Posted by My OB said WHAT?!?.
Jul
2
Posted by My OB said WHAT?!?.
“…The People Who Insist On Following Their Birth Plan *ALWAYS* End Up With A Cesarean…”
“Of course we support birth plans, we want you to have the birth you want! Just don’t be too rigid about it. The people who insist on following their birth plan *ALWAYS* end up with a cesarean section!” -OB to mother.
There are 35 comments to this post.
Alyson Miers had this to say,
Jul 2, 2011 @ 3:19 pm (Quote)
I keep hearing this meme, at this site and other birth-related ones, that birth plans inevitably lead to c-sections, and the only conclusion that I can draw from it is that the L&D staff punish women for presuming to be in control of their birthing. That’s pretty much the idea behind the “warning,” too: if you try to set the terms of how you approach childbirth, you will suffer the consequences. Just do everything we say and we’ll let you off easy.
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Jena Reply:
July 2nd, 2011 at 3:29 pm (Quote)
That’s the explanation, but it still doesn’t make any sense at all. “We’re care providers! We care! Until we have to punish you.”
The floggings will continue until morale improves!
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Alyson Miers Reply:
July 2nd, 2011 at 6:13 pm (Quote)
It makes sense if they see themselves as parental figures and pregnant women as small children who can’t make their own decisions and need to be kept under control.
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Sarah Dorrance-Minch Reply:
July 2nd, 2011 at 6:37 pm (Quote)
According to Barbara Ehrenreich and Deirdre English, that is EXACTLY what most obstetricians and assorted maternity care providers think.
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Evelyn Reply:
July 3rd, 2011 at 11:33 am (Quote)
I had something similar said to me, but not in a “do what we say or we’ll punish you” but “you can write up a detailed birth plan and we’ll keep it in mind, but please keep in mind that birth can go far differently then you might want”. As in, birth can’t be tightly controlled. Perhaps some care providers mean something like that when they say it?
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Kathryn Reply:
July 3rd, 2011 at 1:10 pm (Quote)
If that’s what they mean, then that’s how they need to say it. Again the need for etiquette lessons for birth professionals!
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Alyson Miers Reply:
July 3rd, 2011 at 2:11 pm (Quote)
That’s quite a different message from “If you insist on following your birth plan, you WILL have a c-section.” What I hear even more often is just to skip the “insist on following rigidly” part and go straight to, “IF you make a birth plan (at all), you WILL have a c-section.”
Even while keeping in mind that birth can’t be controlled and complications do happen, surely there are some women who have normal, healthy labors and have the physiological births they wanted. Surely, birth plans can be written in a way that allows for the possibility of complications.
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And if you use that very short birth plan that runs around online? “I wish to be treated with respect, and I will respect you. Please inform me of your planned interventions so I can make a decision about them.”
Or is it that some staff members like the freedom to do whatever they want to the parents, and if the parents have a “birth plan” then they have to break the birth plan just to prove they were in control all along? If not in little ways, then in the biggest way?
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Sarah Dorrance-Minch Reply:
July 2nd, 2011 at 4:46 pm (Quote)
The latter. I’m pretty sure it’s the latter.
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Funny, I know a woman who had a natural non medicated vaginal delivery of her twin girls about 10 days ago. She had to fight for it but she stuck to her birth plan and didn’t let them do anything that she hadn’t said in her plan and she had them fine. Even had the babies while squating beside the bed with only a midwife in the room. They did try to bully her into doing things but she stood firm. the only thing she couldn’t do was birth in water, she let them have that win.
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Sarah Dorrance-Minch had this to say,
Jul 2, 2011 @ 4:45 pm (Quote)
Ancient fortune say: Always beware of care providers who see birth plans as challenges to their authority.
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Cassaundra had this to say,
Jul 2, 2011 @ 5:09 pm (Quote)
hmmmmm. threats of grievious and permanent bodily harm and possible death of self and loved ones unless complete capitulation is demonstrated? sounds like several criminal offenses to me! uttering threats, unlawful confinement, and since she’s a woman and this is about her sexual organs, sexual harassment! which should we do first? revoke your medical license or put you in jail? do you have a jail plan? because you know…..the ones with a jail plan ALWAYS get sodomised by a gang of thugs!
