I don't know when I became so jaded- I had a birth plan with my son...every single thing went the opposite of what we had wanted (induction, ITN with subsequent pukefest and finally stat section for non reassuring heart rate and suspected chorio). But when I see that a patient has a birth plan I cringe! Maybe it's because every couple I've encountered with a birth plan have turned out to be the biggest PITA's I've had to deal with as patients- this last couple...sheesh, the dad interrogated my every action as though he thought I was going to hog tie his newborn daughter and assult her with formula and vaccines.
Their birth plan read as though it was copied out of a book...one of those ever popular "the medical industry and hospitals are EVIL and nurses are bullies and will bully you to do everything you don't want to do!!" Why are nurses and hospitals getting demonized so much? Do they really think we went into nursing because we like to harm babies and mothers and pi** off patients?
Ok, back to the birth plan thing: I've read plans that state "We require a private room" (good thing we have private rooms). "We demand immediate skin to skin and breastfeeding initiation" (gee, I was looking forward to poking your baby and letting him/her starve). "We do not want ANYONE in our room during labor except our accupuncturist and chiropractor".
I suppose these "requests" are not totally unreasonable, maybe it's just the way the plan is worded, and the defensive vibe I get from the patients who copy them from a book or author them themselves.
Oct 26, '12
I find this subject amusing because, so far, I have never encountered a couple with a written birth plan. I'm a very new nurse and have only been a nurse in L&D for 3 months, but even while I was working in L&D for a year as a patient care associate, I had never heard of such a thing at my hospital.
I work in a large teaching hospital in an urban city in New Jersey.... the most frequent request is an epidural... but I'm also finding that most nurses on my unit push for pt's to get an epidural and are not very supportive of women who want to labor naturally...
Sorry if I strayed off topic lol... But I think it's interesting to hear people's false/high expectations for their labor experience. I had a patient the other day who cringed every time the resident came in to give her a vaginal exam... apparently she thought that we could tell how far along someone is dilated just by looking down there ( as if we have x-ray vision or something?) and she also had a major fit when she found out she couldn't eat anything but ice chips, could only have 2 people in the room with her, and the biggest fit of all happened when she found out we weren't going to allow her outside to smoke a cigarette.
Last edit by Kayla.J.RN on Oct 26, '12
: Reason: typo/ had more to add
Oct 28, '12
by Elvish, BSN, RN
The ones that are fourteen pages long and spell out every minute detail are irritating....probably as much because the tone seems to be that I am incompetent and incapable of using common sense to treat people like individuals.
Other than that, a lot of what people want is SOP at my place anyway, like skin-to-skin immediately after birth, delayed shots/drops, walking/position changes during labor, informing people before doing things both during labor and postpartum. No one I work with is a nipple-happy bottlemonger just waiting for you to turn your unsuspecting back so we can fill your baby full of poison AKA formula. (Yes, that was full of hyperbole, not meant to be offensive, just pointing out the defensive tone some birth plans contain. Most of us just want you feed your baby, we'll respect whichever method you choose.) Even still, when faced with a defensive sounding birth plan, I find that when people are defensive like that, it comes from a place of fear. People won't always admit that, or even realize it. It is a good opportunity to talk through stuff. Most people, even ones that can be 'difficult', can be reasoned with. Most people.
What I love, though, are the birth plans that go like this: "We are John and Jane Doe, and we are so excited about the birth of our first (second, seventh) baby. We'd like X, Y, and Z to be done, but we realize things don't always go as planned. If things need to be done differently, we'd like to know what you're doing and why, and we trust your judgment. Also, Jane wants to eat as soon as she can after delivery." (I know, I know....why do we starve women in labor anyway??)
Last edit by Elvish on Oct 28, '12
The general consensus at my hospital was this: the longer the birthplan, the quicker you end up in the OR. And if it was laminted, Katy bar the door! that section was usually stat without even time for an initial instrument count.
I'm all for making a birth experience your own (if we ever had that rare patient that wanted to go natural, I'd end up taking them because I was the most comfortable with natural labors), but I truly believe the doctor in the movie Knocked Up said it best, "You want a special experience? Go to a Jimmy Buffet concert."
I would usually go through them line by line with the patients, and gently try to point out their dumba$$ery. "We do not wish you to circumsice our son without first discussing it with us." "Oh thank you, thank you, thank you, great stupid ones, I always arbitrarily pick out boy babies to circ, and I spirit them away in the dead of night when you are sleeping. Bwa ha ha ha ha!!!!" I really don't give one good dang about who gets circed and who doesn't, and I'm certainly not going to risk my license on something like that.
It reminds me of all the many times I've been asked as I'm about to give medication, "Will that hurt the baby?" OF COURSE it will!! It's our generation's answer to thalidomide, and I'm just drooling in anticipation as I pepare to give your baby flippers! Geesh, what the heck are they thinking? I'm not your enemy, and if you are so convinced that I am, then stay your butt at home!
Last edit by monkeybug on Oct 29, '12
: Reason: change word