One Born Every Minute
When Good Birth Plans Go Bad
Guest post by Laura Sussely-Pope of Pregnancy.org
To borrow (and alter) a well known phrase, “the [plan] to [birth] is paved with good intentions. “
There seems to be an “inside joke” in maternity wards that when an expectant mom shows up with a well thought out birthing plan, they get the c-section room ready. But for moms whose birth plans have gone “bad”, it’s no laughing matter.
There are many reasons why a good birth plan may fail. The word “fail” itself lends itself to making mom herself feel like a failure. If her labor doesn’t progress, if her birth canal doesn’t allow the baby to go through, if the baby is distressed, if the baby is breech – any number of things can happen.
It may be that a woman becomes so attached to her plan that she doesn’t anticipate the pain of labor itself. Her resolve to have avoid medication is suddenly tested and breaks. Does this mean her plan went “bad” because she’s now worshipping her epidural?
Then there‘s the very real possibility that the birth plan might simply be a convenient target to blame for the professionals who have not served mom well.
Perhaps rather than thinking of a birth plan as a “plan”, we should think of it as a birth “goal,” building flexibility into the birth plan. After all, what is more unpredictable than childbirth? There‘s no way to predict ahead of time how long your labor will be, how painful, if a vaginal delivery will in fact be possible or the date that baby will arrive (absent an induction date).
It’s important that moms have as much control as possible over how she delivers her baby. Most women aren’t even aware of their birth rights.
In one article given to Self magazine, Dr. Kimberly D. Gregory of Ceders-Sinai Medical Center in L.A. said, “I think that birth should be a beautiful experience. It should be exactly the way you want it, and doctors should intervene only to preserve the health or life of you or your baby. “
However, she went on to say that if you show up with a birth plan, “You get everything on that list that you don’t want. It’s like a self-fulfilling prophecy.”
Dr. Gregory led an unpublished study that compared women who took traditional hospital birth classes with those who employed Bradley-like training and a birth plan. The birth-plan group trended toward a higher c-section rate and more interventions. “There’s a certain personality type that tends to be more anxious. Maybe the anxiety hormones themselves put them at risk,” Dr. Gregory theorizes. “It seems that being open and honest and choosing the right doctor is probably a better option than writing everything down. Walking in with this list appears to set up an antagonistic relationship.”
As disheartening as this might sound, one wonders whose self-fulfilling prophesies are being fulfilled. We believe that if a birth plan is created and discussed with your care provider and the hospital staff, especially if the ever important flexibility is included, most, if not all, of your goals can be achieved. Once your contractions start, there’s only one person with more control over you than you – your new baby. And you may as well get used to it. That won’t change for a long time to come.
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