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Health Expectations : An International Journal of Public Participation in Health Care and Health Policy logoLink to Health Expectations : An International Journal of Public Participation in Health Care and Health Policy
. 2002 Jan 4;1(2):106–116. doi: 10.1046/j.1369-6513.1998.00023.x

Communication and decision‐making in labour: do birth plans make a difference?

Stephanie J Brown 1, Judith Lumley 1
PMCID: PMC5139894  PMID: 11281865

Abstract

Objectives

To assess usage of birth plans, and examine differences in social and obstetric characteristics, and intrapartum experiences of women who did and did not use a birth plan.

Design

Population‐based survey distributed by hospitals and home birth practitioners, 6–7 months post‐natally.

Setting and participants

Women who gave birth in Victoria, Australia over a 2‐week period in September, 1993, excluding those who had a stillbirth or neonatal death.

Main outcome measures

Use of a written birth plan; perceived helpfulness, advantages and disadvantages of birth plans; relationship between use of birth plans and overall rating of intrapartum care, and involvement in decision‐making.

Results

Twenty per cent of women (270/1336) had prepared a written birth plan and discussed it with caregivers. Women who made use of a birth plan were more likely to be satisfied with pain relief (OR = 1.74[1.3–2.3]), but did not differ from women not completing a birth plan in terms of their overall rating of intrapartum care, or involvement in making decisions about their care.

Conclusions

The lack of association between use of a written birth plan and variables assessing women's views of intrapartum care suggest there are insufficient grounds for continuing to advocate a policy of encouraging pregnant women to complete written birth plans, unless it is within the context of a well‐designed randomized trial able to provide further evidence regarding their effectiveness.

Keywords: birth plan, communication, health care evaluation, patient satisfaction


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