RE: [ozmidwifery] Your thoughts on Birth Plans?

[Kelly @ BellyBelly]

Yes the ‘birth plans’ (and births!) under midwife care compared to those who are not varies in such a big way and unfortunately most Obs don’t really care what sort of environment we want to birth in, let alone read about it, because they will only be there as the hero at the end. My Ob clearly wasn’t thrilled with mine and completely deflated me when I gave it to him, making me think I wasted my time.   The preferences I have unfortunately are not written like the one you describe Andrea, I do encourage them to add more or edit to suit, but they are written for hospital birth without a known carer or much knowledge and are short sharp and shiny, because (and I am not saying everyone is like this as I know all of you on the list think differently, which is why we are all here) often staff in busy hospitals don’t read them unless asked, if at all. Many times I have asked the staff if they have read the preferences and they say, not yet, they will get around to it, and one time an Ob came bounding in DURING a contraction where mum was quite vulnerable. The Ob said, ‘would you like an epidural now?’ Of course mum couldn’t respond at the time. Me, in a cheery tone: ‘She’s doing such a great job, but thanks.’ Ob quite unimpressed with me and she replied: ‘I think she can make her own decision about that.’ Midwife and I looked at each other in frustration, then midwife promptly found a way to get the Ob out the room and told her to read the preferences which clearly stated, ‘Do not offer me pain relief as I am attempting a drug-free birth and will ask for drugs if I need them.’   The women I support who have Obs don’t get that great care and often have no idea where to start or what they can or can’t choose. Of course I can offer some education and direct them to books to read, resources etc., but it is up to the individual woman at the end of the day to do this! When they have little confidence in their bodies and think the system will look after them it’s particularly hard. I do also encourage private birth education and choices for childbirth but they obviously don't always run regularly and some women just can’t get in for when they need to or its not local enough for them.   Are you able to share a copy of the plan? I believe the birthrites site has a good one too. I also have discussed in my article the horrible internet based birth plans which have drop down menus and click n tick boxes and how restrictive and impersonal that is, I try to steer them away from it. Best Regards, Kelly Zantey Creator, BellyBelly.com.au Gentle Solutions From Conception to Parenthood BellyBelly Birth Support - http://www.bellybelly.com.au/birth-support From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of Andrea Quanchi Sent: Thursday, 22 June 2006 10:00 AM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] Your thoughts on Birth Plans?   Doesn't a plan indicate an intention and therefore the desired choice or preference.  They all assume women know there is a choice to make rather than the prescribed doctrine of someone else.   The organisation where I work has a proforma birth plan that attempts to give women spaces to write what they want in certain areas but it is deliberately vague in others like it is difficult to determine where one should write that they would like a physiological 3rd stage as it is assumed that active management is the norm and unless a women says she wants an alternative it will not be raised therefore there is no space for this to be written. It says 'do you object to you or your baby being given any medications that the doctor thinks are necessary type of thing. Still I find it useful when taking over the care of a woman who I have never met before who is already in established labour that I dont need to disturb her to have some idea what she would like to happen. My clients who are planning to birth at the hospital  are encouraged to fill them out with statement like I want to do whatever feels right at the time and will discuss any choices I am offered with my midwife Andrea.  They have some merit. Some women write a prescriptive plan for their labour and birth and they are so hung up on making it happen this way the are not able to listen to their bodies and I find this is an attempt by them to make up for the absence of a known car giver that they trust. I have never had one of my clients write a plan like this because we have discussed so much 'stuff' during the pregnancy and they understand the need to listen to their bodies in labour and do what feels right at the time   Andrea Q   On 22/06/2006, at 9:02 AM, Katy O'Neill wrote: Dear Kelly,  I like the idea of ' birth plans ' and encourage it when I conduct Antenatal groups.  I see it as a way to  have the woman and birthing supports give due consideration to all the options and give a credence to the fact that they do ( or should have ) choice.  Having said that, I get to see very few women who have made one.  Some colleagues however do not feel the same as they think it may set the women up to fail with unfulfilled expectations, and set ideas, not allowing for the range of possible labours.  The change to calling it by another name may give the midwives less concern as the word preference or intension sound less rigid than plan.  So I like the idea.  On a lighter side I did see a plan years ago that was so long ( 15 typed pages ) that I'm not sure there was time to read it all.  Not my women, but from memory, some of her plans were very fixed and not allowing for the vagaries of each women's labour and sadly I think not all went to her plan. I work in country NSW .  Katy ----- Original Message ----- From: Kelly @ BellyBelly To: ozmidwifery@acegraphics.com.au Sent: Wednesday, June 21, 2006 9:27 PM Subject: [ozmidwifery] Your thoughts on Birth Plans?   I am writing an article as we speak on birth plans (I prefer to say birth intentions or birth preferences and hopefully everyone else will too one day!) and I was wondering if anyone would be happy to comment from a midwife perspective?   I’d like to know:   What do you think of birth plans women are writing at the moment What do you think about it being called birth preferences or intentions instead, What you like and dislike when you read them – i.e. too long, too unrealistic or whatever springs to your mind   I won’t put your name to the comments so you can feel free to be open and honest about it, I would really love to add your perspectives if you are open to it. Thank-you in advance J Best Regards, Kelly Zantey Creator, BellyBelly.com.au Gentle Solutions From Conception to Parenthood BellyBelly Birth Support - http://www.bellybelly.com.au/birth-support   __________ NOD32 1.1613 (20060621) Information __________ This message was checked by NOD32 antivirus system. http://www.eset.com