Reactions to Birth Plans

I just read an important, but sad and maddening blog about things overhead by a midwife in the hospital. http://www.themidwifenextdoor.com/?p=1043 One of the things mentioned about hypnobirthers and birth plans really resonated with me — I myself have heard doctors and nurses make comments like, “Anyone with a birth plan or doula or who attended those Bradley classes guarantees themselves a c-section.” I’ve gone to prenatal visits with my clients and met a doctor who says something along the lines of, “Well, a birth plan is ok, just don’t make it one of those crazy Bradley type of birth plans.”

Does this mean you shouldn’t have a birth plan? I don’t think that’s the answer at all. In fact, having a well thought out, concise, yet flexible birth plan can alert you to red flags about your provider or hospital. Some will disagree with me, but my thought is if you’re going to a hospital, you have to abide by certain rules OR spend a lot of energy fighting them. Yes, we have patient rights and informed consent and the right to sign waivers against medical advice — but in my opinion and experience (and it is just my line of thinking) — why place yourself in a position to have to fight against hospital protocol? You have the right to refuse a cesarean section, you have the right to refuse induction, you have the right to a second, third, fourth opinion.. but are you going to have the opportunity, time, and willpower to insist on all of those things?

A birth plan should be just that — a plan. To me, it signals that a woman or couple has taken the time to research some of their options and some procedures and make a decision on their comfort level regarding the options. If women could type up a birth plan and have everything fall into place as written, we’d all have 100% amazing birth experiences. This applies to birth at home, in a birth center, or in a hospital. Sometimes home births are transferred, sometimes a hospital planned birth never happens due to a quick labor at home, etc.  Taking the time to look at your options and write a birth plan shows some investment in your desires. Even following a template for a birth plan (found on many pregnancy websites) helps to educate women and their partners about the process of birth, the choices available, and some procedures they may or may not be comfortable with. A birth plan sets you apart from the provider’s many other patients and helps make your wishes known.

If this is the case, then why are things said negatively about birth plans? A simple reason in my mind is that if your provider disapproves of your birth plan, that’s a red flag that this provider may not be compatible with your choices. Do not discount this! A more complex reason is the fact we live in a litigious country and a birth plan asking for special favors, changes in procedure,  or considerations (despite those being your right) involves many more people and institutions than you and your baby. A doctor or midwife who bucks hospital protocol of prohibiting food and drink during labor may have to explain their choice to a group of their peers or a disciplinary board (Yes, even though prohibiting food and drink makes no sense and is not evidence based). The same with “allowing” a woman to remain monitor free, or take a shower, etc. Nurses are also often caught in the middle of a complex struggle of wanting to care for the laboring woman and her preferences but having hospital protocol and individual doctor’s orders to follow.

What does this mean for you? What can you do about it? By all means, research your options and put in writing those that are important to you. Listen carefully to how your provider reacts to your desires and your birth plan. If you sense a problem, discuss it, and change providers and places of birth if it doesn’t meet your goals and desires. Consider if having a right to fight something is going to serve you best by fighting  or by finding a place better suited to your needs. Sending a clear message about choices is possible by taking your business and birth elsewhere. Pay attention to placating phrases such as, “Well, so long as everything is going ok…”. Ask hard questions. Ask what does going ok mean? It’s easier to ask these hard questions during a prenatal visit as opposed to asking them in labor.

What reactions to birth plans have you experienced?

All Rights Reserved, Kimberly Sebeck, Knoxville Doula, 2011

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3 thoughts on “Reactions to Birth Plans

  1. I was very pleased to be a doula for a client at St. Mary’s/Mercy off of Broadway earlier this year. I was tickled and thanked the staff that they not only read and acknowledged the clients’ birth plan, they adhered to it very well I would say! The client really had almost a homebirth in the hospital, and had a fine baby and all went well, and I thanked the doc and other staff after the birth for being so receptive to the client. If you want to know any names, just email me. I highly recommend them. This client had also had Bradley classes, and they had no problem with it…:) Cathi Cogle, CPM

  2. Hey Kimberly,

    I continue to be surprised by stories like this! I suppose where I live the birthing community is a bit more progressive. I had a fairly homebirth-like birthplan, since I had originally wanted a homebirth anyway and was quite disappointed to be delivering at the hospital. But I probably need to mention that I delivered with a midwife instead of a doctor! So this probably eased the whole experience for me.

    Keep up the great posts 🙂
    Milena

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