Key takeaways:
- Birth plans are a low-cost, practical strategy to better the childbirth experience.
- They were linked to fewer NICU visits as well as increased odds of a normal vaginal delivery and early breastfeeding.
WASHINGTON — Having a birth plan in place was associated with improved maternal and neonatal outcomes, according to research presented at ACOG’s annual meeting.
Giovanna Martin, a medical student at Faculdade Santa Marcelina in Brazil, and colleagues wrote that, in the 1980s, birth plans were developed to enhance a mother’s experience while reducing negative outcomes and unnecessary procedures during delivery, but it is unclear how birth plans actually impact both maternal and neonatal outcomes.
Birth plans are a low-cost, practical strategy to better the childbirth experience. Image: Adobe Stock
Martin, who is also a founder of HerResearch group, a nonprofit that brings those who are interested in obstetrics and gynecology research together, told Healio that the uncertainty in the literature and “what we personally witness in the health care system” were primary motivators for the systematic review and meta-analysis.
“During our training, it’s common to see women in labor with little space to express their preferences, often feeling unheard or excluded from decisions about their own bodies. At the same time, we’ve also seen how powerful it can be when there is real communication,” Martin said. “A birth plan is not just about limiting interventions, it’s about building trust. When that relationship is established, women are more likely to feel safe and supported, even if an intervention becomes necessary. This way, medical decisions are understood not as impositions, but as part of a transparent process.”
“That’s why this topic matters so much to us,” Martin continued. “Birth is a moment of profound vulnerability, and reinforcing trust, respect and communication is essential if we want to move toward a more woman-centered model of care.”
The researchers searched several major databases — Cochrane Central, Embase and PubMed — for any studies published up to July 2025, and found that birth plans were linked to improved maternal and neonatal outcomes.
“We found a higher likelihood of normal vaginal delivery, better rates of early breastfeeding initiation and fewer NICU admissions,” Martin said. “From a clinical perspective, this suggests that birth plans are a practical, low-cost strategy to foster a more positive childbirth experience.”
Specifically, the researchers found that birth plans were linked to a higher chance of normal vaginal delivery (OR = 3.22; 95% CI, 1.49-6.95) and early breastfeeding (OR = 3.68; 95% CI, 1.48–9.15). However, there were no significant benefits for labor augmentation (OR = 0.65; 95% CI, 0.3–1.41) or episiotomy rates (OR = 0.47; 95% CI, 0.02–10.49).
Martin said she thinks these results ultimately come down to “autonomy and communication. When a pregnant individual develops a plan collaboratively with their health care provider, it fosters a sense of preparedness and control. This reduces the ‘fear of the unknown’ and anxiety. It creates a space for shared decision-making, which naturally leans toward more physiological outcomes.”
Martin noted that the researchers “did not perform an item-by-item analysis of the specific contents of each birth plan,” so they “cannot draw firm conclusions about specific components within individual birth plans. However, we do believe that the core principle of a birth plan should be woman-centered care, particularly shared decision-making, respect for maternal preferences and supportive intrapartum care, rather than specific standardized elements,” Martin said. “Birth plans are a powerful tool for respect. They aren’t just a list of demands, they are a roadmap for communication.”
For more information:
Giovanna Martin can be reached at giovannaccastrom@gmail.com or on Instagram @her_research.
Sources/Disclosures
Source:
Martin G. The birth plan role in shaping maternal and neonatal outcomes: A systematic review and meta-analysis of randomized controlled trials. Presented at: ACOG Annual Clinical & Scientific Meeting; May 1-3, 2026; Washington D.C.
Disclosures:
Martin and colleagues report no relevant financial disclosures.
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