Let me say up front that I don't think birth can be planned. Having had eight children, I can assure you that plans are something you make while your baby laughs. And further more, for my one child who was closest to the "plan," it still wound up not being what I had expected. That all said I truly believe that it's acceptable and even desirable to have some idea of how you'd like things to go and what types of things you would like to try when it comes to giving birth. Jill at The Unnecesarean just posted about a woman who had her doctor give her a birth plan of his own that included:
- Routine stirrups for pushing
- Amniotomy at the doctor's discretion, not discussion
- No water births
- Induction around "39-40" weeks
The woman in the story was so floored with the lengthy list of things that her doctor could already promise her at the beginning of the third trimester, that she left his practice. She left because she felt constrained. Her options were being infringed on in her mind.
Now typically you may hear that women who want an unmedicated birth have a birth plan. This type of birth plan might talk about wanting to avoid unnecessary intervention. This is often met with skepticism. Why? If I go in to the hospital for a gall bladder removal, I'm not hoping to come out with a bonus urinary catheter. Heck, I might even tell my doctor I'd prefer to have a laproscopic version (smaller incision) to the older, more traditional and larger incision. Would anyone out there believe that to be odd?
I also wonder if birth plans said things like "I'd like an epidural as soon as I can have it, please." would be met with the same discussion as birth plans that say, "I'd prefer to try non-medicinal pain relief first, please." In my neck of the woods they certainly aren't met with any discussion.
So I'd like to offer up that the problem isn't with women or doctors or midwives and "planning" a birth but rather the comfort level with the preferences expressed in the words. We all get used to doing something a certain way. Chances are the practitioner you choose will see more births than you have babies, but remember, that does not mean that your voice isn't important. In fact, I like to think of it as I'm the expert in me and my provider is the expert at birth, together we form a team who shares the expertise to figure out the best way for me to give birth given my birth preferences and their experience and comfort with their skills to sit back and see where labor goes.
As a labor nurse of almost 10 years, I hate to see a birth plan. For one, I want what you want – a healthy baby and a healthy mom. I am your advocate, and my JOB is to help you have the best but safest birth possible. I dislike having someone come in with an arbitrary piece of paper which is usually not well thought out or even just “checked off” of an online data base. Nurses would prefer women to talk to us, tell us your plan, it is actually in every admission assessment I have ever seen.
I totally agree with part of the decision process being choosing a provider who has a good fit with the type of delivery you want. Most of the younger doctors and dare I say ALL of the certified nurse midwives I have ever worked with don’t do routine episiotomies. Ask tons of questions, if you don’t like the answers or the way the office is run, change practices.
Jennifer,
I couldn’t agree more on most of what you said about having conversations, which, to me, is what the spirit of a birth plan is about. It is NOT checking off things you don’t even want. In childbirth classes I talk about the birth plan as a communication tool. Though I will say that not every hospital has those conversations in admissions and that for some women it’s too late to start having the conversations at that point.