Family planning is a virtue (unless you are of a few extreme religious persuasions).  Wedding planning is expected.  Vacation planning is a necessity. But planning for a birth?  For some reason, people find this controversial.

Anti-homebirth activist Amy Tuteur says, “Birth plans engender hostility from the staff, are usually filled with outdated and irrelevant preferences, and create unrealistic expectations among expectant mothers. But the worst thing about birth plans is they don’t work. They don’t accomplish their purported purpose, make no difference in birth outcomes, and, ironically, predispose women to be less happy with the birth than women who didn’t have birth plans.” (Tuteur cites some evidence to support her views, though her opinions seem to contradict the research findings.  For instance, one study she cites says, “The majority of women agreed that the birth plan enhanced their birth experiences, added control, clarified their thoughts, and improved communication with their health care providers.”)

From Anonymous, who claims to be a physician, posting a comment on Stand and Deliver: “In regards to birth plans. They are all nonsense. When it comes to the delivery room most if not all mean nothing. Your in pain you said I don’t want drugs you change your mind you get drugs.” (grammatical errors are in the original comment, and what birth plan has ever said, “no one should let me change my mind about anything in this plan ever, no matter what”)

From a patient handout from a Texas OB (posted on The Unnecesarean), “I do not accept birth plans. Many birth plans conflict with approved modern obstetrical techniques and guidelines. I follow the guidelines of the American College of Obstetrics and Gynecology which is the organization responsible for setting the standard of care in the United States.” (I have found that almost all of the OBs in my research insist that they follow ACOG guidelines.  And they definitely do follow some of the guidelines.  They apparently are able to block out the ones they do not want to follow–I have yet to meet an OB who does not violate at least some ACOG guidelines at least some of the time.  This OB, for instance, insisted on continuous electronic fetal monitoring and birth in the lithotomy position, stated that amniotomy and episiotomy would be conducted at his discretion and without discussion, and recommended routine elective induction between 39 and 40 weeks)

From a commenter on a birth plan post on The Stir on Cafe Mom: “almost all of our family friends had complications with their births, and none of them went the way that they had planned. Because i’ve seen this happen many times, my reaction is to just go with the flow.  Sure, there are are some things I would prefer not to happen, but I can’t actually control how my baby decides to arrive. I mean that’s the thing about life, in general what will happen will happen and you can’t always plan for everything.”

If you don’t believe in planning your family, you are unlikely to be upset by yet another pregnancy.  If you make no plans for your vacation, you are unlikely to feel cheated if you stay home watching TV for a week.  If you don’t make any plans for a wedding, a quick ceremony with a justice of the peace is probably not a disappointment.  Nor is rain.  But we generally make some plans for these events, even though there is no way to guarantee that our plan will come through exactly as we had hoped.  No one criticizes people for having plans for major life events that are not birth.

As Cristen Pascucci of Improving Birth said, “Birth is one of the last places in America where a modern woman is expected to lie back, shut her mouth, and take what’s done to her.”

It should not be controversial to expect to have a say in what might happen with your own body, even if what ultimately happens may not be what you expected.

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