Why Good Birth Preparation Needs to Prepare You for More Than Plan A

I have a confession to make. I've trained in hypnobirthing before, with a private company. I've taught the techniques, and as a midwife I've cared for many women who have used hypnobirthing during labour and birth. And when it works well, it can be incredible. I've watched women breathe their way through contractions, remain beautifully focused in their own little bubble and stay at home comfortably through the latent phase of labour. I've seen people use breathing, relaxation and visualisation to protect that lovely flow of oxytocin and transition into their chosen place of birth feeling calm, confident and very much in control, and arriving well into established labour, and continue to birth with minimal pain relief.

I love all of that.

What I don’t love is that some of the hypnobirthing I had been taught to deliver felt a little too "one size fits all". There could be a strong emphasis on vaginal birth without pain relief and, sometimes, an underlying suggestion that if you prepared properly enough, remained calm enough and followed the techniques, birth would follow the plan.

Now, I've been a midwife for a long time, in a high risk obstetric unit, community and home births, and now in a Midwifery led unit. I can tell you with full confidence, birth doesn't read the plan.

Birth is beautiful. It is also unpredictable.

No two births are the same, even for the same person: Actually, you aren't even the same person in two different births. Your pregnancy is different. Your baby is different. Your circumstances are different. Your emotional needs may be different. What felt incredibly important to you at 34 weeks pregnant might feel considerably less important when you're in labour. And sometimes new clinical information appears that nobody could have predicted.

That's why I believe good birth preparation needs to prepare you for the birth you want and give you the confidence to pivot if something changes. Remember:

·       Changing your mind isn't failing.

·       Deciding you want pain relief when you had planned not to have it isn't failing.

·       Transferring from home to hospital isn't failing.

·       Choosing an intervention you hadn't originally wanted isn't failing.

·       Having a caesarean isn't failing.

A birth plan should communicate your wishes and preferences. It shouldn't become a set of rules you or your partner is frightened to break. In fact, NICE guidance specifically states that people should discuss and record their preferences for labour and birth, while also being made aware that they are free to change their decisions at any time, including during labour and birth. This is so important, because informed choice doesn't disappear when labour begins.

What happens when Plan A disappears?

This is the bit that has always bothered me.

Some birth preparation is fantastic at teaching people how to remain calm while the birth they're expecting is happening.But what happens when a midwife or doctor says:

"I'm a little concerned about..."

"I'd like to recommend..."

"Can we talk about another option?"

For some people, that's the moment the off-switch gets flicked. The breathing disappears. The visualisation disappears. Adrenaline arrives. The carefully prepared birth suddenly feels as though it's going wrong and chaos crashes in. And ironically, that's exactly the moment when you need those skills the most.

You need to be able to breathe.

You need enough calm to hear what's being said.

You need to understand your options.

You need to feel confident enough to ask questions.

And you need to know that changing the plan doesn't mean you've lost control.

Sometimes maintaining control means confidently changing direction.

The right birth, in the right place, for you

I don't believe there is one "best" way to give birth. There is the birth that is right for you, taking into account your pregnancy, your baby, your clinical circumstances, your preferences, your values and the information available at that time.

For one person, that might be a home birth in a pool. For another, it might be a midwifery-led unit. For somebody else, an obstetric unit with an epidural. And for another person, the right birth might be a planned caesarean.

None of those people has won or lost at birth.

Good maternity care should involve discussing options, benefits, risks and implications while keeping the pregnant person's own preferences and concerns central to decision-making. NICE guidance reflects exactly that principle.

Even when somebody requests a caesarean without a medical indication, NICE recommends balanced information and discussion of the available options, and if, after informed discussion, that person still chooses a caesarean, their choice should be supported. That's informed choice, Not "we know best", And equally, not "my birth plan says this, so nothing can change".

It is good information, good communication and decisions made with the person giving birth at the centre of them.

Your birth partner is an advocate, not your decision-maker

I bloody love a strong birth partner. Give me someone who knows what matters to the person giving birth, understands their preferences, protects their environment, asks questions and isn't frightened to speak up when their partner is concentrating on labour. Brilliant.

But there is an important distinction between advocating for someone and speaking for them. Your birth partner cannot consent to treatment on your behalf. They cannot refuse something on your behalf. And they absolutely cannot tell you that you can't change your mind because "that's not what was in the birth plan".

If you suddenly decide you want the epidural you swore blind you didn't want, you can have that conversation. Your body. Your birth. Your decision.

NICE's shared decision-making guidance recognises that partners, family members and advocates can help someone engage in discussions, explain what matters to them and remember information they've been given. But the person receiving care remains central to that decision-making.

That's the kind of birth partner I want to help create, not a gatekeeper. An educated, calm, useful, essential teammate.

Your relationship with your midwife matters too

Some birth preparation methods include instructions about words healthcare professionals shouldn't use, information being filtered through a partner, or limiting direct communication with the person in labour.

