Posted by My OB said WHAT?!?.
Jul
14
Posted by My OB said WHAT?!?.
“…Let’s Just Get This Baby Born…That’s A Good Plan.”
“Pfft…birth plan, I know a good plan for your birth. Let’s just get this baby born, ha ha, that is a good plan.” – OB to mother asking to discuss her birth plan.
There are 28 comments to this post.
Alyson Miers had this to say,
Jul 14, 2010 @ 4:37 pm (Quote)
I’m sure that doc thinks s/he’s SOOOOOO effing clever.
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I bet this guy is a hoot all the time. “Oh, honey, why do we need a shopping list! As long as stuff gets bought, it was a great shopping trip!”
“Oh, boss, why do we need a budget plan? Let’s just get these bills paid–that’s a good plan!”
Right?
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This totally sounds like the doctor is laying down the groundwork to pull the injured/dead baby card during the birth and the “at least you have a healthy baby” line after the cascade of doc pressed interventions leads to something mother didn’t want and baby probably didn’t need.
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This wasn’t mine, but I actually think my OB said this to me with my first child… at 34 weeks… (when I couldn’t fire him according to my insurance) when he had been awesome and supportive up until that point. And after that, he was nuts. I need to get my stuff together and submit some of the wacky off the wall stuff he said after that.
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I think it is time to drop the term birth plan. the best laid plans of mice and men ya know… I’m thinking personal care policies. A list of things you do and do not belive in with “I will permit” and “I will not consent to.” Plans can change with changing circumstances. Policies exist to deal with all contingencies.
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Jane Reply:
July 15th, 2010 at 5:06 am (Quote)
I like that. A Birth Consent Sheet. I consent to a routine episiotomy; I consent to a tear; I acknowledge the minuscule chance that I may aspirate if I eat or drink something during labor but I accept that chance and will be eating anyhow. I do not consent to being confined to bed. I do not consent to being asked 3208947389478920 whether I am really sure I don’t want that epidural now at 8:04AM even though at 8:03AM I said I didn’t want it. I do not consent to cervical checks every time someone walks by my room. I do not consent to the machine that goes ping. I do not consent to my doctor having a hair appointment or ball game tickets within twenty-four hours of onset of labor. 
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CCindy Reply:
July 15th, 2010 at 6:22 am (Quote)
I’m assuming that you meant that you do NOT consent to a routine episiotomy.
I think a policy statement would be a great opportunity to sneak in some evidence to support each decision and educate a few doctors.
Plus I would love to hear somebody’s very protective and educated huband say, “I’m sorry that is against our policy.” And watch the medical staff wet their pants.
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Sarah Dorrance-Minch Reply:
July 15th, 2010 at 8:37 am (Quote)
Something tells me doctors and hospital staff would pay about as much attention to a consent sheet (even a really legalistic-looking, highly technical, full of waivers, sign-in-triplicate form written in print fine enough that it needs to be read with a microscope) as they do to birth plans.
“Very good. We’ll add that to your file and keep it in mind when you come in for your labour. Just remember, if we feel there is an emergency situation or something else putting the baby’s health at stake, we will need to talk about other options… if there is time to even do so. Remember, all that matters is a healthy baby. You don’t want to have a dead baby because you were rigid about your birth preferences, do you?”
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Jane Reply:
July 15th, 2010 at 8:40 am (Quote)
BIRTH IN THE YEAR 2025:
“My name is Jane and I’m here stating my intention to give birth in the labor and delivery unit of Memorial Hospital of West Cupcake. This is *****, my husband. This is Audrey, my doula. And this is John Smith III, esquire. All conversation with me will be conducted through him, and here’s the documentation entitling him to sign all my paperwork for me. You can also perform all the DVEs you can justify on him, but none on me. Now if you don’t mind, I’ll be filling the labor tub.”
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Sarah Dorrance-Minch Reply:
July 15th, 2010 at 10:11 am (Quote)
Ooh, are we talking AGENT Smith, from _The Matrix_? If I had to give birth in a hospital setting for a nonemergency reason (which would never happen, I would only use a hospital for a real emergency at this point, but let’s get hypothetical) then yes, by all means. I would LOVE to have a bodyguard stationed outside the door, ready to go all ninja on control-happy doctors, bossy nurses, etc. In fact, I’d probably want the bodyguard more than the doula, antisocial birthgiver that I am. Sign me up.
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CCindy Reply:
July 15th, 2010 at 11:41 am (Quote)
Jane, I love the term West Cupcake.
As far as a bodyguard, that is what the 6’3″ tall husband is for.
