What comments do you hear from OB's about birth plans?

  1. I was just wondering... When I was in my L&D rotation in school the OB's I worked with would be very condescending with any woman who gave them a birth plan. Usually it was behind the mom's back. Why do OB's do this? I could understand it if mom was making outrageous demands. But I'm just talking about the mention of a birth plan and the OB rolling his eyes (before he has even looked at it) and saying something sarcastic to the nurses. After witnessing this several times I'm actually dreading giving my OB my birth plan at my next appt. Especially after being told, "just get the epidural.." after I mentioned 'Hypnobirthing'... Anyway... just wondering what L&D nurses have witnessed and think about it.
    Thanks!
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  2. 28 Comments

  3. by   SmilingBluEyes
    Quote from becca.utns
    I was just wondering... When I was in my L&D rotation in school the OB's I worked with would be very condescending with any woman who gave them a birth plan. Usually it was behind the mom's back. Why do OB's do this? I could understand it if mom was making outrageous demands. But I'm just talking about the mention of a birth plan and the OB rolling his eyes (before he has even looked at it) and saying something sarcastic to the nurses. After witnessing this several times I'm actually dreading giving my OB my birth plan at my next appt. Especially after being told, "just get the epidural.." after I mentioned 'Hypnobirthing'... Anyway... just wondering what L&D nurses have witnessed and think about it.
    Thanks!

    First, I do NOT consider most birth plans "outrageous" or "demanding". Birthing families just want some control and say over their experiences, and to me, that is reasonable. Most plans ask for very little we cannot accomodate and try to our utmost to do, at least where I work.

    I find that if BOTH birthing families and medical personnel are flexible, everyone is happier. If a family understands their plan is a clear communication to staff as to what their optimal experience would be, NOT WRITTEN IN STONE---- and IF medical personnel respect this, we all get along. NO ONE I work with (including doctors) laughs at these or makes fun of families trying to assert some control over what interventions they do and do not receive while in our care. I honestly have not witnessed a doctor "laugh" or make rude remarks at these.

    I think it would be very helpful for you to present your plan to your OB/MIDWIFE at your EARLIEST convenience, discussing each part of it thoroughly. (like you plan to do). Make sure the hospital staff have a copy when you are admitted and they are clear on what you would like. This way, you all are clear on what you want and what can be reasonably accomodated early-on. Consider having a doula present, if you want, to communicate your needs to the staff, esp. if you plan to go naturally. They are indispensible this way and worth the money!!!! When things get tough, they can be an excellent comfort and voice for your needs to medical/nursing staff.

    REMEMBER: Be openminded yourself and understand that things can and do change fast in obstetrics. If an emergent condition arises, know you may have to change game-plans fast and just being aware of this can be helpful.

    Before I forget, hypnobirthing is a real site to behold. I am in awe of it when it does work.... And with some people, it does work and well. It varies by individual. I would give it a try. Next time someone tells you "just get the epidural" tell them thanks for the information, but you are clear on what you want and IF you change your mind, you will be sure and let them know. The less defensive you are, the better your message will come across. You have EVERY right to a low-intervention birth experience, medical conditions allowing. Be clear on why each intervention is being done--- upfront--- before allowing it done. You have the right to have all procedures explained as to benefits and risks PRIOR to having them done! That did not change with the advent of birth planning. (grin)

    I wish you luck. Every birthing family has the right to as near an ideal birth experience as they can achieve. Be clear in what you need from your OB and the nursing staff from the get-go and be openminded, as well. You will do fine! Best wishes and congratulations!!!!
    Last edit by SmilingBluEyes on Jun 29, '04
  4. by   becca.utns
    Thanks for the reply! I didn't think many OB's had this attitude, maybe it was because the location of the hospital I had my clinical. It was in a poor part of town and many of the moms were teens. Maybe the OB's didn't see too many birth plans. Obviously the teens did not usually have birth plans, it was two women in their 20's & 30's who actually had a birth plan and the doc's were sarcastic about it. This wasn't the most professional hospital I have been to. (That's a whole different thread).

    I hope to work in L&D in the future and would be pleased if mom had a birth plan. I think it shows that she has educated herself and is prepared.
  5. by   BRANDY LPN
    From my experience most of the birthplans have been stuff that we do anyways. Also the ones I have seen are from people who are inflexible in what they want. The best thing I can tell some one is that they need to research ALL of their birhting options then come in with an open mind, kinda play it by ear, I have seen too many women who say they want it to go exactly like their birhtplans and they are the ones who are most often very disappointed by the ways things end up.

    But noone should laugh or make fun or roll their eyes because you have researched and have a clear idea of what you want. Just make sure that you understand that your birthplan is a guide line and not the absolute only way to have a healthy and happy delivery. And if something is not working don't be afraid to chuck it out the window and take suggestions from the nurses, doulas or provider.
  6. by   fergus51
    GO DEB!!!!

    I do laugh a bit at some birth plans (the "no enemas" type are just a little outdated and I admit to giggling when I see it) but most of them are reasonable. I think it's more about tone than content.
  7. by   Zhlake
    Quote from fergus51
    GO DEB!!!!

