Are birth plans a waste of time?

[BellyBelly]

I think it is a problem at the moment where people are hiring a doula (through good word of mouth etc) but they expect the doula to do all the work/fix/prevent everything. But they can't. They cant prevent things happening as a result of your choices. We are not miracle workers but we try our best to work in all situations, with what we have.

[Smoke Jaguar]

Reminds me of education - people pay school fees and expect teachers not only to educate their children, but to teach them morals and good values, manners, and set them up for stellar academic careers. The crux of my parallel here is that money can't substitute for responsibility.
I'm worried about the whole "that's what I've paid for" wrt doulas. We only pay for them now because they are not to be found down the road from every birthing woman, the way these birth support women were years ago. Nowadays, because women have been separated from that art, they have to pay for training and, now, travel expenses. You don't pay a doula to be your prize-fighter - they're not your birthing 'heavy', as a job description. To me, a doula is there to keep you 'in the zone' primarily, during birth, adhering to your values as much as circumstances permit.

[*Efjay*]

As long as "as a rule" Doulas do & will speak up when needed. I don't expect a doula to go in with all guns blazing but as long as something is said when it needs to be then great.
I know creating conflict issn't the answer, but I just didn't see it as creating conflict if you are simply voicing whats int he birth plan for something like being told the details of progression.

It sounds as though a Doula is going to do what I would expect of them. I have just put across what I want wrong. I agree that conflict would be unproffesional & going the round about way is better.

This is the main reason I don't feel I need a doula, because I will happily stand up & kick & scream if somethig I don't want or feel I need is being pushed on me.
Perfect example was with Isla, the Ob wanted to break my waters the morning of the evening she was born when I went in for montioring due to being 12 days over. I pretty much told him to get stuffed & would do so again.
Even with my first birth I went in with what I did & didn't want firmly placed in my mind. Yeah it was a long, terrifing labour & birth as it was my first. But I wasn't going to be pushed in to drugs I didn't want. But back then I was just using my stubborness to get me through. Now I use my knowladge & expereince.

[Smoke Jaguar]

I think the good thing about talking my birth plan through with my midwife team at the FBC, and DP knowing it back to front, was that by the time I was in labour, everyone knew where everyone stood and I could get on with producing endorphins - there is no way I would want to leave any room for having to stand up for myself, because that would take me away from my peaceful birthing. Had I been going into a maternity ward, I would have probably had a doula to help keep me in endorphin-mode, and DP could do the fighting for me!
Labour is not a time I ever want to have to rely on my tenacity - and there aren't many people who'd say I don't have gumption!
We didn't have a doula for DS's birth. In hindsight I probably didn't need one whilst labouring at home, I was happy to just withdraw and use what I had practices from HypnoBirthing. The way we wanted it was that we would arrive at the FBC ready to birth, and we did. Our birth plan was, admittedly, not a problem because most of what it dealt with was rendered irrelevant by having laboured entirely at home! Everything else was in line with the FBC philosophy, as I've said.
My point is that I did the hard yards before the birth to ensure my birth plan was workable.

[tsgirl]

The benefits are huge. From 16 studies around the world:

Labour Statistics
? 50% reduction on caesarian rate
? 20% shorter labour
? 60% reduction in the need for epidurals
? 40% reduction in forcep use
? 40% reduction in Syntocinon use (induction)
? 30% reduction in analgesia use (narcotics)

Benefits for Mothers
? Better bonding with baby and partner after birth
? Lower rates of Post Natal Depression
? Higher rates of successful breastfeeding
? Greater sense of achievement
? Greater sense of support
? Greater satisfaction with her partners role in supporting her in labour

Benefits for Fathers
? Less pressure as the sole support person
? Ability to have breaks without abandoning partner
? Encouragement and guidance in how to support a labouring woman
? Emotional support and reassurance
? Greater satisfaction for the support you are able to provide your partner
? Greater sense of involvement in being able to absorb the birth experience

Benefits for Baby
? Less admissions to neonatal/special care nurseries
? Higher rates of breastfeeding success
? Higher AGPAR ratings after birth

Kelly are those stats specific to Doulas or are they the stats related to having support through pregnancy from consistent skilled caregiver?

I think this is a really interesting discussion. It highlights the contract BETWEEN the individuals involved in the birthing process. I agree with FJ that I would expect a Doula to act in the situation re: progress not being reported. Similarly, I agree with Kelly that potentially the worst outcome is for the Doula to end up in conflict with the OB/MW. The idea that you catch more flies with honey than vinegar is an important one. It irritates me that 'the game' continues in the health system, but ultimately the only way to effect change is for OBs/MWs to experience normal delivery on enough occasions that they come to recognise how it 'can' be. That will never happen if the battlelines are drawn so firmly that the system is tipped even further against a woman delivery normally in a hospital environment. A Doula CAN assist a woman against the pressures of the system IF the woman has invested time and energy in educating herself.

