Birth Plan Research Articles

Health professionals' and women's knowledge and experiences of caring for small gestational age (SGA) infants in Pakistan

BackgroundIn Pakistan, every third baby is born small for gestational age (SGA). Early antenatal detection of SGA helps with birth planning and initial treatment of mother and baby, thereby reducing complications. Screening and diagnosis of SGA however are challenging, especially in low and middle-income countries where access to technological advances may be limited and there is a lack of routine antenatal screening. AimsTo explore the current practices, knowledge, and experiences of caring for SGA infants with women and health professionals in Pakistan. DesignA cross-sectional survey with healthcare professionals and focus groups or interviews with health professionals and mothers of SGA babies were undertaken. Survey data were analysed descriptively and integrated with the qualitative data using thematic data analysis. Subjects78 completed surveys were returned and eight FGDs and five interviews were undertaken with 77 participants – 67 healthcare professionals (gynecologists/obstetricians, neonatologists, Lady Health Workers, and Lady Health Visitors) and 10 mothers of SGA infants aged under 12 months. ResultsThe survey highlighted a general lack of training on SGA for all health care professionals, but particularly amongst community staff who often act as primary caregivers for women. Five qualitative themes described the challenges and issues faced in the management, treatment, and prevention of SGA in Pakistan: Lack of policies and training, Lack of resources, Lack of access to healthcare, Not following the guidance, and Lack of data and reporting. ConclusionsA whole system approach to improve service provision and outcomes is needed. This should include epidemiological research, country-specific policies, training for healthcare professionals and awareness raising amongst women and community members.

Exploration of The Birth Planning and Complications Prevention Program Implementation

The Birth Planning and Complications Prevention Program or Program Perencanaan Persalinan dan Pencegahan Komplikasi (P4K) is an effort by the government to reduce the maternal mortality rate in Indonesia. This study aimed to determine the implementation of P4K to reduce maternal mortality in the catchment area of Waihaong Health Center Ambon in 2020. This was a qualitative study with a case study approach. Data collection was conducted in February-May 2020 in the catchment area of Waihaong Health Center. There were 13 informants interviewed in this study (nine pregnant women, two health workers, and two cadres). Data analysis was conducted using content analysis by identifying the emerging themes based on the research objectives. The results of this study show that the implementation of P4K has been running, but it has yet to be maximized because several P4K components still need to be completed. The pregnant woman prepares the components in the P4K sticker without any discussion with the midwife, and some pregnant women still choose to give birth with the help of a traditional birth attendant or “mama biang”. The mother's need for more knowledge about P4K and the lack of human resources as a program administrator was an obstacle to implementing this program. This study indicates that there is still a need for counseling for pregnant women to increase knowledge and awareness of the benefits of P4K and to carry out further training and collaboration between midwives and village cadres to improve P4K implementation.

Dampak Ketakutan terhadap Proses Intranatal

This research aims to determine the impact of fear on intranatal and postnatal processes. The research method used was a scoping review of articles about the effects of fear of giving birth by searching database sources from Pubmed, Ebsco, and the Google Scholar search engine. The keywords used for the first search are "Childbirth Fear" AND "Impact of Childbirth Fear" OR "Effects of Childbirth Fear". Research results show that fear of giving birth that continues or is not handled correctly can cause mental well-being disorders after giving birth. These include postnatal anxiety, postnatal depression, and posttraumatic stress disorder. Persistent, unresolved fears can affect the bond between mother and baby. A prolonged fear of giving birth can increase the risk of premature birth or a baby with a low birth weight. The nursing intervention that can be carried out is making a directed and comprehensive birth plan involving the medical and nursing team. In conclusion, fear can trigger a stress response and increase physical and emotional tension in pregnant women during labor, causing delayed delivery or hindering the progression of work. Continued fear can lead to posttraumatic stress disorder, postpartum depression, or difficulty in meeting their baby's emotional and mental needs.
 Keywords: Maternal Emotions, Fear of Childbirth, Baby Risks

Assessment of Levels of Anxiety and Fear of Covid-19 in a Population of Pregnant Women in Spain.

