{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T02:10:47Z","timestamp":1794276647878,"version":"4.9.0"},"reference-count":20,"publisher":"Georg Thieme Verlag KG","issue":"14","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>This systematic review and meta-analysis discuss how birth plans impact maternal and infant outcomes. Our main objective is to analyze maternal fear of childbirth, labor phases duration, delivery method, neonatal admission, and early breastfeeding initiation.<\/jats:p>\n                  <jats:p>We systematically searched PubMed, Embase, and Cochrane Central for studies published from inception until July 2025. Only randomized controlled trials involving pregnant individuals in labor that compared birth plan use (written or verbal) to standard care without a plan were included. A random-effects meta-analysis was conducted through RStudio version 4.4.1 to pool prevalences and rates. Heterogeneity and sensitivity analyses were performed with leave-one-out analysis. We used version 2 of the Cochrane Risk-of-Bias Tool for quality assessment.<\/jats:p>\n                  <jats:p>Birth plans were associated with a higher likelihood of normal vaginal delivery (risk ratio [RR]: 3.22; 95% confidence interval [CI]: 1.49\u20136.95; p\u2009=\u20090.003) and increased odds of early breastfeeding (RR: 3.68; 95% CI: 1.48\u20139.15; p\u2009=\u20090.005). No significant benefits were observed for episiotomy rates (RR: 0.47; 95% CI: 0.02\u201310.49; p\u2009=\u20090.636) or labor augmentation (RR: 0.65; 95% CI: 0.30\u20131.41; p\u2009=\u20090.274). Risk of bias was low across all studies.<\/jats:p>\n                  <jats:p>Birth plans may be associated with improved maternal outcomes, including increased rates of vaginal delivery, and early breastfeeding. The overall evidence suggests birth plans as a strategy to promote a more respectful childbirth.<\/jats:p>","DOI":"10.1055\/a-2849-7990","type":"journal-article","created":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T22:58:33Z","timestamp":1775689113000},"page":"1976-1983","source":"Crossref","is-referenced-by-count":1,"title":["The Role of Birth Plan in Shaping Maternal and Neonatal Outcomes: A Systematic Review and Meta-analysis of Randomized Controlled Trials"],"prefix":"10.1055","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5792-4760","authenticated-orcid":false,"given":"Giovanna Cristina de Castro","family":"Martin","sequence":"additional","affiliation":[{"name":"Department of Medicine, Faculdade Santa Marcelina, S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Clara Pimenta","family":"Servidoni","sequence":"additional","affiliation":[{"name":"Department of Medicine, Faculdade Santa Marcelina, S\u00e3o Paulo, S\u00e3o Paulo, Brazil"},{"name":"Obstetrics, Gynecology and Reproductive Science Department, Yale School of Medicine, New Haven, Connecticut, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guilherme Franceschini","family":"Machado","sequence":"additional","affiliation":[{"name":"Department of Medicine, Hospital Santa Marcelina, S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas","family":"Habiro Alves","sequence":"additional","affiliation":[{"name":"Department of Medicine, Hospital Santa Marcelina, S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruna Benigna Sales","family":"Armstrong","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology Department, Faculdade de Ci\u00eancias M\u00e9dicas Santa Casa de Sao Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cain\u00e3 Gon\u00e7alves","family":"Rodrigues","sequence":"additional","affiliation":[{"name":"Department of Medicine, Federal University of Ceara, Ceara, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Julia","family":"Lemos","sequence":"additional","affiliation":[{"name":"Department of Medicine, Uniredentor, Itaperuna, Rio de Janeiro, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcio Delascio","family":"Lopes","sequence":"additional","affiliation":[{"name":"Department of Medicine, Hospital Santa Marcelina, S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcelo","family":"Zugaib","sequence":"additional","affiliation":[{"name":"Obstetrics Department, USP, S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,4,28]]},"reference":[{"key":"ref1","volume-title":"Obstetr\u00edcia psicossom\u00e1tica","author":"J JA Tedesco","year":"1997"},{"issue":"02","key":"ref2","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1111\/j.1552-6909.2006.00042.x","article-title":"Birth plans: the good, the bad, and the future","volume":"35","author":"J Lothian","year":"2006","journal-title":"J Obstet Gynecol Neonatal Nurs"},{"issue":"11","key":"ref3","doi-asserted-by":"crossref","first-page":"979","DOI":"10.1016\/S1701-2163(15)30785-4","article-title":"Perspectives of expectant women and health care providers on birth plans","volume":"35","author":"M Aragon","year":"2013","journal-title":"J Obstet Gynaecol Can"},{"issue":"01","key":"ref4","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1111\/j.1523-536X.2006.00126.x","article-title":"Birth plans: after 25 years, women still want to be heard","volume":"34","author":"P Penny Simkin","year":"2007","journal-title":"Birth"},{"issue":"03","key":"ref5","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1891\/1058-1243.21.3.158","article-title":"The impact of choice and control on women's childbirth experiences","volume":"21","author":"K Cook","year":"2012","journal-title":"J Perinat Educ"},{"issue":"03","key":"ref6","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1590\/0104-1169.0067.2583","article-title":"Use and influence of delivery and birth plan in the humanizing delivery process","volume":"23","author":"M Su\u00e1rez","year":"2015","journal-title":"Rev. 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Issues"},{"issue":"04","key":"ref19","first-page":"200","article-title":"\u201cIt wasn't what I wanted\u201d: women's experiences of a birth that differed from their birth plan","volume":"31","author":"S N Jolley","year":"2018","journal-title":"Women Birth"},{"issue":"03","key":"ref20","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1111\/jmwh.12187","article-title":"The role of maternity care providers in promoting shared decision making regarding birthing positions during the second stage of labor","volume":"59","author":"M J Nieuwenhuijze","year":"2014","journal-title":"J Midwifery Womens Health"}],"container-title":["American Journal of 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