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.

Why is pit used so often? I am not an L/D nurse so I am curious. Had my first baby in 3 hours from start to finish. Went in for baby number 2 and saw the nurse setting up the pit, I was like for the love of God, do not give that to me! That labor was 2 hours give or take, and I was gawked at for refusing. Now that I think about it, it's probably just policy for every patient. But I'm proof, we don't all need help contracting!

I didn't have a birth plan, but had I known it was so common, no pitocin unless it was necessary would have been my only request.

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Specializes in OB.

Most of these birth plans are simply funny and I'm telling you why. Most of the people who choose a birth plan are new parents, never been through pregnancy, labor or delivery. To laugh or to smirk at a document is not making fun of the person. Most of these so called birth plans come from web sites in which people just click on boxes and they don't even know what they're clicking on or not clicking on. How can you say you consent the circumcision for your baby girl? Really? Do you even know what a circumcision is? Vitamin K is not a vaccine, it is used to help the newborn with clotting since their ability to do it doesn't come in for a few months and there are things that could happen that not having gotten vitamin k may result in the baby's loss. People are not educating themselves the correct way. Or the are over educating themselves totally the wrong way. Example "I'm 35 weeks already, I'm fat, I'm swollen, I want this baby out now, my sisters best friends cousins mom had a bay at 35 weeks and the baby is totally fine". Things and comments like that are the ones that get the laughs. Not being ignorant but choosing to be. Labor is a serious thing and when someone has all this expectations and denies even having an IV with saline water not even pit, it's when the problems start. It's like they say "it's not the same calling the devil but seeing it come", you could be having the best labor in the world, baby's heart drops and you continue to decline a c-section because it is not part of the "birth plan" keep that up and there will be no "birth". Also home deliveries with lay midwives who are not even nurses is another bad idea. But people still think it's ok. Yes, many, many years ago everyone was born at home, but how many of those mothers and/or babies didn't make it because in the middle of pushing they discover a prolapsed cord or that the baby turned and now it's breech. Now what? Birth plans can be ok. A woman should be ok to have her preferences but also needs to keep an open mind that things do go wrong and can change in a matter of minutes.

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I presume you do not speech of a trained nonnurse midwife??

Most of these birth plans are simply funny and I'm telling you why. Most of the people who choose a birth plan are new parents, never been through pregnancy, labor or delivery. To laugh or to smirk at a document is not making fun of the person. Most of these so called birth plans come from web sites in which people just click on boxes and they don't even know what they're clicking on or not clicking on. How can you say you consent the circumcision for your baby girl? Really? Do you even know what a circumcision is? Vitamin K is not a vaccine, it is used to help the newborn with clotting since their ability to do it doesn't come in for a few months and there are things that could happen that not having gotten vitamin k may result in the baby's loss. People are not educating themselves the correct way. Or the are over educating themselves totally the wrong way. Example "I'm 35 weeks already, I'm fat, I'm swollen, I want this baby out now, my sisters best friends cousins mom had a bay at 35 weeks and the baby is totally fine". Things and comments like that are the ones that get the laughs. Not being ignorant but choosing to be. Labor is a serious thing and when someone has all this expectations and denies even having an IV with saline water not even pit, it's when the problems start. It's like they say "it's not the same calling the devil but seeing it come", you could be having the best labor in the world, baby's heart drops and you continue to decline a c-section because it is not part of the "birth plan" keep that up and there will be no "birth". Also home deliveries with lay midwives who are not even nurses is another bad idea. But people still think it's ok. Yes, many, many years ago everyone was born at home, but how many of those mothers and/or babies didn't make it because in the middle of pushing they discover a prolapsed cord or that the baby turned and now it's breech. Now what? Birth plans can be ok. A woman should be ok to have her preferences but also needs to keep an open mind that things do go wrong and can change in a matter of minutes.
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Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.

The ONLY times I've seen women decline C/S in spite of a baby that looks bad is women in North African countries where C/S is culturally forbidden.

Even the most crunchy granola hippie birth mamas consent to C/S if their infant is truly at risk, in spite of the birth plan.

In the cases you describe, ADORN, it's not the birth plan that's the problem, it's the lack of education or informed consent that is the problem. As I've mentioned before, I LOVE birth plans, because it tells me that the couple has at least made an effort to do a little research about their preferences. I use it as a jumping off point to have a dialogue with my mothers/couples about what is SOP, what is preference, on what issues we have leeway, what issues are non-negotiable, etc. It's an opportunity to educate.

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Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.
Why is pit used so often?.

Impatience and lack of faith in the natural birth process. There are times when it's appropriate. Often it's used when it's not necessary.

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The thing about birthing plans are that they are contracts as to what all parties will expect from each other. There is one signatory who is absent, however, and that is the one known in nursing parlance as "the passenger."

I actually tell this to my patients. I tell them that I will read it, and then we discuss it. Every once in a while, it will be sensible, and just lets me know that these are people who have hopes, fears, and are cognizant of the fact that ultimately, the goal is a living mother-baby couplet. Sometimes, sadly, that is at the expense of having the birthing plan adhered to.

One recent case of a mother who was trying for VBAC resulted in her baby's demise because she did not want a repeat cesarean delivery, and all signs showed that not only was the baby in distress, but he was running out of reserves.