The aim of the study was to assess the levels of fear and anxiety in the particularly vulnerable population group of women during pregnancy. Cross-sectional study between March 2022 and July 2022 involving 978 pregnant women aged 16 to 50 years. It was carried out based on the scale for the assessment of fear and anxiety in pregnant women (AMICO_Pregnant) and the collection of sociodemographic data. Normality analysis was performed prior to univariate and bivariate statistical analysis. The sample was composed of a total of 978 pregnant women. The mean of the AMICO_Pregnant scale was intermediate (5.04 points; SD=2.36). The bivariate analysis showed a statistically significant relationship between the AMICO_Pregnant scale and the following variables: vaccination schedule status, contact with the disease, weeks of gestation, altered delivery or birth plan. Women with pregnancies closer to term, with no contact with the disease, without a complete vaccination schedule, or who had undergone changes in their delivery or birth plans, showed higher levels of fear and anxiety.

The afterlife of "doing medicine": Birth planning, chronic illness, and regeneration among the Lisu on the China-Myanmar border.

Between the late 1970s and 1990s, many indigenous Lisu people in the Nu River Valley, an Eastern Himalayan region of China bordering Myanmar and Tibet, underwent what they referred to as "doing medicine"-abortions, vasectomies, and tubal ligations-as part of China's Birth Planning Policy. Lisu, who endured these procedures, struggle with strength loss, nervousness, and pain. Government discourses diminish the Lisu experience, arguing that the policy was lenient toward them. Lisu themselves are reticent to share their experiences but have devised new practices to care for those affected. Drawing on long-term ethnographic fieldwork, I argue that these chronic illnesses and accompanying care practices constitute everyday forms of remembering through which Lisu give shape to their experiences of cultural loss under Chinese colonization while generating new social relationships. This analysis sheds light on Indigenous experiences of birth planning in China with broader implications for understanding the bureaucratic violence of medicine.

Understanding the healthcare provider role on post abortion contraception adoption in India using National Family Health Survey-5

BackgroundPost abortion contraceptive use is an important area in provisioning of services associated with child birth planning. This study examines the factors related to the type and timing of initiation of contraception adoption among women who had undergone induced abortion. Study also tries to identify the role of personnel who provided the abortion service on decision of family planning adoption using complementary log–log model in India.MethodologyThe study uses the secondary data from the fifth round of the National Family Health Survey conducted during 2019–21. For, the analysis, we have used five-year women’s reproductive calendar to extract information on contraceptive use, post last induced abortion among women. We used complementary log–log regression models, to estimate relative risk ratios and its 95% Confidence intervals (CI).ResultsAccording to NFHS-5, out of all the last pregnancies (2,55,549), about three percent resulted in abortion. Most of the abortion occurred in private facilities (55%), with the help of health professionals (71%). From the women’s reproductive calendar, it was found that around 40% of the women adopted modern methods of contraception, with maximum adopting spacing method (33%), and only handful adopted permanent method (7%). It was also found that the likelihood of early adoption of permanent method increased to two times when the abortion is done by health professional compared to others [95% CI (1.25–3.30)].ConclusionThis emphasises a need for quality counselling related to timing and types of family planning as an essential part of the family planning program ensuring client centric approach suited to their needs and contexts that helps in alleviating any apprehensions associated with adverse effects of modern contraceptive methods.

Brainstorming Effect in Pregnant Women on Knowledge of Childbirth Planning and Complications Prevention Programs

The birth planning and complication prevention program (P4K) is an effort from the government to reduce maternal mortality (MMR). To support these efforts, learning needs to be provided; brainstorming provides a structured format that can increase the quantity and quality of responses from the participants. The brainstorming method effectively delivers information according to the mother's characteristics. However, the effect of health education on the brainstorming method for pregnant women on the P4K is still not explained. This study aims to explain the impact of brainstorming on pregnant women on knowledge of P4K in Kertosari Village, Lumajang Regency. The design of this research is a Quasy Experiment with a pre-post design. The sample in this study was 30 pregnant women who were taken using total sampling. This research was conducted in Kertosari Village, Pasrujambe District, Lumajang Regency. This research concludes that there is an effect of brainstorming on the knowledge of pregnant women about the Birth Planning and Complications Prevention (P4K) Program in Kertosari Village, Lumajang Regency, with (ρ=0.000<0.05). It is hoped that Brainstorming can be used as an alternative in providing health education to pregnant women in promotive and preventive efforts in the success of the Childbirth Planning and Complications Prevention Program (P4K).

Do birth plans influence caesarean section rates?

David Grant USAF Medical Center FMR, Travis AFB, CA The corresponding author is Colby Neville; [email protected]. The authors declare no conflicts of interest. The opinions and assertions contained herein are those of the authors and are not to be construed as official or as reflecting the views of the U.S. Air Force Medical Department, the Air Force at large, or the Department of Defense.

