The Role of Birth Plan in Shaping Maternal and Neonatal Outcomes: A Systematic Review and Meta-analysis of Randomized Controlled Trials.
Giovanna Cristina de Castro Martin, Ana Clara Pimenta Servidoni, Guilherme Franceschini Machado et al.
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In 30 seconds
This systematic review and random-effects meta-analysis examined randomized controlled trials comparing written or verbal birth plans with standard care among pregnant individuals in labor. Birth plans were associated with a higher likelihood of normal vaginal delivery (RR: 3.22; 95% CI: 1.49-6.95; p = 0.003) and increased early breastfeeding (RR: 3.68; 95% CI: 1.48-9.15; p = 0.005). The review found no significant differences in episiotomy rates or labor augmentation. The authors conclude that birth plans may support improved maternal outcomes and more respectful childbirth.
Key findings
- Birth plans were associated with greater likelihood of normal vaginal delivery (RR: 3.22; 95% CI: 1.49-6.95; p = 0.003).
- Early breastfeeding was more likely with birth plans (RR: 3.68; 95% CI: 1.48-9.15; p = 0.005).
- No significant benefit was observed for episiotomy rates (RR: 0.47; 95% CI: 0.02-10.49; p = 0.636) or labor augmentation (RR: 0.65; 95% CI: 0.30-1.41; p = 0.274).
Why it matters
Birth plans are a potentially relevant component of maternity care because the pooled trial findings link their use with vaginal delivery and early breastfeeding. These outcomes may inform discussions about how preferences are communicated during labor. However, the results do not establish benefit across all maternal or neonatal outcomes, and the reported associations should be interpreted within the evidence available from the included trials.
What to keep in mind
The abstract does not report the number of trials or participants, limiting assessment of the evidence base's size. Confidence intervals for the reported effects are wide, particularly for episiotomy.