Table 1.

Characteristics of the reviewed studies

No	Author	Type of research	The purpose of the research	Number of samples	Research tool	Result
1	Hidalgo-Lopezosa (2021)[11]	Multicenter and retrospective case-control	Determining the association between birth plan use and maternal and neonatal outcomes in southern Spain: a case-control study	457 pregnant women	Birth plan, questionnaire to check demographic characteristics and maternal and newborn outcomes	Birth programs were associated with less intervention, a more natural birth process, and better outcomes for mothers and babies. Birth plans can improve the well-being of mother and baby and lead to a more natural birth.
2	Hidalgo-Lopezosa (2017)[8]	Retrospective, descriptive and analytical	Adherence to the birth schedule and its relationship with maternal and newborn outcomes	178 pregnant women	Birth plan, questionnaire to check demographic characteristics and maternal and newborn outcomes	A birth plan can be an effective tool to achieve better outcomes for the mother and her child.
3	Farahat (2015)[9]	semi experimental	The effect of implementing a birth plan on women’s childbirth experiences and maternal and neonatal outcomes	260 pregnant women	Demographic questionnaire, birth expectation fulfillment questionnaire and birth satisfaction data, semi-structured interview with nurse and doctor, observation checklist to evaluate mother and baby outcomes.	Women who receive birth planning care during childbirth are more satisfied than women who do not receive the necessary care.
4	López-Gimeno (2021)[12]	Descriptive multicenter retrospective	Presentation of birth plan to hospitals and its relationship with midwifery results and selected methods of pain relief during childbirth	432 pregnant women	Birth plan, demographic profile questionnaire and observation checklist	Mothers with a birth plan were more likely to initiate breastfeeding in the delivery room. Epidural analgesia was the most commonly used method for pain relief, and women who presented with a birth plan tended to use more concurrent non-pharmacological methods.
5	Ahmadpour (2020)[13]	Qualitative	Evaluation of birth program implementation: a parallel convergent mixed study	106 pregnant women	Obstetric history review questionnaire, birth plan checklist, childbirth experience questionnaire, Edinburgh postpartum depression scale, partogram, childbirth fear scale, PTSD symptoms scale, maternal-fetal outcome evaluation checklist	The importance of birth planning stems from the principle of respect for biology and independence, and as a result, increases women’s control over the birth process and their satisfaction. Also, due to providing information and creating awareness and communication with women, it can reduce their fear and create positive feedback for women. The birth plan facilitates communication with obstetricians and gynecologists and increases women’s satisfaction with the birth process and increases participation in the decision-making process for childbirth.
6	Soliman Abdelalim (2020)[10]	Intervention	The effect of implementation of the birth plan on childbirth outcomes and women’s empowerment	194 pregnant women	Birth plan implementation questionnaire, childbirth results questionnaire, empowerment scale related to childbirth	The birth program leads to a higher implementation of maternity care, it has a positive effect on maternal and fetal outcomes, and in total, women’s empowerment scores increased significantly after the implementation of the birth and delivery program compared to the control group.
7	Davis (2019)[14]	A prospective, non-randomized controlled trial	The effect of the birth plan on the outcomes of mother and baby delivery		Birth plan, maternal and newborn outcome assessment checklist	A delivery schedule was associated with a significant increase in metabolic acidemia indices in infants. A longer delivery schedule was also associated with a significantly higher rate of cesarean delivery.
8	Hidalgo-Lopezosa (2013)[15]	Retrospective case-control	Are birth plans associated with improved maternal or neonatal outcomes?	182 pregnant women	Birth plan, maternal and newborn outcome assessment checklist	Birth plans may be beneficial and not associated with any adverse obstetric or neonatal outcomes. Mothers who have birth plans and their babies have at least as good outcomes as those who do not. Infants of primiparous women with planned delivery had better umbilical cord blood pH values than those of primiparous women without planned delivery.
9	Hadar (2013)[16]	Retrospect	Obstetric outcomes in women with self-planned birth plans	All women with birth plans	Birth plan, maternal outcome assessment checklist	Compared to the control group matched for age, fertility and gestational week, women who present with a birth plan are less likely to undergo cesarean section, have a higher probability of first and second degree perineal tears, and are more likely to use an epidural.
10	Deering (2007)[17]	Evidence case	Patients presenting with delivery plans: a case-control study of delivery outcomes	128 pregnant women	Birth plan, maternal outcome assessment checklist	Compared with age- and parity-matched controls, patients with birth plans did not have an increased incidence of episiotomy or caesarean section, but were less likely to receive an epidural during labor.
11	Medeiros (2019)[18]	Review	Determining the consequences of using the birth plan in the birth process	13 articles	Integrated literature review in LILACS, PUBMED, CINAHL and SciELO, in the period from 2008 to 2018	The birth plan increases the mother’s satisfaction with childbirth. There are still challenges related to using this program.
12	Alba-Rodríguez (2022)[19]	Qualitative	The birth program experience - a pilot qualitative study in southern Spain	7 contributors	interview	Women find it helpful to be offered a birth plan because it informs them about the birth process and gives them the opportunity to have a better birth experience.
13	Mirghafourvand (2019)[20]	Review	The impact of birth plans on the birth experience: a systematic review	3 clinical trial articles	Cochrane Library, Web of Science, MEDLINE, Embase, CINAHL, Scopus, PsycINFO, ACP Journal Club, Google Scholar and Persian databases (SID, Magiran and Barakat) until February 10, 2018	There is insufficient evidence to support or refute that birth planning can improve the birth experience or birth satisfaction.
14	Jolles (2019)[21]	Retrospect	Prevalence, characteristics and women’s satisfaction with birth planning in the Netherlands	1159	Birth plan, demographic profile survey questionnaire	Although birth plans are recommended for every pregnant woman, it is still not a routine practice. Therefore, the purpose of birth plans, to facilitate shared decision-making, is not fully realized. Implementation strategies are needed to increase the acceptance of birth plans for every woman.
15	Afshar (2017)[22]	Retrospective section	Childbirth training classes and childbirth programs are associated with natural childbirth	14630 people	Birth plan, demographic profile survey questionnaire	Attending a childbirth preparation class and/or having a birth plan was associated with natural birth. These findings suggest that patient education and birth preparation may influence delivery. Childbirth preparation classes and childbirth programs can be used as quality improvement tools to potentially reduce cesarean rates.
16	Afshar (2018)[23]	Prospective cohort	Birth plans - influence on mode of delivery, midwifery interventions, and satisfaction with the birth experience: a prospective cohort study.	297 people	Birth plan, maternal characteristics questionnaire, factors during pregnancy, newborn characteristics and patient satisfaction criteria	Women with and without a birth plan had similar odds of cesarean delivery. Although women with a birth plan had fewer midwifery interventions, they were less satisfied with their birth experience. More research is needed to understand how to improve patient satisfaction with childbirth.
17	Hadar (2012)[16]	Retrospec	Obstetric outcomes in women with self-prepared birth plan	616 people		Compared to the control group matched for age, fertility, and gestational week, women who come with a birth plan are less likely to have a cesarean section, and have a lower probability of first- and second-degree perineal tears. Also, women with a birth plan are more likely to use an epidural. Lack of data and misconceptions of medical staff suggest that larger prospective studies are needed.