I understand the intention, protecting someone's birth space is incredibly important. But we need to be careful that protecting the space doesn't accidentally build a wall between the person giving birth and the people caring for them. The Midwife-Birthing person relationship has to be strong, trust in the midwife is crucial for the birthing person to feel safe. That relationship can only be built via communication, and that often must happen very quickly, as often the first time you will meet your birth midwife is when you are already in labour.

Good maternity care depends on communication and trust, but that doesn't mean blindly agreeing with everything you're offered. Absolutely not, it means being confident enough to ask:

·       What are my options?

·       What are the benefits?

·       What are the risks?

·       What happens if we wait?

·       Are there alternatives?

·       Do we have time to think about this?

·       What happens if I say no?

NICE recommends encouraging people to ask questions, discussing risks, benefits and consequences, and where possible, giving them time to consider their options and make a supported decision. That is informed decision making.

And I would much rather teach someone how to have that conversation confidently than teach them to fear the conversation happening in the first place.

So I decided to do birth preparation differently

I didn't want to throw hypnobirthing away, far from it. I wanted to take the bits I've seen work beautifully and combine them with what years of actually standing beside people during labour and birth have taught me they need.

That's where Don't Panic, Have a Baby came from. It isn't about preparing you for one particular kind of birth.

It's about three things:

Protection

The final weeks of pregnancy can suddenly invite an extraordinary amount of unsolicited opinion. Other people's traumatic birth stories. Comments about the size of your bump. Predictions about whether you'll "manage" without pain relief. Social media algorithms feeding you frightening birth content at 2am. And Janet down the road constantly asking “not had the baby yet?”

No, thank you.

We'll look at protecting your emotional space, recognising what is and isn't useful information, and keeping other people's experiences from becoming your expectations.

Confidence

Not just confidence that your body can give birth.

·       Confidence in you.

·       Confidence to ask questions.

·       Confidence to understand your options.

·       Confidence to challenge something respectfully when you need more information.

·       Confidence to say yes.

·       Confidence to say no.

·       And confidence to say, "I've changed my mind."

We'll talk about decision-making tools that you and your partner can use when something unexpected comes up, so that you don't have to suddenly learn how to make a complex decision while adrenaline is pouring through your body.

Calm

Yes, we're absolutely keeping the good stuff.

·       Breathing.

·       Deep relaxation.

·       Visualisation.

·       Self-hypnosis.

Understanding how fear and stress can affect the body and why creating an environment in which you feel safe matters.

But, those techniques DO NOT belong exclusively to an unmedicated vaginal birth. I will show you how to take them with you.

·       Use them during latent labour at home.

·       Use them during an induction.

·       Use them while somebody examines you.

·       Use them while you're waiting for an epidural.

·       Use them during a transfer into hospital.

·       Use them before theatre.

·       Use them during your planned or emergency caesarean.

And most importantly, use them when somebody tells you something you weren't expecting and you need a moment to gather yourself and think.

Your calm shouldn't have an off-switch.

And then we learn how to pivot

Being prepared to pivot doesn't mean expecting birth to “go wrong”. It means understanding that if the pathway changes, you haven't lost control of the journey.

I'll teach you practical ways to support the physiology of labour, including movement and positions that may help encourage your baby into a favourable position for birth. If your aim is to optimise your opportunity for a physiological vaginal birth, we'll work with that.

If you're planning a caesarean, we'll talk about how you can make that birth feel calm, personal, connected and special.

If your plan changes during labour, the tools come with you. Because vaginal birth without pain relief isn't the prize at the end of pregnancy. Feeling heard, respected, informed, safe and involved in your birth matters too.

And your partner is coming with us

Birth partners aren't an optional extra in this preparation. I want them to understand what labour may look like, or what a caesarean may look like, aswell as  what you need from them, how they can protect your calm and what they can do when things become intense.

I'll teach them how to advocate without taking over, How to ask useful questions, How to help you understand information when you're overwhelmed, how to remind the room what matters to you, And how to support you if you change your mind - without their own expectations of "the plan" getting in the way, because sometimes they need to confidently pivot too.

Birth preparation shouldn't teach you how to have the perfect birth

Spoiker alert …. There isn't one. Good birth preparation should help you understand your body, understand your choices, communicate confidently, make informed decisions and remain connected to yourself when circumstances change.

It should prepare your partner to be useful rather than simply giving them a list of rules. And the techniques you learn should still work whether you're breathing through contractions in your kitchen, labouring in water, having an induction, asking for an epidural or meeting your baby in theatre.

The aim isn't to control birth, It's to stop birth taking away your sense of control.

The right birth, in the right place, with the right support, for you.

And that is exactly why I created “Don't Panic, Have a Baby.”

References

National Institute for Health and Care Excellence (NICE) (2021) Caesarean birth (NG192). Available at: NICE Caesarean birth guidance (Accessed: 10 September 2026).

National Institute for Health and Care Excellence (NICE) (2021) Shared decision making (NG197). Available at: NICE Shared decision making guidance (Accessed: 10 September 2026).

National Institute for Health and Care Excellence (NICE) (2023) Intrapartum care (NG235). Available at: NICE Intrapartum care guidance (Accessed: 10 September 2026).