So again, for me, it's important that a Doula isn't viewed as someone who can 'give' you a particular experience, but rather someone who will work 'with' you for the most positive experience.

[BellyBelly]

They are doula studies - where they were not employed by the hospital.

[Tobily]

I think in the progression scenario specifically - I would probably say something about that. Simply because in the big scheme of things it is a relatively minor request - on a par with things like keeping the lights down etc. It's one of those things that is purely for the mother's comfort and mental state. There is no reason for them to disrespect that so I think in that specific instance I would remind them, or at the very least encourage the father to.

I think though that we do need to remember that a doula's primary role is that of birth support - focusing on the mother and her partner, supporting them through the process of birth itself. Advocacy at a birth is a very small part of what we do because we are essentially quite restricted. This comes back to what kelly was saying, there is an increasing perception that doula's are paid "birth bouncers". We are not and I am crystal clear with my clients about this. Often the situations that cause conflict are those with OBs and midwives in attendence that aren't very tolerant on their decisions being questioned generally - by parents and much less by what they might view as a paid "ring in". Confrontational doula's get thrown out of births by carers like this and that it is a deterimental outcome for everyone - the doula, the couple who then left completely on their own, and every couple with a doula that crosses the path of that carer thereafter.

Absolutely agree too that there a too many new doulas with zero idea about how to act professionally in hospitals and I think its a disgraceful shortfall in certain "training" programs.

We walk a very fine line. They'll chuck a doula out but a father will get away with more. They don't like throwing father's out. So unfortunately in a hostile environment he may be the only one who can say what needs to be said. I talk to dads alot about this before births and like kelly, ask passive questions during labour. When I can see things coming I ask them in the presence of the caregiver if they're ok with it and if they need to time to think and discuss. That is all I can do.

I give this to all my clients:

Promises of a Doula..

You cannot hurt my feelings in labour.

I won't lie to you in labour.

I will do everything in my power so you do not suffer.

I will help you feel safe.

I cannot speak for you but I will make sure that you have a voice and I will make sure you are heard.

[Ca Plane Pour Moi]

Hell yeah.

Discussed the plan with all and sundry. The hospital "lost" it (put it in my bag while I was in labour, took it out my notes and put it in my bag!) and DH seemed to forget that I was giving birth and knew my body and my baby, not the midwives and obs.

There was IMPORTANT medical info in there, stuff that involved DS breathing or not at birth, and I ended up explaining it to EVERY person who wandered into the room because I was worried about the drugs they wanted to give me (paranoid pregnant woman, don't listen to her - oh wait, the baby's not breathing), DH ignored ALL my wishes and just agreed to everything the Obs said... what was the point?

As for "it's my fault because of my choices" (which seems to be the attitude in this thread generally) - yeah. My fault. My fault that no-one listened to me when I told them something. My fault that when I said I didn't want this then it was overridden by everyone else around me. My fault I can't give birth.

I'm ready to just give up on the whole thing, I really am. I'm a failure and cannot birth - at least I'm more at peace with only having one child now. I'll need a lot of convincing before I set myself up to fail again because I educate myself as much as possible, fight as much as possible and still fail... what hope will I ever have?

[{sarah}]

I've reflected a bit on my birth plan & I think it was a really good idea to have it in place even though I didn't have my VBAC. There were things I wanted in case of an emergency c/s that I got which wouldn't have happened had I gone in without a plan.

I was not told the time & was only told of my progress when I asked for it, something that was very important to me. My support people & the midwives refused to discuss pain relief whilst I was in the middle of contractions which was exactly what I wanted (at the time though I wasn't happy about it LOL). I wanted the cord to stop pulsating before it was clamped & that was done even though I had a c/s.

[Trillian]

Going back to the original question of are birth plans a waste of time? I think not. If you really think about it, they are a plan of what you would like to happen just in case that senario arrises - you might have a plan in place to deal with you having a post partum haemorrage; or one for a c/s; or whatever senario you can think of and it saves valuable 'thinking time' - so if it does happen, then what your preferences are, are already right there in black and white on paper - no woman should be made to think during her birth and move away from using the primal part of her brain to the thinking part of her brain and distract her from the job she is meant to be doing - GIVING BIRTH! If you read a lot of birth stories, you will read ones where the mother has had to make a choice in birth that has distressed her and she momentarily loses groove and needs to find that again. If her care providers actually read the bit of paper they were given it would save the birthing mum a lot of angst I think.

Admittedly I only ever had one for my 4th birth - with the first three I just went with the flow and we decided to take birth as it came kwim? We knew what options we had, but we didn't think that a plan was necessary in our situation. It wasn't until I had a somewhat traumatic third birth that I realised the importance of needing one for my 4th.