The socioemotional impact of the COVID-19 pandemic on pregnant and postpartum people: a qualitative study.

The social isolation and safety measures imposed during the COVID-19 pandemic differentially burdened pregnant and postpartum people, disrupting health care and social support systems. We sought to understand the experiences of people navigating pre- and postnatal care, from pregnancy through to the early postpartum period, during the pandemic. In this qualitative investigation, we conducted semistructured interviews with people residing in British Columbia and Alberta, Canada, during the second half of pregnancy and again at 4-6 weeks' post partum between June 2020 and July 2021. Interviews were conducted remotely (via Zoom or telephone) and focused on the impact of the COVID-19 pandemic on pre- and postnatal care, birth and labour planning, and the birthing experience. We used content and thematic analysis to analyze the data, and checked patterns using NVivo. We interviewed 19 people during the second half of pregnancy and 18 of these people at 4-6 weeks' post partum. We identified 7 themes/subthemes describing how the COVID-19 pandemic affected their experiences: disrupted support systems, isolation, disrupted health care experiences (pre- and postnatal care, and labour and birth/hospital protocols), violated social norms (including typical rituals such as baby showers), impact on mental health and unexpected benefits (such as a no-visitor policy in hospitals after the birth, which provided a quiet period to bond with baby). Pregnant and postpartum people were uniquely vulnerable during the COVID-19 pandemic and would have benefited from increased access to support in both health care and social settings. Future work should investigate maternal and infant/child functioning and behaviour to assess the long-term impact of the pandemic on Canadian families and developing children, with an aim to increase support where necessary.

Preferences for labor and childbirth, expressed orally or as a written birth plan: Prevalence and determinants from a nationwide population-based study.

Shared decision-making is an important component of a patient-centered healthcare system. We assessed the prevalence of parturients with preferences for their labor and childbirth, expressed verbally in the birthing room or as a written birth plan, and studied maternal, obstetric, and organizational factors associated with their expression. Data came from the 2016 National Perinatal Survey, a cross-sectional nationwide population-based survey conducted in France. Preferences for labor and childbirth were studied in three categories: expressed verbally, in writing (birth plan), or unexpressed or nonexistent. Analyses used multinomial multilevel logistic regression. The analysis included 11,633 parturients: 3.7% had written a birth plan, 17.3% expressed their preferences verbally, and 79.0% either did not have or did not express any preferences. Compared with the latter group, written or verbal preferences were both significantly associated with prenatal care by independent midwives (respectively, adjusted odds ratio (aOR) 2.19; 95% confidence interval (CI), [1.59-3.03], and aOR 1.43; 95% CI [1.19-1.71]) and with attendance at childbirth education classes (respectively, aOR 4.99; 95% CI [3.49-7.15], and aOR 2.27; 95% CI [1.98-2.62]). As years in traditional schooling increased, so did its association with preferences. Conversely, parturients from African countries were significantly less likely than French mothers to express preferences. A written birth plan was also associated with characteristics of maternity unit organization. Only one in five parturients reported having expressed preferences for labor and childbirth to healthcare professionals in the birthing room. This expression of preferences was associated with maternal characteristics and the organization of care.

COVID-19 Impact on Group Prenatal Education: A Comparison of Virtual and In-Person Formats.

This retrospective study compared knowledge, intention, and satisfaction outcomes between pregnant women who attended prenatal education in person (n = 202; 55%) prior to the COVID-19 pandemic or virtually (n = 166; 45%) during the pandemic. Results identified increases in knowledge and intention for a healthy pregnancy and safe infant care for both groups. Virtual participants were less likely to endorse developing a birth plan (p = 0.035), knowledge of breastfeeding resources (p = 0.006), confidence in the ability to breastfeed (p = 0.033), and plans to use only a safe infant sleep location (p = 0.045). Important education was provided by continuing Baby Talk during the pandemic. However, topics with activities/demonstrations during in-person learning that were discontinued for virtual learning had significantly lower increases for virtual participants. Virtual education should incorporate more demonstrations/activities.

