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BACKGROUND : It has not been established whether birth plans are helpful or not for pregnant women. We tested an original Norwegian version of a birth plan that gives women much room for expressing their wishes and expectations in their own words. MATERIAL AND METHODS : A questionnaire survey to pregnant women who used the Norwegian birth plan during the period 1 February through 30 September 2002, all living in five communities within one county and planning to give birth at a nearby university hospital. A control group of women living in other communities who gave birth at the same hospital were given a copy of the birth plan in the maternity ward. We asked about their total experience, feeling of safety, and the quality of information given, specifically during each of these stages: pregnancy, childbirth and the neonatal period. Respondents also evaluated the use of the birth plan, those in the control group with hypothetical questions. RESULTS : 189 out of 283 (67%) in the intervention group and 111 out of 271 (41%) in the control group responded. The groups were not significantly different with regard to age, proportion of married women, educational attainment, parity, or native tongue. Women in the intervention group felt significantly less safe at childbirth than those in the control group. In both groups the women evaluated the information given about the neonatal period as significantly less satisfactory than the information about pregnancy and childbirth. The birth plan was evaluated positively, though women in the control group given hypothetical questions were more enthusiastic about it. INTERPRETATION : The Norwegian birth plan did not positively influence the experience of safety during pregnancy, childbirth, or the neonatal period.

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