Why the birth plan blows up in your face

I was in a certification training course just this week for labor and delivery and nursery nurses.  Our instructor smiles during one of the lectures and says “Who knows what a birth plan really means?” and we all smiled and yelled “C-Section!” Which, I am afraid happens more often than it doesn’t for many moms who come in packing that dreaded sheet of paper…

I know, you have it all planned out in your head–you’ve followed all the online guides to the T and you’ve written it all down, discussed it with your birth coach and had it signed by your doctor. But honestly girls, that birth plan means squat to your nurse when you are in labor.  It’s a bit of a soapbox for me, but listen to me closely…if you don’t want to me monitored, don’t want your water broken, don’t want Pitocin (can’t say I blame you there though) and want to deliver hanging from the light fixtures, then don’t come to a hospital to have your baby. Instead, seek out a birthing center, or do it at home with a trained midwife. I know, home births are quite risky and that’s another blog entirely, but hospitals and medical care that is delivered there is focused on prevention and treatment. Pregnancy is not an illness, I know that. But many people treat it as such. And I’m afraid many labor and delivery units are the same way–simply because they have to be prepared for anything.

Monitoring is essential to know when and if your baby goes south…and I don’t mean down toward your feet. I mean, there may be a complication that you won’t “just feel”–it  must be seen on a monitor and treated in order for you and your baby to have the best outcomes. You can have a plan if you must, but know and understand that those plans go straight out the window the minute something changes.  I can easily say that I have only cared for one or two mothers who actually had a birth that went according to their documents. Everyone else ended up with the most invasive, complication-riddled Cesarean Section you could imagine.  Their babies, that they wanted to have no bath, no vaccines and no invasive care ended up in the NICU on a vent and clinging to life–and it just happens.  Sure, we nurses joke about how freaky it is that it turns out that way, but it is very upsetting to parents who had their heart set on something completely different.

Birth plans are not really birth plans.  Confused? In reality, they are a mother’s attempt to maintain some sense of control in a situation when she has none.  Labor is one of the few events in life, aside from death that happens to us whether we are willing to go through it or not. And that’s really scary for a lot of women. I can absolutely see why having a birth plan might bring you a sense of reassurance and I hope for you that it works out that way.  (Am I a pessimist today or what?)