Background As a written document outlining preferences and opinions, the birth plan can act as a bridge for communication prior to labour and improve maternal satisfaction with care during labour.

Objective Explore the use, intrapartum experience and overall obstetric outcomes in women with a birth plan.

Methods Small retrospective study of postpartum patients within 1 week of delivery at St Thomas' Hospital, London. A structured questionnaire was administered based on maternal satisfaction with labour, perception of birth plans and involvement in decision making.

Results 53.8% of women prepared a written birth plan (n=50). Of these, (52.3%) were more likely to be primiparous with low complication rates. Women with birth plans reported less satisfaction with the relationship with their midwife (71.4 vs 88.9%, p<0.05), pain relief (66.6 vs 83.3%, p<0.05) and overall care (42.9 vs 66.7%, p<0.05), but greater involvement in decision making (61.1 vs 57.1%). 57.1% of patients rated birth plans as helpful in preparation for labour. There were lower rates of epidural use in labour (57.1 vs 61.1%) and fewer caesarean and instrumental deliveries reported in women with a birth plan (38.1 vs 50%).

Conclusions In this sample, birth plans did not appear to improve overall satisfaction with labour but did appear to enhance decision making by the patient. There was also an association with improved obstetric outcomes.