Birth plans – are they realistic?
In a word, YES. You are entitled to what you want your birth to look like. As Milli Hill depicts in her book, Giving Birth Like a Femnist, this does not mean completely natural with no medications. It means, choosing what works best for you and remember that in the birthing process YOU MATTER.
Recently I was at my Maternal Fetal Medicine appointment and my doctor said “keep that brith plan in your head”. Although I knew at the time we were talking about how birth is dynamic, which is difficult to plan for, it started me thinking. I know that as a health care provider I myself have said statements to patients like this, well meaning but disempowering. Why is it that women are capable of making life plans, but when it comes to a birth plan we should just “let everything happen”?
In fact, when we look at women’s experience in birth, it was found that the ability to make decisions increased satisfaction of the birth process rather than following a birth plan. If this is the case, why as a provider do I advocate for birth plans? There is so much research that shows that women who give brith with birth plans have more satisfaction, better communication, and typically improved maternal and fetal outcomes.
I am looking forward to the conclusion of this study that is comparing the birth plan to the actual scenario AND comparing it with how women felt about their pregnancy. Unfortunately, this meta analysis (highest level of research) shows the bias of the healthcare system against birth plans and also the need for higher quality research on birth plans versus outcomes. When research points us in no direction, what has always been done tends to be the fallback for healthcare providers.
In addition, the birthing process has been highly medicalized. Did you know the typical vaginal birth in America costs $13,000.00 dollars? And having a cesarean section increases the cost to closer to $18,000.00? The average cost of a birth center birth is lower than $2000.00. In addition to higher costs, birthing in hospitals tends to lead to higher rates of interventions (27% cesarean rate) than birthing centers of just 6%. No wonder we are encouraged to give birth in the hospitals!
Midwives are excellent care partners that are highly educated and improve maternal outcomes related to birth. I use midwives almost exclusively for my women’s care needs as I found they tend to be more centered around the whole woman and explain my options in a way that feels best to me. And of course, I went to Frontier Nursing University (the oldest midwifery school in the country) founded by Mary Brekenridge – so I might be a little biased.
To the original topic, birth plans allow you to know what you want and to be more prepared. Do you want soft lighting, music, aromatherapy? Do you want to be touched without asking? Do you want to be able to move around? Do you want monitoring or an IV in your arm? Do you want to be able to go outside? Is eating important to you? What do you want your birth to look, feel, smell, or taste like? Knowing what you want and advocating for this does not make you a Karen, it makes you an informed and empowered patient. Go ahead, have a fairy tail birth in your head. It’s okay to dream about your future.
Famously Mary Brekenridge stated “Work for children should begin before they are born… These are the formative years, whether for their bodies, their minds or their loving hearts”. So too do we move through our lives, although this quote centers on the child the woman is the vessel. Honor her body and her needs as she is the vessel of life.