    I do laugh a bit at some birth plans (the "no enemas" type are just a little outdated and I admit to giggling when I see it) but most of them are reasonable. I think it's more about tone than content.

    We still have a doc that does routine enemas---so it is not completely out of line for a mom to put that!

    For my birth in March, I had a birth preference sheet. Obviously, I knew what things I wanted that were outside of the norm.

    The key to birth preferences is being educated about options and understanding that you can't plan birth. (hence listing my preferences and not a plan) I got this wording from the great book birthing from within--that actually discourages birth plans.
  8. by   BabyRN2Be
    As a new doula, several years ago I outright asked a nurse who worked in L&D about how she felt about birth plans. She told me what really makes them roll their eyes is those who come through with the whole stack from birthplan.com, they've checked what they do and do not want, and the staff has to go through the whole stack to see what they've checked. Now that, understandably, can irritate a hurried staff. I tell all my doula clients to go through a birth plan, mark what they want, and CONDENSE the BP to what pertains in L&D (leave off the stuff about rooming in, breast feeding, circumcision, etc.). Make it no more than half a page, one page TOPS. After they've moved to PP, they can give the other part to the staff. None of our hospitals have LDRPs, so when they are inevitably transferred, they can give that portion to the staff that it pertains to.

    Also, I tell my clients that they MUST have their PCP review the birthplan. Whether s/he rolls their eyes or not is a good indication of a possible need to change providers. Some of the eyerolling might come from those who don't talk to their PCP before labor, and the PCP is caught by surprise by a birthplan when the couple shows up in labor. I tell my clients to have their physician sign the plan, make up 3 copies. One for the physician for him/her to keep, a CONDENSED one for the staff in L&D, and one for themselves. This tends to work well.

    Keep the lines of communication open and I hope that your birth goes well!
  9. by   fergus51
    Quote from Zhlake
    We still have a doc that does routine enemas---so it is not completely out of line for a mom to put that!
    That's crazy! Where are you if you don't mind my asking? I have never seen or heard of a doc wanting shaves or enemas anywhere I have worked, even the dinosaurs. It is funny where I worked because we don't even have the necessary equipment in the place
  10. by   SmilingBluEyes
    I have had several patients through the years REQUEST enemas.......go figure.
  11. by   BabyRN2Be
    OK, I've been doing some reading on birth plans over the web (I don't have access to mine as the drive it's stored on isn't being cooperative), and there are some things that really don't need to be mentioned in a birth plan. If you want to keep the lights low, have someone with you (a doula, perhaps? ) who can express this to the staff when they come into the room. If you want to wear your own clothes (I really don't recommend this due to "birth glop" getting all over something you really like), this doesn't need to be mentioned in a birth plan. Just tell them you don't want to wear their Christian Dior hospital gowns!

    Save the space for what you REALLY want to communicate to the staff, such as pain med choices, wishes regarding an IV (which you MUST talk to your PCP first!), wishes regarding the pushing stages, etc. If you are using natural childbirth methods, communicate that you will be using nonpharmacologic relief methods - massage, aromatherapy, accupressure, etc. If you want to use water for relief (either a tub or shower) keep in mind that if you want or need an IV, this MIGHT be a little problematic.

    Just keep the L&D portion short and sweet. In my experience, this is greatly appreciated by the staff. Also, include a line stating that these are only preferences and that you are flexible in case something unplanned arises. It's give and take, and be prepared to compromise. I've seen this more often than not, the more complicated the birth plan, the greater the chance of a birth ending as a c/s.

    Think through what you want, and condense. It's best to be informed of all your choices before you go in.
  12. by   fergus51
    Deb, that is just WIERD!!! EEEWWWW. We always laugh about it and would tease the newest nurse on the unit by saying "Well, the lady doesn't want an enema, so I guess you won't get to go to the drug store to buy an enema kit today, sorry"
  13. by   SmilingBluEyes
    roflmao fergus!!!!!!!!!!!!!!!!!!!!!!!
  14. by   Zhlake
    Quote from fergus51
    That's crazy! Where are you if you don't mind my asking? I have never seen or heard of a doc wanting shaves or enemas anywhere I have worked, even the dinosaurs. It is funny where I worked because we don't even have the necessary equipment in the place

    He is very archaic in many many ways. AND in fact, he retired TODAY. this was his last day. He wanted shave and preps with every labor patient. Always always always did an episiotomy. I was in a delivery once with a multip with him. He was out doing rounds at 4am because she wasn't close enough for him. All of the sudden baby was crowning. I run out and find him and we get back just in time. He didn't have time to get on both gloves--but he did manage an episiotomy--with baby's head half way out. I swear to God. In fact, I teach prenatal class and during the episiotomy talk--I tell them about current research and ACOG's guidelines against routine epis. He talked to my director and was all upset that I told this to the class. I printed off ACOGs guidelines and gave him a copy. Is it that hard to keep up on you own professional groups guidelines?? He is a big "cutter" too. We have a lot of "5 o'clock c/s". You know...yeah we will pit you all day with unfavorable cervix--if you haven't delivered by 5 than we wil section. Okay I must get off my soap box. I could go on and on......

    He also allowed nothing by mouth until flatus and then clear liquids only until bm.

    He drives me crazy!!! Thank God he is gone.

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