In this thread, OBs discuss amongst themselves the issue of women forming their own birth plans. (Quelle horreur!)
Easily panicked control-freak Steven Richman opened the proceedings:
hello listers…….very busy day today and last pt. presents me with her “birth plan” at 36 weeks. The plan was entirely reasonable and certainly within the scope of how we practice……As I was tired and she was only 18, I kinda freaked and told her that we would not honor the plan and that the Dr/pt relationship requires mutual trust etc. etc…. With over 20 yrs of experience I truly feel I have gone along with the ebb and flow of obstetrical practice and procedure …….But I object to being put in a position where the “well-informed customer” feels it necessary to dictate the mode of operation.
I use the Ontario ANC record and it has a check item “Birth Plan”. When I reach the item I say “We don’t do that here.”, tick it off and move on.
Dr Anna Meenan:
I would not look on it so much as “dictating the mode of operation” as expressing her preferences for the way she hopes the most important event in her life will be allowed to proceed. I find that quite reasonable and wonder why anyone else wouldn’t, especially if the plan was quite reasonable and well within the scope of your practice. You speak of mutual trust. Does that mean she must trust you to know what her preferences are? Most docs I know do not have ESP. I wonder, if her birth plan called for induction at 39 weeks, early amniotomy, high-dose pitocin, forceps, and a midline episiotomy, would you accuse her of dictating the mode of operation?
Eberhard Lisse, responding to Dr Meenan:
Blah Blah Blah.
Jesus Christ, remind me to stay the fuck away from doctors. o.o