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

[PeepnBiscuitsRN]

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.

[dmw2010]

I've read a few birth plans in my day as a L/D nurse. I have mixed feelings about them.

Whenever I hear that my patient has a birth plan, my immediate, gut reaction is to roll my eyes (in my head, of course). It seems to be a bad omen (it seems like they get a c-section more often with a birth plan- or maybe those particular c-sections are more memorable since it was the last thing she wanted in the world and we feel like we failed). It is intimidating because anything put into writing is supposed to be followed- or else. It tells me that the patient might think she is more enlightened than I am about how things should be done (even though it's her first rodeo), and it puts up a front that she thinks we won't do things in her or her baby's best interest. And I hope that she will understand why we have to deviate from the plan, for legitimate reasons, of course. I find that so long as I honor the plan as much as possible, and I am respectful in explaining why we have to deviate from the plan, she will usually cooperate and change her plan. However, I have heard (and seen) patients actively evade the doctor's plans, because they didn't fit in with "her plan," and that is always a nail biting scenario.

On the other hand, I have seen patients who don't have a clue about anything with regard to the labor process. Never read anything, never questioned anything. And she ended up with an induction at 39 weeks for no good reason (doctor convenience), her water broken at 2 cm without being given the option of going home and trying again later (or 1 cm if he could get the amnihook in there; I cringed when he ordered amnicots for this purpose....), and ultimately, a c-section on my night shift for failure to progress. When I left the hospital, there was an ongoing discussion with the Chief of OB about this particular doctor's induction practices and whether they were appropriate.

This is truly an issue in our profession. I think a lot of patients feel like they have to tell us what to do because they hear about women being taken advantage of (or she had a bad experience in the past and is determined to not let it happen again). So while I don't like birth plans, I understand them. The key is to form a trusting relationship with the patient and do what is right for her, whether she has a birth plan or not.

[dmw2010]

....wrong post

[haunani, BSN, RN]

I was a birth plan mom, too, but my excuse is that I didn't know what WAS normal at my hospital, so I just spelled out all of my preferences. And yes, they were just preferences and not demands.

As a nurse, I've taken care of both types of birth plan moms... the ones like me, and the ones who refused to deviate from their plan for any reason and believed everything in a hospital was evil.

Honestly, I can understand and appreciate both sides. I've had friends who have had horrific experiences and others who have had perfect ones. Every hospital is different in what "their" normal is, and most moms coming in don't know the standard practices at their hospital.

Some have had pain medication given without their consent. Some have had their waters broken without consent. Some have been given labor augmentation without consent. One was even threatened to have her child taken away from her (and was barred from even seeing him for 6 hours) because they refused the PKU on religious grounds (the PKU wasn't explained to them correctly, which led to their refusal).

Now that I work in our birthplace center at my hospital, I know what our normal is, and I can say my birthplan for #2 (yes I'll still have one) will be dramatically shorter.

[k-t-did]

My favorite that comes FREQUENTLY because it's on an online checklist...

"We do not want fetal monitoring unless our baby is in distress."

Ok honey. I'll just wave my hands over your belly and say, "hmmmm......I think.....I feel...hm.....probably not in distress.."

Or just whip out the crystal ball.

Seriously? Do they even think?

[caregiver1977]

The most ridiculous one I've seen dictated that the patient required 7 orgasms during the 2nd stage of labor to help her relax, and that the labor nurse should assist her with achieving those. Uh, hello?? Call me crazy, but isn't that called sex?? For the record, the nurse that was taking care of her said that she told her she would NOT be helping her with that part of her birth plan, but that if her husband wanted to take care of that, she would give them some privacy.

Ok, stop the press...

You mean they actually asked for 7 orgasms!!! I'm sorry, but didn't that patient just sexually harrass the nurse, the nursing staff, or whomever the request was aimed at? What if this had been a man asking for 7 orgasms in order to "relax?" I may be overreacting, but I think that was totally inappropriate.

But for the record, I did do that myself during a couple of my labors (and I think it worked well), but I didn't ASK anyone else to do it!!

[nursekate8]

Similar to other post-ers, I appreciate the birth plans as an important tool for patients, but I love a good silly birth plan. My most recent favorite was as a request for "no enema and no pubic shaving".

It was tough, but I made sure her wishes were carried out ;-)