Faktor determinan kematian ibu di Kabupaten Sintang periode Agustus 2021 – 2022

Background: indicators of maternal health in a country can be seen through the high and low Maternal Mortality Rate (MMR). Sintang District in 2021 will be the second highest contributor to MMR in West Kalimantan Province. The determinants of maternal mortality are inconclusive and show different results in each region according to the method of collecting maternal mortality data.Objectives: the general objective of this research is to find out the Determinant Factors for Maternal Mortality in Sintang District for the period August 2021 – August 2022.Methods: using a mix of quantitative and qualitative methods with sequential explanatory. Quantitative research samples totaled 16 cases and qualitative informants amounted to 40 informants with indepth interview method. .Results: quantitative proxy determinant of maternal death caused by complications of childbirth (37.5%) 6 cases, determinant intermediate age > 35 years (68.75%) 11 cases and ANC examination (68.75%) 11 cases, contextual determinant geographical area (75%) 12 cases. The qualitative results of the proxy determinants of maternal death were cases of retained placenta bleeding, the determinant intermediate the risk factors for maternal age > 35 years, high maternal parity ≥ 3 times giving birth and incomplete ANC examinations < 6 times. The determinant is far because it is in a rural area.Conclusion: the causes of maternal death in Sintang district are very complex and multifactor. Assistance for high-risk pregnant women by health personnel and monitoring periodic evaluations of the Program Birth Planning and Complication Prevention (P4K) must be carried out to reduce MMR in Sintang District.

Association of continuity of carer and women's experiences of maternity care during the COVID-19 pandemic: A cross-sectional survey

BackgroundRecent research highlights the impact of the COVID-19 pandemic on maternity services, although none to date have analysed the association between continuity of carer and how women felt about the changes to pregnancy care and birth plans. AimTo describe pregnant women's self-reported changes to their planned pregnancy care and associations between continuity of carer and how women feel about changes to their planned care. MethodsA cross-sectional online survey of pregnant women aged over 18 years in their final trimester of pregnancy in Australia. Findings1668 women completed the survey. Most women reported at least one change to pregnancy care and birthing plans. Women receiving full continuity of carer were more likely to rate the changes to care as neutral/positive (p<.001) when compared with women who received partial or no continuity. DiscussionPregnant women experienced many changes to their planned pregnancy and birth care during the COVID-19 pandemic. Women who received full continuity of carer experienced fewer changes to care and were more likely to feel neutral/positive about the changes than women who did not receive full continuity of carer.

Role of palliative care in fetal neurological consultations: Guiding through uncertainty and hope.

Fetal neurology is a rapidly evolving and expanding field. Discussions about diagnosis, prognosis, treatment options, and goals of care often begin in the antenatal period. However, there are inherent challenges to fetal counseling of neurological diagnoses due to limitations of fetal imaging, prognostic uncertainty, and variability in neurodevelopmental outcomes. In the midst of uncertainty, families are challenged with preparing a care plan for their baby while simultaneously experiencing profound grief. The paradigms of perinatal palliative care can assist with the grieving process and help frame diagnostic testing and complex decision-making within the context of a family's spiritual, cultural, and social belief system. This ultimately leads to a shared decision-making process and value driven medical care. While perinatal palliative care programs have expanded, many families faced with such diagnoses never meet with a palliative care team prior to delivery. Moreover, there is significant variability in the availability of palliative care services throughout the country. Using an illustrative vignette of a patient with a prenatally diagnosed encephalocele, this review aims to provide a basic framework of perinatal palliative care for fetal neurology diagnoses that emphasizes 1) importance of clear, consistent, and transparent communication among all subspecialists and families, 2) creation of a palliative care birth plan, 3) importance of consistent care providers and longitudinal points of contact prenatally and post-delivery, 4) close communication between the prenatal and post-natal providers to allow for optimal continuity of care, and 5) recognize that information, care plans, and goals of care often evolve over time.

The Effect of Structured Antenatal Education on Childbirth Self-Efficacy.

Antenatal (prenatal) education is a vital role of midwives when giving antenatal care to pregnant women. Particularly in the late stages of pregnancy, antenatal education regarding the natural-labor process, the introduction of labor rooms, coping strategies, and labor-pain management may enhance maternal self-efficacy and perceptions of childbirth. However, educational programs that include birth plans, pain-relief measures, and birth preparation are not a structured part of the Saudi healthcare system. This is the first study to investigate the effect of antenatal education on maternal self-efficacy in Saudi Arabia. The aim of this study was to investigate the effect of an antenatal education program on maternal self-efficacy in primiparous pregnant women and to determine the relationship between maternal self-efficacy and their sociodemographic characteristics in Jeddah, Saudi Arabia. A randomized control trial (pretest/posttest) design was conducted with 94 primiparous pregnant women. Two groups were compared: an intervention group, which received a structured antenatal educational program (n = 46), and a control group, which received routine antenatal care (n = 48). The childbirth self-efficacy inventory (CBSEI) was used to assess maternal self-efficacy. The data were analyzed using IBM SPSS Statistics for Windows, Version 24 (Released 2016; IBM Corp., Armonk, New York, United States). The mean score on the CBSEI pretest was 238.5 ± 237.4 compared to 242.9 ± 276.2 in the posttest mean score, with significant differences (p < .05)in maternal self-efficacy between the pretest and posttest scores for both groups. The findings of this study suggest that an antenatal educational program could serve as an essential tool, providing access to high-quality information and skills during the antenatal period and significantly enhancing maternal self-efficacy. It is crucial to invest resources to empower and equip pregnant women in ways that promote positive perceptions andboost their confidence regarding childbirth.

