The fantasy of "ideal childbirth": The Birth Plan

Creating a birth plan can be an empowering and clarifying process. Knowing your wants and expectations can help demystify the childbirth experience, and sharing your birth plan with your obstetrician is a great way to facilitate discussion and direct communication.

The reasons for having a birth plan run the gamut. Some women have the perception that a hospital birth is "over-medicalized," and a birth plan is often seen as a way to ensure a "natural" experience during labor. This may mean saying "no" to medication, an epidural or even a possible cesarean section. The other extreme may be a woman who wants an early epidural or a c-section on demand.

Every obstetrician wants one thing--flexibility on the part of the patient. While making out a birth plan can help alleviate anxiety and clarify expectations, an overly rigid birth plan can cause a great deal of misery for all involved--the patient, the patient's family and the obstetrician.

One of the most common birth plan requests that my husband receives is that no epidural be administered during labor. While some patients are able to tough out the pain, it's not uncommon for a laboring patient to request the epidural when it's too late to administer it. In one case, the laboring patient devolved into the Godzilla of patients--cursing medical staff and family, kicking wildly, and even biting her beleaguered husband, who had been trying to coach her through the pain.

Often, patients become all-consumed by the idea of the "perfect" childbirth, and to deviate from a birth plan can be perceived as a failure. However, it may be good to know that your obstetrician is also obsessed with the "perfect" childbirth though her definition may differ from yours.

The overriding goal for a physician is always the well-being of the patient and baby. While a physician will try hard to adhere to a patient's expectations, sometimes the unexpected occurs. For instance, a baby's heartbeat may dip repeatedly to the point that a physician decides a c-section is necessary.

The perfect birth plan is having both mom and baby healthy and safe, and that is one plan that both patient and doctor can agree upon.