The most ridiculous birth plans you've had the pleasure of reading

Specialties Ob/Gyn

Published

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.

Specializes in Eventually Midwifery.
Klone,

You are aware that the vast majority of midwives that do home births in the US have nowhere near the amount of education and training that European midwives have. In most states literally anyone can advertise themselves as a midwife with little to no repercussions and if anything goes wrong they can simply move to another area and start over again. You simply cannot compare the two.

I'm not sure what state you live in, but to practice in South Carolina you must be certified, either as a LM/PM or CNM. And from what I gather from other posters and personal research, there are several states in which ONLY CNM's may practice midwifery. Can you back this up with evidence?

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.

Studies comparing safety of homebirth vs. hospital birth (and keep in mind, these are only the studies that compared homebirth vs. hospital birth WRT midwifery practice, apples to apples, so to speak):

Kataoka, Y., Hiromi, E., & Mariko, I. (2013), Outcomes of independent midwifery attended births in birth centres and home births: A retrospective cohort study in Japan. Midwifery, 2013; 29 (8): 965-72.

Miller, S. and Skinner, J. (2012), Are First-Time Mothers Who Plan Home Birth More Likely to Receive Evidence-Based Care? A Comparative Study of Home and Hospital Care Provided by the Same Midwives. Birth, 39: 135-144.

Davis, D., Baddock, S., Pairman, S., et al (2011), Planned Place of Birth in New Zealand: Does it Affect Mode of Birth and Intervention Rates Among Low-Risk Women? BIRTH, 2011 Jun; 38 (2): 111-9.

Outcomes associated with planned home and planned hospital births in low-risk women attended by midwives in Ontario, Canada, 2003-2006: a retrospective cohort study. Hutton EK1, Reitsma AH, Kaufman K.

Outcomes of planned home births and planned hospital births in low-risk women in Norway between 1990 and 2007: a retrospective cohort study. Blix E1, Huitfeldt AS, Ă˜ian P, Straume B, Kumle M.

Outcomes of planned home birth with registered midwife versus planned hospital birth with midwife or physician. Janssen PA1, Saxell L, Page LA, Klein MC, Liston RM, Lee SK.

Outcomes of planned home births versus planned hospital births after regulation of midwifery in British Columbia. Janssen PA1, Lee SK, Ryan EM, Etches DJ, Farquharson DF, Peacock D, Klein MC.

Specializes in OB/GYN, L&D, Postpartum Couplet Care.
No I'm not kidding. Everyone has a story about a friend or family member. Negative bias and confirmation bias.[/quote']

Well then by that rationale, you should not listen to or take into consideration anyone's positive home birth stories either, right?

Those stories are not hearsay or grapevine stories from a friend of a friend of a friend. They're real people's real stories and you (or anyone else) would be a fool to completely blow them off. They can shed some light on WHY home births can be dangerous.

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.
Well then by that rationale, you should not listen to or take into consideration anyone's positive home birth stories either, right?

Which is why I look to the research, rather than the anecdotal stories.

Christy Collins, a homebirth midwife, was charged with a misdemeanor for practicing medicine without a license in California. She moved to Nevada where she recently crowd sourced a life or death decision about a labor as it was happening on the midwifery today page through jan trittan. Baby Gavin Michael is now dead. The response by the community was to delete the thread and refuse to respond to any questions. No professional review or censure has been done and she is free to continue practicing with her patients none the wiser.

Bambi Chapman was recently banned on Facebook for posting a picture of her daughter Mary Beth who died due to a homebirth midwife's neglect and ignorance. No professional or legal recourse was available. Eight more babies have died at her hands and she continues to practice.

There is no national or state registry for any lay or CPM midwife. They carry no so lawyers don't want to sue because they won't get paid.

You can see the screen shots about baby Gavin on the skepticalob.com blog and Bambi has a blog about her experience as well.

Every story on hurtbyhomebirth is a reflection of the women's lack of education and regulation.

The official journal of CNMs recently published a study about better regulation for homebirth for CNMs. The conclusion reached was that they did not want to sacrifice professional autonomy in order to build relationships with hospitals and OBs.

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.
There is no national or state registry for any lay or CPM midwife.

There *is* in fact a state registry of CPMs. It's called NARM, the accreditation body.

Look, there are lots of cowboys out there. That is why it's so important to make homebirth midwifery LEGAL and REGULATED in every state, with collaboration with hospitals and OBs, like they do in Europe (gosh, feel like I'm just repeating myself here).

Did you C&P this from somewhere? If so, you are committing plagiarization. Please cite where this came from. Also, please cite the reference to the statement that ACNM is opposed to better regulation because they don't want to build relationships with hospitals and OBs. Considering that in the vast majority of states, CNMs only work in hospitals, I find that statement specious.

http://www.ajog.org/article/S0002-9378(13)01155-1/fulltext

Homebirth 4 times more likely to cause fetal death. Please note that this is a US study. Any study conducted outside of the US is irrelevant because of the differences in education and health care delivery systems.

When is the last time NARM actually censured anybody?

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.
When is the last time NARM actually censured anybody?

I have no idea. What's your point?

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.
Elsevier

Homebirth 4 times more likely to cause fetal death. Please note that this is a US study. Any study conducted outside of the US is irrelevant because of the differences in education and health care delivery systems.

Yet, I've just produced 7 - SEVEN - studies that have shown homebirth to be as safe as hospital birth in low risk women. There are more.

Specializes in Eventually Midwifery.

Here you can find the requirements for a BS in Midwifery from King's college in London. Midwifery Studies with Registration BSc- Structure - Undergraduate programmes - King's College London : Online prospectus

Currently, students study the following modules:

YEAR 1

In their first year, students study the following modules:

YEAR 1 CORE

Midwifery Practice 1

Biology and Midwifery Practice 1

Biology and Midwifery Practice 2

Searching for Midwifery Evidence

Foundations of Midwifery

Pharmacology for Midwifery

Social Science and Midwifery

YEAR 2

Midwifery Practice 2

Public Health and Midwifery

Research Methods

Midwifery and Sexual Health

Medical Issues and Childbirth 1

Medical Issues and Childbirth 2

Needs Assessment and Care Pathways

Organisation and Models of Care (continues into year 3)

YEAR 3

Midwifery Emergencies

Midwifery Practice 3

Management and Education

Newborn Assessment

Student Project

Organisation and Models of Care (continued)

The entrance requirements for a student from the US is simply taking the SAT.

Overall, I do not see much of a difference in educational requirements between England's direct entry program and equivalent programs for LM/PM here in the US

Specializes in OB/GYN, L&D, Postpartum Couplet Care.
Did you C&P this from somewhere? If so you are committing plagiarization[/quote']

Did you mean plagiarism Klone? :)

I normally wouldn't point out such a blatant grammatical error but she comes across so educationally superior to everyone that I just couldn't help myself.

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