Women’s experiences of birth and birth options counselling after laparoscopic or open myomectomy

There is emerging evidence that vaginal birth after open and laparoscopic myomectomy may be safe in many pregnancies, however, there are no studies examining the perspectives of women who have given birth post myomectomy and their preferences regarding mode of birth. We performed a retrospective questionnaire survey of women who had an open or laparoscopic myomectomy followed by a pregnancy within 3 maternity units in a single NHS trust in the UK over a 5-year period. Our results revealed only 53% felt actively involved in the decision making for their birth plan and 90% had not been offered a specific birth options counselling clinic. Of those who had either a successful trial of labour after myomectomy (TOLAM) or elective caesarean section (ELCS) in the index pregnancy, 95% indicated satisfaction with their mode of birth however, 80% would prefer vaginal birth in a future pregnancy. Whilst long term prospective data is required to fully establish the safety of vaginal birth after laparoscopic and open myomectomy, this study is the first to explore the subjective experiences of women who had given birth post laparoscopic or open myomectomy and has highlighted the inadequate involvement of these women in the decision-making process. IMPACT STATEMENT What is already known on this subject? Fibroids are the commonest female solid tumours in women of childbearing age with surgical management including open and laparoscopic excision techniques. However, the management of a subsequent pregnancy and birth remains controversial with no robust guidance on which women may be suitable for vaginal birth. What do the results of this study add? We present the first study to our knowledge which explores women’s experiences of birth and birth options counselling after open and laparoscopic myomectomy. What are the implications of these findings for clinical practice and/or further research? We provide a rationale for using birth options clinics to facilitate an informed decision-making process and highlight the current inadequate guidance for clinicians on how to advise women having a pregnancy following a myomectomy. Whilst long term prospective data is required to fully establish the safety of vaginal birth after laparoscopic and open myomectomy, this needs to be carried out in a way which promotes the preferences of the women affected by this research.

Factors predicting birth satisfaction in Hungary

Birth satisfaction is influenced by demographic, obstetric and cognitive factors. There is a paucity of research on birth satisfaction in Hungary, despite the country displaying high rates of medical interventions during childbirth. A cross-sectional study was conducted online with 78 Hungarian women. Participants completed the Birth Satisfaction and the Birth Beliefs scales alongside a demographic and obstetric questionnaire. Birth satisfaction was associated with parity, place of birth, pain management methods, delivery mode and adherence to birth plan, as well as beliefs in birth as a medical process, but not with self-efficacy or birth beliefs as a natural process. However, when considered together, none of the variables predicted birth satisfaction, implying that other factors may be at play. Given the limited research on birth satisfaction in Hungary, these results constitute important foundations for further research.

Changes to Birth Plans Due to COVID-19: A Survey of Utah Midwives and Doulas.

This study seeks to understand the experiences of Utah midwives and doulas caring for patients during the recent coronavirus disease 2019 (COVID-19) pandemic. Specifically, the goal of the study was to describe the perceived impact on the community birth system and explore differences in the access and use of personal protective equipment (PPE) between in- and out-of-hospital births. This study used a cross-sectional, descriptive study design. A 26-item survey developed by the research team was sent via email to Utah birth workers, including nurse-midwives, community midwives, and doulas. Quantitative data were collected during December 2020 and January 2021. Descriptive statistics were used in the analysis. Of the 409 birth workers who were sent a link to the survey, 120 (30%) responded: 38 (32%) CNMs, 30 (25%) direct-entry or community midwives, and 52 (43%) doulas. The majority (79%) reported changes to clinical practice during the COVID-19 pandemic. Community midwives (71%) who responded indicated practice volume increased. Survey participants reported an increased patient preference for home births (53%) and birth center births (43%). Among those with one or more patient transfers to the hospital, 61% experienced a change in the process. One participant reported that it took 43 minutes longer to transfer to the hospital. Community midwives and doulas reported poor access to a regular source of PPE. Survey participants reported changes to planned birth locations during the COVID-19 pandemic. When necessary, transfers to hospitals were reported to be slower. Community midwives and doulas reported having insufficient access to PPE and reported limited knowledge about COVID-19 testing resources and resources for educating patients on COVID-19. This study adds an important perspective to the existing literature on COVID-19 by indicating that policymakers should include community birth partners in community planning for natural disasters and future pandemics.

