Decisions and conversations during labour and birth

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As labour begins, decisions are usually made step by step, rather than all at once. These decisions happen over time, based on what is happening for you and your baby.

You don’t need medical knowledge to be involved in decisions about your care. You don’t need to have the “right” words or understand everything straight away. It’s always okay to ask questions or ask for things to be explained more clearly.

It’s normal for labour to feel unpredictable, even if this is not your first time being in labour. Labour may start, stop, or pause. It is ok to seek guidance and reassurance from your maternity care provider and for your preferences and needs to change.

Your care should always be based on respect, clear communication, and your right to be involved in decisions about your body and your baby.

Common conversations as labour begins

You and your maternity care provider may talk about:

when and how to contact your maternity care provider if you think labour has started
when it’s safe to stay home and when it’s time to go to your place of birth
your plans for comfort and pain relief during the different stages of labour
how or if you would like pain relief to be discussed with you
what checks or monitoring are recommended, and why
who you would like with you for support, and does this align with the visitor policy at your intended place of birth.

These conversations are a normal part of care and can happen more than once if they need to and an interpreter can help facilitate these conversations if needed.

You can change your mind

During labour, you can revisit decisions at any point. Plans change with new information. What matters most is what feels safe and right for you in the moment.

Start with what matters to you

It can help to think about:

What helps you feel calm, safe, and supported
How you like information to be shared (simple, detailed, repeated, or written)
Who you want involved in decisions
What matters most if plans need to change.

Knowing what is important to you can help guide your care, even if things don’t go to plan.

Asking questions
When choices are discussed, you can:
Ask questions
Take your time
Ask for things to be explained as many times as you need to understand.
You can also ask:
Are there other options?
What is expected to happen if I say yes/or no?
You have the right to understand your care and be part of every decision.

Your birth goals and preferences

You may have been thinking about and planning your labour and birth for some time. You may have even spoken to your maternity care provider about your preferences. These are commonly called your birth goals or preferences.

Sharing your goals can help your maternity care provider to understand:

what matters most to you
how best to support you during labour
what to focus on if things change
specific wishes around the birth.

Birth preferences are not fixed plans, but a way to share what matters most to you and help to guide your care. You can change your mind at any time, for any reason. Your preferences are a starting point, and they can change as your labour unfolds. It’s important you have the information you need to make an informed decision about your care and that you feel heard, respected and supported.

Some people decide to write their preferences somewhere. This can be short and simple or more detailed — whatever feels right for you. Writing things down can help you share your wishes clearly with your care team and help your support partner to know how you want to be supported. You can also ask for your preferences to be included in your medical record.

Our Values-Based Maternity Care Plan can help guide your thinking and support conversations with your care team, based on what is important to you.

Learn more

Values-Based Maternity Care Plan | Safer Care Victoria

Birth goals and preferences | Better Health Channel

Birth plan examples

Some other inclusive examples of birth plans you may find useful are:

Making a birth plan - what to include, purpose, benefits | Pregnancy Birth and Baby

Tiny Feet, Big Journey

Template: neuroaffirming birth | Autism Spectrum Australia | Aspect

Asking questions and being in control of your care

Asking questions can help you feel more informed and confident in your care. Your maternity care provider should support you to ask questions and make decisions about your care.

When decisions feel urgent

Labour and birth can change quickly, however, you decide what happens, with support and guidance from your maternity care team, to help keep you and your baby safe.

Sometimes decisions need to be made quickly, especially if there are concerns about your health or your baby’s wellbeing. Even in these situations:

You have the right to know what is happening and why
Things should be explained as clearly as possible and as many times as necessary
You should be treated with respect and kindness
You should always be asked to give your consent before anything is done

If things don’t go as you expected, you can ask to talk about what happened later, when you feel ready, and as many times as you need.

Urgency does not remove your right to respect, clear communication, or involvement in decisions about your care.

Informed consent

Informed consent means you are given clear and balanced information about your care options, including the benefits, risks and options available to you.

You should have the chance to ask questions and take part in the decision before agreeing, this includes using an interpreter if you prefer to communicate in a language other than English or by Auslan.

This supports your right to make your own decisions about your body and your care.

You can choose a care option that is different from what is recommended. Your care team should respect your decision and continue to provide safe, respectful care.

What it sounds like

Being asked if I agree or have concerns, not being told I am putting my baby at harm.

What it feels like

Feeling heard and having my decisions respected, feeling confident I’m making the right decision for me and not feeling like I’ve just said what I think clinicians want to hear.