Jan 6

“You Know What We Call People With Birth Plans…?”

“You know what we call people with birth plans? Cesarean Sections!” -OB to mother during prenatal when asked to discuss birth plans.

139 people dislike these words.

There are 22 comments to this post.

Lauren had this to say, Jan 6, 2010 @ 4:57 am (Quote)

Ugh, what a pig.

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Thomasin had this to say, Jan 6, 2010 @ 5:00 am (Quote)

Was that a threat? Or did the provider really believe that someone could “interfere” enough in her own labor that there would be a *need* for a c-section?

Either way: a FAIL.

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Jane Reply:
January 6th, 2010 at 9:16 am Jane(Quote)

Sure, a woman could interfere in her own labor enough to stop it. She could put herself flat on her back, tethered in place, in a bright, noisy place, deny herself food and drink and surround herself with insensitive clock-watchers who leave her unable to relax. :-b

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Jane had this to say, Jan 6, 2010 @ 5:08 am (Quote)

Well, it certainly sounds as if SOMEONE has plans for how birth ought to work!

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Debbie P. had this to say, Jan 6, 2010 @ 5:24 am (Quote)

At least Dr. said it at a prenatal, so she had time to run, run, as fast as she can!!

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KDB had this to say, Jan 6, 2010 @ 6:03 am (Quote)

You know what I call OBs who say things like this to me?
Fired!

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Dawn had this to say, Jan 6, 2010 @ 6:19 am (Quote)

Lovely. Hmmm…know what we call doctors like you? “MY FORMER OB”

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mommymichael Reply:
January 6th, 2010 at 7:30 am mommymichael(Quote)

took the words right out of my mouth!! But I think yours were kinder.

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Alyssa Reply:
January 6th, 2010 at 12:28 pm Alyssa(Quote)

Why yes, she IS my former OB! I wasn’t smart enough to fire her immediately (I honestly didn’t know there were other options) but I did find other options with my second.

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Wendy had this to say, Jan 6, 2010 @ 7:02 am (Quote)

Oh, that’s cute. If women want some say in their maternity care, let’s go ahead and punish them with cesareans.

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mamasara had this to say, Jan 6, 2010 @ 9:13 am (Quote)

but, I’ve read so many nursing blogs where the L&D nurses say the same thing. What is so wrong with wanting to have some control over what goes on in your vagina and with your baby?

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Dou-la-la had this to say, Jan 6, 2010 @ 11:41 am (Quote)

KDB and Dawn, RIGHT ON!

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Rebekah had this to say, Jan 6, 2010 @ 6:55 pm (Quote)

My friend had a nurse say this to her when she was admitted to the hospital in labor. She then had to deal with the OB threating her with a court order for a c-section since the baby was breech and she would not consent to one. While the doc was out getting the court order, my friend pushed her baby on out.

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Knitted in the Womb had this to say, Jan 6, 2010 @ 10:13 pm (Quote)

I’d like to see a study done on the cesarean rate in women with birth plans compared to those who don’t have them. Just looking at the cesareans in my clients compared to the local cesarean rate, I can say that my clients (who are probably more likely to have birth plans than the women in the general population) have a lower cesarean rate.

I hear this kind of comment too though. Actually, in one hospital I advise my clients NOT to submit a birth plan since it will be actively undermined, no matter what they request.

I think the issue with care providers who make comments like this is one of selective observation. When a woman submits a birthplan, suddenly the care providers are watching to see how the birth turns out. When it ends in cesarean, they “notice” it more than when it turns out more along the lines of what the mother wanted.

They don’t really notice that women that *don’t* have birth plans are probably having cesareans more frequently than those who do.

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Kat Reply:
January 7th, 2010 at 7:34 am Kat(Quote)

Wow, that is sick that the nurses would actively undermine a patients birth preferences.

I wonder… I would be tempted to submit a “dummy” birth plan once, requesting that the nurses offer drugs constantly, saying that I wanted to be in the bed with constant monitoring, and that if I was in labor for more than 8 hours I wanted a c-section immediately. >.<

(I have never had active labor last longer than 8 hours with the exception of my unnecessary 39-week induction with my first. I tend to have a few weeks of prodromal labor followed by 4-5 hours of intense active labor).

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Wendy Reply:
January 7th, 2010 at 8:53 am Wendy(Quote)

You won’t see any such study, Knitted. An alarmingly high amount of obstetric practice is anecdote-based, not evidence-based.

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Knitted in the Womb Reply:
January 7th, 2010 at 9:19 am Knitted in the Womb(Quote)

Wendy: You won’t see any such study, Knitted. An alarmingly high amount of obstetric practice is anecdote-based, not evidence-based.

Oh, I know, but one can dream right?

Actually, it would be a perfect thing for Childbirth Connection to look at in their next “Listening to Mothers” survey (I hope they are going to keep doing them?)

There actually was a small study done on the “homebirth transfer train wrecks”–another stunning example of anectdotes driving OB beliefs. Apparently a hospital approached a university researcher–U. of Minnesota if I remember correctly…SHEESH, I should have kept a copy of that article!, and asked her to document the frequency at which homebirth transfers were traumatic situations.

What the researcher found was that it wasn’t happening all that often, that most homebirth transfers were for pain meds or other “non-emergency” situations. BUT….the OB’s would inflate the situation when they told their collegues. So often within a matter of just a few days after the transfer occurred, the staff at the recipient hospital would all be talking about the woman who “transferred in last week on death’s doorstep.”

It wasn’t long after that came out with ACOG had that gaffe with people discovering they were soliciting homebirth transfer horror stories on their website. I guess whoever initiated the original study was hoping that if they just widened their “net” in trying to find the horror stories, more would come pouring in. Funny, but I haven’t heard ACOG publishing a huge list of them….

Kat: Wow, that is sick that the nurses would actively undermine a patients birth preferences.I wonder… I would be tempted to submit a “dummy” birth plan once,

Kat, this kind of behavior I think is more widespread than folks realize. The nurses sometimes take birth plans as an “affront” to their authority. Blech.

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Wendy Reply:
January 7th, 2010 at 2:23 pm Wendy(Quote)

Ah, yes! LOL! I remember that “study” that ACOG was launching. I heeded the action alert from the childbirth reform community/blogosphere and entered my natural, normal home birth. In the comments section, I entered: “Good luck with your fishing expedition.” ACOG probably fired whatever PR genius made that little gem public.

If you find the original “train wreck” study, I’d love to see the abstract! And you’re right about Childbirth Connection. You should pose that suggestion to them that they survey women on their experiences with birth plans.

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Courtney Reply:
January 8th, 2010 at 5:55 am Courtney(Quote)

This is exactly why I never had a birth plan, but did discuss everything I wanted with my MW. The nurses in the hospital had no idea what I did and didn’t want so they couldn’t plan how to undermine me ahead of time. The MW did know what I wanted and she was fine with it and I knew she had delivered many babies before me in the same way (intervention free, as natural as possible, whatever position you want etc.)

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Becky had this to say, Jan 20, 2010 @ 9:03 pm (Quote)

My OB said this to me! I thought he was joking. It wasn’t until I was admitted for something else, and tried to leave the hospital WITHOUT a c-section at 38 weeks that I realized he wasn’t. Oops. My bad. Next baby? Free-birth.

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