum or a caesarean is needed), whether you want to use a birthing pool, to stay active and which position you prefer, whether you are happy for trainees to be present, your pain relief preferences and how you plan to feed the baby (NHS, 2026). Pain relief is not a separate part of the French directive, but many couples want to talk about it: our template gives it a box of its own.

How to discuss it with your team

A birth plan is not a document you hand in: it is a basis for dialogue. For any medical act, professionals must give you clear, appropriate and scientifically justified information so that you can consent or not, and some of your wishes may change or turn out not to be possible for medical reasons (Audipog et al., 2023). A few pointers so that the discussion is useful:

• show it to your midwife or doctor well before the birth and ask what is possible in your maternity unit;
• find out about the practices of the place where you will give birth: in metropolitan France in 2021, 69.3% of maternity units had at least one room for less medicalised births (a physiological space, a “nature room”) and more than 65% said they often or systematically offered women the chance to write a birth plan (ENP, 2021);
• keep to the essentials: we suggest three or four priorities rather than writing everything (practical advice that the directive does not give). It says that the plan gives the team an overall view of what matters to you, which lets professionals get to the essentials and quickly establish a personal contact, and that you can fill in only part of it (Audipog et al., 2023);
• phrase wishes and questions rather than demands;
• keep a copy in your pregnancy notes and bring one on the day: on admission, English guidance asks the team to discuss your labour and birth preferences and review any written birth plan (NICE, 2023).

The birth partner’s role in the birth plan

French health authorities speak of the active participation of the woman and the couple in their birth plan (HAS, 2005), the WHO recommends that every woman can be accompanied by the person of her choice throughout labour and birth (WHO, 2018), and the 2023 directive devotes a part to it: who do you want at your side, and what place for your companion at the moment of birth (Audipog et al., 2023).

Writing the plan together also prepares the partner’s role. In practice, they can:

• take part in writing it, not only in reading it over;
• know the chosen priorities by heart, so as to repeat them to the team if the mother has no energy left;
• say what they want to do (guide the breathing, do skin-to-skin, cut the cord) and what is hard for them;
• prepare their own presence: continuous support during labour is associated with slightly less use of pain relief and a less often negative memory of the birth, with evidence that is partly of low quality; this Cochrane review covers continuous support in general (hospital staff, a trained companion in a doula role, or someone the woman chooses) and does not single out the partner (Bohren et al., 2017).

Example wording

These sentences are examples to adapt, not official texts. They say what you want, leave room for the team’s opinion and keep safety as a shared priority:

• “We would like to be able to move and change position during labour, if monitoring and health allow.”
• “For pain, we would like to try breathing, the bath or the ball first, keeping the option to ask for an epidural at any time.”
• “If possible, we would like soft lighting, and my partner to be able to stay with me throughout.”
• “If a caesarean became necessary, we would like my partner to be able to be present, if conditions allow.”
• “After the birth, we would like skin-to-skin as soon as possible, without separation unless medically necessary.”
• “We are afraid of [to be filled in]. We would like the team to explain what they are doing as they go.”

When things do not go as planned

A birth plan is not a script. The 2023 directive specifies that some wishes may change at your request or prove impossible for medical reasons, hence the value of discussing it beforehand and anticipating possible scenarios (Audipog et al., 2023). The NHS reminds us that giving birth does not always go perfectly to plan and that things may have to change at the last minute, and that your midwife will help you make the best and safest decision (NHS, 2026). French health authorities add that it is possible to move from one approach to another, by choice or by necessity (HAS, 2017).

Changing your mind, asking for an epidural, accepting an intervention that is offered: none of this is a failure of the plan. Preparing two or three plan Bs together, with their reasons, helps you live through them more calmly.

Frequently asked questions about birth plans

A few short answers, sourced in the article.

Further reading

• Preparing for childbirth: methods, when to start and what is covered in France
• The birth partner’s role during labour: preparing together
• Epidural and mental preparation: do they go together?
• Fear of childbirth: where it comes from and how to ease it
• Tokophobia: when the fear of childbirth takes over