It wasn't her plan to have another cesarean. I don't think that it was her plan to have to make arrangements to bury her baby, either.

On the other hand, an experienced and knowledgeable Labor nurse is also going to be helping her patient to change positions for maximum comfort and best placental perfusion. This becomes easier when the nurses are not to take on two laboring patients, and at least one of them wants to try for unmedicated childbirth. Between teaching, comforting, and finding the fetal heart tones again, and, oh, how could I forget, charting all of these things, such that a lawyer cannot find fault with them, being creative is a lot to ask. Flexibility and charting are mutually inimical to each other, if you have more than one patient, and we often have two. "Tying'em down," with the monitor means that while you are not giving everyone the best experience possible, you are able to do what you are supposed to do. Staffing ratios do not take the needs of the staff and patients in mind, especially when a little thing like happiness is concerned.

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Specializes in Eventually Midwifery.
"Tying'em down," with the monitor means that while you are not giving everyone the best experience possible, you are able to do what you are supposed to do. Staffing ratios do not take the needs of the staff and patients in mind, especially when a little thing like happiness is concerned.

This attitude is a prime example of why hospital births can be so awful. In a hospital, giving birth is focused on what is convenient for the OB/Nurse/ hospital. Continuous fetal monitoring has not been proven by the evidence to lead to better outcomes for mom or baby- and as this nurse has pointed out, it allows him/her to "do their job," which has nothing to do with evidence based practice. It basically takes mom out of the equation, and along with her goes her personal health choices. A birth plan is designed to protect the integrity of her choices.

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I have never seen this. I thoroughly enjoy when my patients ask me questions, regardless of race, because it sows they actually cae and want to do the absolute best for their babies.

I am glad you have never seen this and I hope you never do. It still happens.

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As somebody who has lived in the South for my entire life, this is one of the most ignorant statements I've ever read.

Okay, I have to bite...what is so ignorant about what I said? Just because you have never seen it happen?

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Specializes in OB/GYN, L&D, Postpartum Couplet Care.
This attitude is a prime example of why hospital births can be so awful. In a hospital giving birth is focused on what is convenient for the OB/Nurse/ hospital. Continuous fetal monitoring has not been proven by the evidence to lead to better outcomes for mom or baby- and as this nurse has pointed out, it allows him/her to "do their job," which has nothing to do with evidence based practice. It basically takes mom out of the equation, and along with her goes her personal health choices. A birth plan is designed to protect the integrity of her choices.[/quote']

Hospital births can be "so awful" because CYA is the name of the game in this litigious society. Continuous EFM and well-documented interventions with category 2 and 3 strips is the only thing that'll keep the hospital, doctors, and nurses out of hot water legally. Patients want better care but with every lawsuit, they're driving the nurse away from the bedside and to the computer for more thorough charting ("if it wasn't charted, it wasn't done."). It's a vicious cycle. They don't want an IV until a life saving transfusion can save their lives. They don't want EFM until those prolonged, late decels with loss of variability convince them their baby is in trouble. They don't want PCN until their baby exhibits signs of respiratory distress after delivery. Everyone thinks nothing bad is going to happen to them...until it does. Then I've never met one mom who wasn't so very thankful for such a skilled medical team taking care of her and her baby. We're all on the same team guys. We all want the same thing - happy and healthy mom and baby and to fulfill as many birth wishes as are reasonably possible without compromising lives.

The unfortunate thing about this hostility towards medical intervention is it's driving women to consider delivering at home which can be very dangerous. Things can go from good to really tragic in less than a minute, and if something goes wrong, you may be too far from that medical help you've demonized for so long.

I feel the best and safest compromise is a hospital birth with a well researched, reasonable and flexible birth plan, never losing sight of the ultimate goal of a live and healthy mom and baby when it's all said and done. Patients need to realize they have way more rights than they exercise. If they have a hostile nurse when they present their birth plan, fire her. Ask for the charge nurse and request from her a nurse who is accommodating and supportive of birth plans. As you can see from this dialogue, nurses and their opinions, attitudes, and professionalism vary widely. If the nurse you've been assigned isn't a good fit, ask for another. It could be the difference between an awful hospital birth experience and a fabulous one.

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Specializes in Med-Surg.
And I don't want to be seen as someone who brings race into everything but at some hospitals, especially in the South, black patients who want to ask intelligent questions about their healthcare and medical treatment are treated very, very badly. I'm not talking about patients who only want to argue, threaten, or curse. There are patients who merely want information and are treated badly for not just shutting up and taking whatever the hospital dishes out.[/quote']

Hate to tell you, but as a Caucasian woman and nurse who ended up with a very unpleasant AA OB, when I asked intelligent questions about my care or *gasp* refused certain treatments I knew were unnecessary at the time, I was treated like an idiot and given attitude too. So I don't know how much of it has to do with skin color and how much of it is just docs with God complexes.

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Specializes in M/S, LTC, Corrections, PDN & drug rehab.

I've only been an LVN for 4 years & being an LVN not able to work in L&D. I'm pregnant with my first child & it just boggles my mind what mothers/parents request from reading this post. I don't have a birth plan, per say. But I do know what I do & don't want. I am flexible & know my baby's health comes first rather than any plan. Especially when things can go from great to horrible in the blink of an eye. I just wish I could have one of you L&D nurses as my own when I deliver.

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