[BhoysGirl]

Rosehip - your post makes me sad, probably especially from you, as I think of you as such a strong, articulate, together kind of a girl, to have you say that you feel like failure - well, is about all I can do.

I completely understand the disappointment in not getting a natural birth, having gone through the experience ending up with an em c/s for which I just wasn't mentally ready, I was too convinced that my body would do what it was supposed to do. But to think of yourself as a failure - for any woman to think of her birthing experience as a failure - is just so sad. I think that it's wrong to attibute a pass/fail approach to birthing but absolutely right to feel disappointment & varying degrees of grief when things don't to go to plan. Birth is an incredible rite of passage for us, but at the end of the day, such a small part of the whole picture, a day, maybe 2 out of a lifetime (per child I guess), so don't judge yourself on the birth experience, save that for the rest of the days when you can really get some motherguilt worked up

[BhoysGirl]

And back to the topic - for me, a birth plan next time will be worthwhile, in that it will allow me to hope (visualise) for the best, but prepare for the worst, so that I'm not so thrown if things go haywire again.

[~clover~]

Rosehip - your post makes me sad, probably especially from you, as I think of you as such a strong, articulate, together kind of a girl, to have you say that you feel like failure - well, is about all I can do.

I completely understand the disappointment in not getting a natural birth, having gone through the experience ending up with an em c/s for which I just wasn't mentally ready, I was too convinced that my body would do what it was supposed to do. But to think of yourself as a failure - for any woman to think of her birthing experience as a failure - is just so sad. I think that it's wrong to attibute a pass/fail approach to birthing but absolutely right to feel disappointment & varying degrees of grief when things don't to go to plan. Birth is an incredible rite of passage for us, but at the end of the day, such a small part of the whole picture, a day, maybe 2 out of a lifetime (per child I guess), so don't judge yourself on the birth experience, save that for the rest of the days when you can really get some motherguilt worked up

I think EVERYONE who is disappointed with a birth experience should read this.

[Snowy Love]

Rosehip Fairy - I've read you stories and from what I've read it wasn't your birth plan that was a waste of time, it was the midwives and your DH. Next time you need to clone yourself (or pay for one of the lovely ladies from BB to fly to England) so you have a strong advocate!

[QueenMab]

Ticklish - I am so sorry that your bith plan was not followed & you felt that you had nobody to stand up for what you wanted during your bith.

Is writing a birth plan a waste of time? I don't think so even though my own birth plan didn't make it out of my labour bag!! I was good to have written it, to have though carefully about everything I wanted, about the choices I would have to make, to take DP through it. I do agree with Kelly about the birthing mother having to make the right choices all the way up to the birth to get as close as they can to their desired outcome; for me that was choosing the birth centre & letting my midwives know what I did & didn't want from the start. Lucky for me when I went in to labour the head midwife of the birth centre was on duty & she directed DP in ways to help when she wasn't there as well as never offering me any drugs, even though I was not so subtly implying that drugs would be a great idea lol. So, even if the birth plan does nothing but get everything straight in your mind about what you want, it is worth it, IMO.

About Doulas.... could those stats have anything to do with the the kinds of women that choose to have a doula? I am not saying that doulas don't contribute to better natural birth outcomes, but for a woman to spend a considerable amount of money on one then they would be, in the first place, quite dedicated to the idea of a natural birth?

I have to say also that I see FJs POV about wondering why a doula cannot advocate for the birthing mother if that is what she wants, if it is purely because of the 'system' then it is a lot worse than we already thought.

[Smoke Jaguar]

RF - I think your experiences have coloured your perceptions here. I do not believe anyone here is saying that it's your 'fault' about what happened. I am certainly not saying that, at the very least. I am saying that a birth plan's power may well be diminished in direct proportion to the medicalisation of the birthing environment. My point is, if it's a sound birth plan, don't blame the birth plan - blame the caregivers who choose to ignore it because of the structures that 'justify' their actions. What I am saying is that this needs to be taken into consideration when thinking about the kind of birth you want. If the place you are going to does not naturally or easily support the birth that is outlined in your plan, then you are likely not to achieve the birth you want easily. That is not an individual 'failing'.

[BellyBelly]

Re doulas - studies were all sorts of countries, people with private or public care - all round.

Just ask people who have used doulas what they think.

[Nai]

I don't think a birth plan is a waste of time - no my birth didn't go according to plan but when I did have to have the unplanned c/s at least I felt empowered and knew that getting to 7cm dilated drug-free and focused was achieved in the way that I wanted.

I am going for a VBAC this time and will also have a birth plan and I will also have a doula - I see DP as the one who will ensure that my birth plan is followed. My doula will be there to help with the birthing things that DP doesn't know about ie. the best position for me to be in at any point in my labour and birth.