Husband participation in birth preparedness and complication readiness and its predictors among men whose wife was admitted for an obstetric referral at South Gondar zone: A multicenter cross-sectional study

BackgroundHusbands' participation in maternal health care, as seen by an appropriate birth plan and readiness for complications, reduces maternal death by avoiding delays in recognizing danger signs, reaching a site of care, and seeking aid. As a result, this study aimed to determine the husband's participation in birth preparation and complication readiness, as well as its predictors, among men whose wives were referred to obstetric referral in the South Gondar Zone of North West Ethiopia. MethodsA hospital-based cross-sectional study was conducted among husbands whose wives were admitted with obstetric referrals in the selected hospitals from February to March 2021. A total of 393 individuals were chosen proportionally from the selected hospitals using a systematic random sampling technique. An interviewer-administered structured questionnaire was used to collect data, which was then entered into Epi Data Version 3.1 and exported to Stata version 14 for analysis. To find predictors of the outcome variable, a binary logistic regression model was used. The final model's results were expressed as adjusted odds ratios, 95% confidence intervals, and P-values. ResultThe magnitude of husband participation in birth preparedness and complication readiness among obstetric referrals was 282 (71.8%). Planned pregnancy [AOR, 95% CI: 2.78 (1.68–4.62)], discussion with their wife [AOR, 95% CI: 2.85 (1.72–4.71)], and good knowledge of danger signs during pregnancy, delivery, and postpartum [AOR, 95%CI:2.71 (1.67–4.42)] were significantly associated with husband participation as compared to its counterparts. Conclusion and RecommendationThe husband's participation in birth preparedness and complication readiness for obstetric referrals in the South Gondar zone were reasonably good. For good husband participation in birth preparedness and complication readiness, knowledge of danger signs, pregnancy planning status, and discussion with wife about pregnancy were responsible. Healthcare providers should support mothers in discussing the danger signs of pregnancy, birth preparedness, and complication readiness with their husbands during ANC visits.

Effect of birth plans integrated into childbirth preparation classes on maternal and neonatal outcomes of Iranian women: A randomized controlled trial.

Involvement of women in the decision-making process during childbirth plays an important role in their physical and psychosocial preparation. A birth plan allows the woman to express her expectations and facilitates her participation in her own care. The present study is the first to assess the implementation of birth plans integrated into childbirth preparation classes in Tehran, Iran. This study is a randomized controlled clinical trial performed on 300 pregnant women at 32-33 weeks of gestation referring to four public health centers in Tehran, Iran. The participants were randomly allocated into intervention and control groups using block randomization method. A training session on the items of the birth plan checklist was held in the fifth session of childbirth preparation classes for the participants in the intervention group. Accordingly, a birth plan was prepared according to the requests of mothers. The birth plan was implemented after the women were admitted to the maternity ward. The primary outcomes were frequency of vaginal birth, mean duration of labor stages, and mean score of childbirth satisfaction. We used a checklist of maternal and neonatal outcomes, Mackey's childbirth satisfaction questionnaire, and a partogram form for data collection. Independent t-test, Mann-Whitney U-test, Chi-square test, Fisher's exact test, and logistic regression were used for data analysis. Vaginal birth rates were significantly higher in women who had birth plans compared with those without (81.9% vs. 48.7%, p < 0.001). Also, the lengths of the first and the second stages of labor were significantly shorter in women having a birth plan (p = 0.02). Women in the birth plan group were significantly more satisfied with the process of labor and childbearing (p < 0.001), and started breastfeeding after birth earlier than those in the control group (p < 0.001). Having a birth plan and attending childbirth preparation classes can increase the rate of normal vaginal birth. Also, according to our results, women's participation in the decision- making process and fulfilling their preferences during birth can improve maternal and neonatal outcomes and childbirth satisfaction.Trial registration: IRCT20190415043283N2. 2020-12-07.