--- title: "Planning for birth: choices to think about" description: "Think about where to give birth, pain relief, support, and decisions about induction or a caesarean, while leaving room for change." url: "https://myruva.co/learn/birth-planning-choices" language: "en-GB" topic: "Pregnancy" published: "2026-10-18" updated: "2026-10-19" author: "Ruva team" reading_minutes: 4 --- # Planning for birth: choices to think about Think about where to give birth, pain relief, support, and decisions about induction or a caesarean, while leaving room for change. *Written and reviewed by the Ruva team · Updated 2026-10-19 · Pregnancy* ## Key points - A birth plan writes down what you’d like, and helps your team understand what matters to you. - Where you give birth depends on your needs, any risks and the services near you. - You can talk about pain relief beforehand and decide what you need during labour. - Plans can change as labour goes on. A birth plan can say who you want with you, what pain relief you’d like to think about and where you’d prefer to give birth. It helps your care team understand what you want during labour. It can also be a starting point for questions you haven’t answered yet. Put what matters most near the top. You might ask the team to explain decisions to you directly, give you time to ask questions where they can, or check with you before bringing in people you haven’t met. ## Start with the setting and the backup plan In the UK, you may be able to give birth at home, in a midwifery unit or in hospital. What suits you depends on your health, your pregnancy and the services available. The NHS advises giving birth in hospital if your pregnancy is high risk or you have certain medical conditions, because specialist care is there if needed. If your pregnancy is straightforward, a planned home birth may be an option. The NHS says that for a first baby, a home birth carries a slightly higher risk of serious problems for the baby than a hospital birth. Talk about what a home birth would mean for you, including how you’d get to hospital if needed. Midwifery units may be next to a hospital or separate from one. A separate unit doesn’t have doctors for birth, newborn care or anaesthetics on hand. Ask which hospital you’d go to if you needed to move, how long that might take and who would travel with you. These options are for UK services. In the US and elsewhere, ask your own maternity team which places and services are available to you. ACOG advises talking about the pain relief your hospital or birth centre offers before labour starts. ## Consider your pain relief options Ways to stay comfortable include breathing techniques, changing position, massage, and a bath or shower if one is available. You can use these alongside medicine. Ask your birth partner which kinds of practical support they’d feel happy to help with. Medicines include gas you breathe in, opioid painkillers and an epidural. Gas and air is a mix of oxygen and nitrous oxide, and you hold the mask or mouthpiece yourself. Opioids may be given as an injection or through a drip. An epidural gives medicine through a thin tube in your lower back. Each option has limits and possible side effects. Opioids can make you drowsy and affect the baby’s breathing for a short time. An epidural can give very good pain relief, but it may need adjusting and doesn’t always work fully. In the UK, you can’t have one at home. Ask about monitoring, moving around, and what happens if the option you’d like isn’t available or doesn’t help enough. Your clinician can explain which options suit you and how any health conditions affect your choices. ACOG says you can decide about pain medicine during labour, even if you’ve talked about it beforehand. ## Write down who and what you want with you Your birth partner might be a partner, friend or relative. The NHS birth plan checklist includes several things. Who you’d like with you if you need an assisted birth or a caesarean. What you’d like about positions and equipment. And skin-to-skin contact and feeding after the birth. Ask what’s possible where you plan to give birth. Write down what support means to you. It might be quiet company, help asking questions, or someone to keep relatives updated. Include any worries you’d like to talk about in private. You can leave things open if you haven’t decided yet. ## Discuss induction and caesarean birth Induction means using medicines or other methods to start labour. It may be suggested if carrying on with the pregnancy would be risky for you or the baby. Ask why it’s being suggested, what the other options are and what would happen if you waited. A caesarean is an operation to deliver the baby through a cut in the tummy and womb. It may be planned, or needed urgently. If you’re thinking of asking for one, ask about the benefits and risks compared with a vaginal birth, the recovery, and what it could mean for future pregnancies. ## Ask for support with fear or changing plans If fear of giving birth is troubling you, book a talk with your midwife or GP in the UK, your obstetric clinician in the US, or your local maternity team. NHS guidance recommends offering support during pregnancy and labour to people who are anxious about giving birth. What you want can change, and things may happen during the birth that need a different plan. Talk it through with your midwife or doctor. Ask: “If this option isn’t suitable any more, what choices would I have?” ## When to get help - **Book an appointment:** Arrange a talk with your midwife or GP (UK), obstetric clinician (US), or local maternity team if fear of giving birth is upsetting you or you want to talk about a caesarean. ## Where you live Services and advice differ between countries. - **UK:** The NHS describes giving birth at home, in a midwifery unit or in hospital, depending on your needs and risks. You can’t have an epidural at home. - **US:** ACOG advises finding out which pain relief your hospital or birth centre offers before labour. Talk to your obstetric clinician about decisions on induction. - **Elsewhere:** Elsewhere, talk to your maternity team about the places to give birth near you, pain relief and how transfers work. ## Sources 1. [What to include in your birth plan](https://www.nhs.uk/best-start-in-life/pregnancy/preparing-for-labour-and-birth/what-to-include-in-your-birth-plan/), NHS 2. [Where to give birth: the options](https://www.nhs.uk/pregnancy/labour-and-birth/where-to-give-birth-the-options/), NHS 3. [Medications for Pain Relief During Labor and Delivery](https://www.acog.org/womens-health/faqs/medications-for-pain-relief-during-labor-and-delivery), ACOG 4. [Pain relief in labour](https://www.nhs.uk/pregnancy/labour-and-birth/pain-relief-in-labour/), NHS 5. [Labor Induction](https://www.acog.org/womens-health/faqs/labor-induction), ACOG 6. [Caesarean section](https://www.nhs.uk/tests-and-treatments/caesarean-section/), NHS --- This guide is general information to help you keep and use your own records. It isn’t medical advice. If you’re worried about a symptom, or something changes suddenly, talk to a doctor, nurse or pharmacist.