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Sarah Dorrance-Minch Reply:
July 2nd, 2011 at 5:28 pm (Quote)
None of the above. As a pregnant woman, she is assumed to be “hysterical” (wandering womb, temporary insanity) and also a mere vessel for her far more precious cargo, the unborn baby. Cue the paternalistic court-ordered c-sections and the birthrape. If she tries to press charges, she’ll be told that the hospital followed protocol, the doctor provided the “standard of care,” and the baby survived, so nothing else matters.
Which was why my birth plan for my youngest two children was “stay at home unless terrible emergency arises.” It was easy enough to follow that plan.
Birth plans in general are only useful as ways to help the mother think about what she envisions birth as, and to facilitate communication between her and the care provider. Unless you roll them up and use them to beat medical profesionals about the head, they are lousy forms of protection against unwanted interventions. Even then they aren’t all that useful. As opposed to, say, closing the door to the LDRP room and blocking it with some furniture.
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Carly Reply:
July 3rd, 2011 at 8:37 am (Quote)
Do you think it would be more useful to have a list of “I do not consent to…” statements as the “birthplan” and get your OB(s) to sign it well before labour? The idea would be to establish clear refusal of consent so that even if the OB later claimed that an intervention was necessitated by an emergency situation and the woman was incapable of consenting because she was in labour, he would still have no legal justification to proceed.
I’m not sure how effective that would be, but it would seem to be more effective than a lot of “We would prefer to X, unless you really feel that Y is necessary”.
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Sarah Dorrance-Minch Reply:
July 3rd, 2011 at 8:45 am (Quote)
More useful would be interviewing your care provider at the start of the relationship, and firing him/her if your care provider’s views are incompatible with yours.
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Jane Reply:
July 3rd, 2011 at 10:14 am (Quote)
I’m not very good at telling when people are lying to me. Many people aren’t, and most of these doctors genuinely believe they are only doing these interventions when absolutely necessary, and that these interventions happen to be necessary 99.87% of the time. Meaning they’re very convincing when they say exactly what the mom wants to hear. Of COURSE we’ll try to give you as natural an experience as possible! Of COURSE we would only do these things if necessary! Don’t worry — I’m your doctor! I’d never hurt you!
Then birth comes and all that flies out the window because they believe it’s all necessary and you’re just being difficult and “natural” is any birth where the baby doesn’t come out the mom’s nose.
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Hmm, that’s funny, my birth plan was basically just “avoid unnecessary intervention” & I didn’t get a c-section.
But maybe that’s because I didn’t write it down & instead explained my wishes in detail over the several months of my pregnancy.
Or maybe it’s because instead of an OB, I hired an independant midwife for a (trialled) homebirth & when I did have to transfer, I had a whole “birth army” to protect me when the OB on duty started insisting I needed a c-section before even looking at my chart/paperwork/readings from the machine that goes ‘ping’.
I think it was the latter 
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Of course we support birth plans, Just don’t be too rigid about it, because if you fight us, we’ll fight back and we’ll win – with the ultimate – a cesarean section! And then we’ll rub your nose in it afterwards by making you *thank* us for “saving” you!
*barf*
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You know, my nurses followed my birth plan. My doctor came in and gave me an episiotomy without my consent. Then again, I have a vaginally delivered son, so did I just turn down the wrong hallway or something? Was I supposed to go to the surgery wing rather than labor and delivery?
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Me again! This was actually at the same preconception visit as the “Don’t temp, you’ll ovulate on day 14″ comment from a few days ago. I had gone in armed with a list of questions I wanted to ask my OB, like c-section rate, episiotomy rate, etc. As I said there, she tried to get out of the room within a minute or two of walking in. I got the critical things out of the way (what do I need to do before TTC, pain meds) and then instead of going down my whole list asked her this literally as she was gathering up her stuff and walking out the door. She said the above with a sincere smile and left. She seemed to think she was being nice by letting me in on this secret so I wouldn’t make the mistake of trying to keep any self-sufficiency or involvement in my birth.
This was the final cue to find a new care provider for my births when I end up pregnant! I had been thinking I wanted a midwife before the meeting, but she had been a really good GYN and when I first started going several years ago took all kinds of time to talk with her patients, so I wanted to give her a chance. Now I will be looking for a midwife. I want someone who views my birth plan as OUR goals, not MY goals.
