Wednesday, February 02, 2011

Why birth plans exist

Two timely examples of why birth plans exist in our current maternity care system. Not necessarily that they guarantee anything--after all, the piece of paper itself has no magical powers.

A Normal Pregnancy is a Retrospective Diagnosis By J.D. Kleinke (thanks to Jill at The Unnecesarean)

The Feminist Breeder's description of Lifetime TV's "One Born Every Minute." 


  1. Just go to that "One Born Every Minute" page and see how the home page portrays women in labor. Those images with the little captions make women look like hysterical clowns and I for one find it to be extrememly degrading and horrible. You don't have to watch the show to see how birth is portrayed and the beliefs of the producers of the show. Women are characatures, disgusting.


  2. Kleinke's article illustrates EXACTLY what I have observed, too many times to count, among various friends and family members who want a natural birth. When a care provider presents them with a scenario that has a possible terrifying outcome -- and don't they ALL??? -- she caves.

    Seriously. Hundreds of births, over the last 15 years or so of my interest in natural birthing, this has almost invariably been the case. A woman is talked out of -- scared out of -- birthing naturally.

    Kleinke does bring up an interesting point, though: We Americans refuse to believe that some outcomes just won't be good, no matter what we throw at it. And, we often feel better throwing medical expertise at something, even when that expertise actually makes the situation WORSE!! We feel like we are actively participating in our health when we decide (usually under pressure) to "do something" about it.


    Food for thought.

    I have given the whole idea of birth plans a lot of thought over the last few days, due to your posts. I had a birth plan for my first: Gave it to my doc, who was 100% in support of it -- he was a low-interventionist who had a healthy skepticism of the American medical establishment. I went into labor nearly two weeks early whilst my doc was out of town, and my first was delivered by the on-call doc who gave me an unconsented episiotomy.

    IOW, a birth plan does not make for a perfect birth, even if one's expectations are well-reasoned and well-researched.

    Second birth was with a CNM who really was useless. She did nothing.

    It really wasn't until after my third birth, which was accidentally unassisted because the nurse didn't believe my friend when I sent her to tell the nurse that my baby was coming; I pushed him out with no medical staff in the room at all... AFTER that point, even though all three of my births had been unmedicated and with no interventions (save the episiotomy), no drugs, no pit, labor starting on its own, etc... Only after that did I gain the confidence and the knowledge to really know what I was capable of, and what I could really expect of myself and of my births. Although I had read and studied a bit, it wasn't until after that birth that I gained a real distrust of the medicalization of birth, and my own ability to really birth with no oversight. It wasn't until after that third birth that I really started reading up and researching about birth in America.

    This is an epic comment; I've been saving up my thoughts!!

    Birth plans don't make for great births. Education, experience, and a trusted team of care providers (which really is nearly impossible to gather), and personal support (husband, doula, whomever), and having the courage of one's convictions (SO RARE!), at least in my experience, is the key to having a normal/natural birth.

  3. I'm so glad that you're doing this series (is that even the right word?) on birth plans. It's at the forefront of my mind and both of those articles were really interesting. I was so wary of that 'One Born Every Minute' show and I'm not surprised to find out that I was right in my suspicions.

    However, they'll use the most dramatic and the most inflammatory cases because that's what sells tv. Yes, it's real and the cascade of interventions does exist but I hate the fact that this is what gets highlighted.

    I just wish someone would make a show about encouraging and empowering women and shining the light on those medical professionals that do, instead of giving time and energy to those that don't. But, such is life right?

    The scary and dramatic sells ads and money talks, end of story. :-(

  4. The UK version is much better (not ideal, but better). Some clips here

  5. I'm sure your Google alert tripped this today:

    “Deliveries are complicated,” Dr. William C. Hamilton, chairman of the department of obstetrics and gynecology at Meritus, said in an interview at the hospital, adding that no one wanted to be distracted. “I’m not a baseball catcher with a mitt, just catching a baby,” he said.

    Do you think a (hospital) birth plan could get away with saying,
    "Just catch the baby, I'll do the rest."


  6. Erin--I actually hadn't seen the article. Really interesting. And while some frame it in terms of safety, it's not really about the safety of mother & baby, but about safety from litigation. Look how almost every banning hospital mentioned potential litigation as the reason to ban filming.

    My birth plan is basically "leave me alone, stay out of my way, I'll catch the baby, and if I need anything I'll ask."


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