Birth plans are useless and do seem to be a red flag in the face of the Jekle and Hyde types. In my experience I assumed that my first doctor understood that his job as lifeguard was to keep his hands to himself until it was time to catch. Boy was I wrong! And with the second, I know I got lucky, but we just clicked. I found him through recommendation from midwives. He was their back up. I told him I wanted a VBAC. I was also studying to be a childbirth educator. I would take my books with me to appointments. I never wrote up a birth plan.
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Rebecca Reply:
August 6th, 2010 at 11:55 am (Quote)
I love my husband, but he’s no bodyguard. After my daughter’s birth he said “I guess I should have said something when they started putting stuff in your IV” (I was given pitocin without it being discussed) Actually, he’s very “follow doctor’s orders” in general, and likes the idea that someone is doing something
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Alright. Let’s just wing it. Just remember that I’m calling the shots. Wait, what? You thought you were? And now you think a “plan” might not be such a bad idea? (cause what you had in your head wasn’t a “plan”, it was just good, evidence based medicine according to the contingencies? Yeah, right).
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Sarah Dorrance-Minch had this to say,
Jul 15, 2010 @ 8:51 am (Quote)
Like Cynthia, “let’s just get this baby born” is how I approach birth, too… provided I am the one calling the shots and do everything my way. I find birth plans to be useless.
First, because all the reading I’ve done suggests that the vast majority of professionals in the obstetric field laugh at them or ignore them or use them to justify railroading the mother into an unwanted c-section. Needing a birth plan to me is a red flag that you don’t trust your caregiver to honour your wishes and needs if you vocalize them during labour. About the only situation I could see that might be useful would be agreeing in advance (if that is what you want, anyway) that during transition, when you are at the point of giving up and start talking about medication, to ignore such requests. And even then I think an agreement to use a safeword would work at least as well as a written birth plan, if not better. Bottom line is that the caregiver and the mother need to leave communication lines open, and the caregiver needs to follow the mother’s lead, only stepping in to intervene if there’s a medical emergency.
Second, because the way *I* labour (wham! bam! thank you, Mom! congratulations!) leaves no time for birth plan elements such as bouncing, walking, etc. With me, I walk around in prodromal labour for a couple of weeks or so (btw: I’m not sure, but I think I MIGHT be just starting to efface, which means, if it’s the case, Catharine will be coming out in a week or two. Then again, she could just be head butting my cervix. Not a clue) and then hang on for dear life for an hour or two while my uterus and cervix do all the work, which feels like instant transition, and whatever birth dreams I might have get simplified to three little words: “Leave me alone. AAAAAAAAAIGH!” Okay, maybe four little words. Is AAAAAAAAAIGH a word?
And yes, like Cynthia, I suspect most mainstream birth professionals, faced with this approach (let’s just do it; by the way, you’re doing it my way or the highway) would prefer a written birth plan that has plenty of aromatherapy drums, chanting doulas, twinkle lights, and carefully written and mostly meaningless instructions.
On a side note, was that doctor actually LAUGHING AT the mother above? What a charming specimen. Just what every mother wants from her care provider: belittlement. I hope there’s no extra charge for the service.
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Vallery Reply:
July 15th, 2010 at 9:33 am (Quote)
There’s gotta be an extra charge – why else would the procedure be so routine?
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CCindy Reply:
July 16th, 2010 at 5:43 am (Quote)
I’m thinking writing up a birth plan tells the doctor exactly what you are most afraid of. Then of course he can choose to use that against you. If I wrote up a plan that said I will be checked once upon arrival at the hospital for prolased cord and again when I feel the need to push. Well bingo you now know that a fear prolapsed cord. Now you can tell me that while I’m not prolapsed the baby is floating very high and could prolapse at any time and if my water is broken it is important that I not walk around, but stay in bed with continuous fetal monitoring…Road map to c-section. Not exactly how it happened, but you get my point.
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I’ve always hated the term ‘birth plan’ too. I did write up a list (with short discriptions of reasoning, understanding of risk, or evidence where applicable) of practices I did and did not consent to, a short opening declaring my right to informed consent for myself and for my baby as her ‘natural and legal guardian’ and giving my husband proxy. The doctors just glanced at it, until they saw that I had a place to sign stating that they had read it, then they very carefully went back and actually read and discussed it. I have found doctors take very seriously what you make them sign! (Most of it was abided by and the part that wasn’t had more to do with how fast everything was going than anything else, I was in the hospital less than an hour and most of that was in the admittance rooms. I got to the l&d suite maybe 15 minutes before the birth)
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Writing a birth plan gives you an opportunity to think about and discuss with your partner and your healthcare practitioner how — ideally — you’d like your baby’s birth to be handled. Even though there’s no way you can control every aspect of labor and delivery, a printed document gives you a place to make your wishes clear. Just remember that you’ll need to stay flexible in case something comes up that requires your birth team to depart from your plan.
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Lets discuss your job status Mr. Doctor..
Fired!
Hope your birth went to plan OP.
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