I'm confused too, because why dont people prepare a birth plan and give it to their OB, midwife, birth attendant, support people etc, so if they cannot speak on their behalf due to pain or tiredness they can speak on their behalf about their request and have them listened to. Furthermore, it should be mandatory and mentioned at the pregnant womens first visit to the hospital or shared care or OB to have a birth plan whether you do public or private hospital births. And personally thank god for Belly Belly who I found on the Web when pregnant with my first child so I was able to prepare myself with all the information and birthplan etc.
Belle while a birth plan is good tool it is not, and should never be used as, a substitute for making choices (about caregivers and birth places) that are congruent with how you want to birth.

I get very nervous when I hear birth plans being talked about like they're a sort of "insurance policy" or first line of defence against the things you don't want. In fact, they are a last defence. Your very first defence is making smart choices to minimise the likelihood of your having to deal with these things blindsiding you in the birthing room. And you cannot make those choices in an informed way without having some idea of what your odds are of having those interventions with the obstetrician or hospital you are using.

And it is often not a matter of just having these things on your birth plan and they are automatically respected either. There is a massive power differential at play in hospitals and women and their partners are not on their own turf. This means they are usually less confident in their decision making, less assertive with "authority" etc...lots of issues for many people here.

At my parenting class before my first birth I was given the stats of rates of c/s both emergency and elective at my private hospital. Pity they dont seem to do the same thing in the public sector.
Belle this actually fairly unusual. The public sector is more transparent because they are run by the government and by extension tax payers. So the Health Department requires that public hospitals disclose their stats. There is no such onus on private hospitals.