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Charity had this to say,
Jul 3, 2011 @ 12:58 pm (Quote)
My midwife said something similar to me. She said, “The women who are so against c-sections are the ones who end up getting them. You can’t be against any interventions here.” That was before she witnessed the miracle of natural birth. My son was her first.
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Kat Reply:
July 3rd, 2011 at 2:42 pm (Quote)
Are there REALLY women out there who are completely against c-sections though?
I know women who had previously never had a c-section, and prefer natural birth, who had c-sections due to a severe condition requiring surgery immediately after birth, due to placenta previa, due to the baby being breech with the cord tight around the neck (and pre-term labor), and that’s just 3 of the people I know who have had medically very necessary c-sections.
I don’t think I’ve EVER met a woman who is against all c-sections ever for any reason. I know plenty who are against unnecessary c-sections, myself included. I wrote up a birth plan that was about a page and a half last time. Of course I gave birth 15 minutes after walking into the hospital, but I didn’t have a c-section!
I think your midwife would not like me, since no one is allowed to be against “any interventions” according to her. I’m against routine episiotomy, premature cord clamping, routine use of pitocin just because the mother’s labor isn’t progressing “fast enough,” and against constant fetal monitoring as intermittent has been proven sufficient.
I guess I’m just “lucky” I didn’t end up with a c-section every time. It boggles the mind that a MIDWIFE of all people would not grasp the concept. Sigh.
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Charity Reply:
July 3rd, 2011 at 3:18 pm (Quote)
I think, given all the interventions doctors and CNMs insist on is what makes the c-section rate so high here. They make it nearly impossible to have a baby naturally anymore. It’s hospital policy to have an OB in the room at least once during a delivery with a midwife. That OB gives you all the risks of having the baby naturally… Pain being the biggest risk. “Why would you want to suffer when there’s proper pain medication out there? This isn’t the 1500s you know…” I’ve heard so many horrible things come from these doctors. No actual benefits to their interventions, only risks of doing it my way.
I do have to say that I’m against any unnecessary c-sections. The OB my midwife worked for has a 50% c-section rate and he swears they are all medically necessary. When asked to explain those reasons, he refuses to answer. He has a deep disrespect for any woman who wants to actually learn something about her body. He also has a deep disrespect for anyone who doesn’t have MD after their name. I’d like to think that no one actually plans on having a c-section, but I think so many OBs put that thought in the back of their patients’ minds. I’ve overheard several say, “There’s a good chance you’ll need a c-section. No need to worry about it though. There are very few risks.” WTF? I can’t trust a doctor who says that to anyone! To minimalize it like that makes all those poor women who’ve been forced into a c-section by all those “necessary interventions” think it’s ok. It’s NOT ok.
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Cassaundra had this to say,
Jul 3, 2011 @ 7:09 pm (Quote)
well, since i had my first back in 1992, before the c-section rate skyrocketed and since it’s the first birth that has the highest risk of being an unecesarean, i have been lucky to have five vaginal births. i do mean lucky because i wasn’t fully educated and there were many places where the births could and should have been handled differently. and I now believe that my first birth, which was mid-forceps, (and nowadays would almost certainly have ended up as a section) wouldn’t have been problemmatic if i had had a good doula.
all that said, and my own presumption at theorising a situation i have never been in, i think i can say that i am that woman who would never have a c-section. i discussed it with my first husband before i gave birth the first time and made it clear to him that if it was a choice between c-section and death, i preferred to die. and yes, both my child and I. it was what i wanted. i absolutely REFUSED to go under the surgical knife, period. at all. ever. no-one has even mentioned the possibility of such a thing to me since, perhaps because with every vaginal birth it became less of an issue. clearly i can birth just fine. and i would be conflicted if i had children already alive, about dying in birthing another. but my gut still says, outside of any logic or rationality, that i would MUCH rather die than be gutted like a fish, while tied up, in front of an audience. death is no big deal, it happens all the time. but i simply would and could not survive the trauma of a section. some women are able to survive that and i applaud them, but that is not a strength that i have.
so yes, i think there IS a mythical woman who would absolutely refuse a section no matter the consequences. me.
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Add Your Comment.
Even if this were, in fact, true on an anecdotal level, it makes no sense. Unless someone’s birth plan included a scheduled or emergent c/s, following the birth plan exactly would never end in a c/s. Only deviating from the plan would.
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