Opinion needed: anti birthplan letter from doctor?!
Had my first appointment with the new doctor today. Switched doc's to be closer to home for L&D. Didn't have any discussion about natural birth yet, it was pretty much a medical history review, in and out visit. But they gave me a packet of info to take home, and in it was this letter. Please read below and give me your opinion! What do you think about this?
To Our Patients:
Re: Birth Plans
We understand and empathize with your desire to have as natural and as comfortable a bith possible. We will do whatever we can to insure that you have a birth experience that is emotionally fulfilling and meets the needs of both you and your baby. However, a large part of a good birth experience is having trust in your physician, and your physician's judgement. With this in mind, we DO NOT ACCEPT birth plans of any type.
Becoming a parent means becoming flexible, and open to changing situations and needs. This begins with labor and delivery, which is an event that cannot be predicted or "scripted", As your doctors, we need to be able to provide the care that will lead to the best outcome and the safest delivery. While we are open to your suggestions and requests, and are glad to work with you on things that are important to you. However, pre-written birth plans frequently contain instructions that are counter to good medical practice and leads to unrealistic expectations. Please realize that, as lovely and idealistic as they may sound, birth plans are bad medicine; we do not accept them.
OK is it just me or does this sound harsh? I understand written birth plans can get lenghty, and maybe they decided not to accept them which is ok. But the letter sounds downright angry to me. Natural Birth mommies Opinions please?
Re: Opinion needed: anti birthplan letter from doctor?!
I don't like the sound of that at all. It's very confrontational. You need someone who will work with you, not immediately tell you what they will and will not "allow" or "accept." I understand that a few people do write ridiculous birth plans, but that shouldn't be a reason for them to ban all of them. My suggestion would be to run away as quickly as you can!
Do you know anyone who has had a natural birth who could recommend a provider? Do you have a Bradley or Hypnobabies teacher you could ask? Maybe even ask your local ICAN chapter for recommendations.
"Birth plans are bad medicine; we do not accept them" is jaw dropping. Bad medicine? How is laying out your wishes for how procedures and decisions are made regarding your own body bad medicine? To me, this letter basically translates to: "Don't question us or our decisions because we know best and you know nothing."
I'd be apt to call them up and tell them that you'll be finding care elsewhere based solely on their inflexibility (which ironically is what they are saying mothers with birth plans are being) regarding birth and your wishes.
Why didn't they just include a sample of what they think of as a good, realistic concise birthplan...instead of being all we-know-everything-and-you-don't-know-a-thing? Or offer to go over your birth plan ahead of time with you (like my OB did) so you know what to expect and where to prepare mentally to be flexible?
No way would I trust them with my care, if that's the attitude they have about your wishes.
no thank you.
no thank you at all. i'd find another doctor, but before I left this one I'd make sure they knew how I felt.
a birth plan that demans satin sheets and the perfect music playing are silly. and women who refuse to realize their plan may have to change are setting themselves up for some let down. BUT... a plan is just that. it's a plan. it's plan A. its what we're hoping for. it's a "wish list" so to speak. and many, many of the things on our list CAN and SHOULD be met by our doctors and staff.
they say they are "willing" to listen to your requests and needs, but they don't want it written down? so they dont want time to prepare? no actually i'd imagine they dont want anything in writing that might be held against them at some point if they end up NOT following your simple requests. i'd run far away.
this!
I would wave goodbye and also let them know what I think, come on we are adults, we should be able to make choices specially in the birth of our children, if I say no epi, I mean no epi, don't try to trick me into it, help me through it!
Sounds like they are just going to want to do it their way and no other way...run if you really do want a natural birth
This is what they are saying:
To Our Patients:
Re: Birth Plans
We do not understand nor empathize with your desire to have as natural and as comfortable a bith possible. We will do whatever we can to insure that you have a birth experience that is emotionally fulfilling and meets the needs of both you and your baby, me and the hospital staff. However, a large part of a good birth experience is having blind faith trust in your physician, and your physician's judgement. With this in mind, we DO NOT ACCEPT birth plans of any type, except OURS.
Becoming a parent means becoming flexible not opinionated, and open to changing situations and needs, which there will be once we start messing with you. This begins with labor and delivery, which is an event that cannot be predicted or "scripted", and clearly, if you have any ideas as to what you want your birth to be like, that means you are trying to predict and ?script? everything. As your doctors, we need to be able to provide the care that will lead to the best outcome and the safest fastest delivery. While we are open to your suggestions and requests, and are glad to work with you on things that are important to you, but we will belittle you and mock your choices behind your back (maybe even to your face), and feel the need to remind you that there?s no medal for getting an epidural. However, pre-written birth plans frequently contain instructions that are counter to good medical practice what we normally like to do and leads to unrealistic expectations. Please realize that, as lovely and idealistic as they may sound, birth plans are bad medicine; we do not accept them, as they could hold us accountable for things, and we don?t want that, now do we. Be a good little girl and sign here.
I remember seeing a similar response to an anti birth plan letter on a blog a while back.
That letter is much less flexible than any birth plan I've come across. I would run far far away from that hospital if you want a drug free birth.
" However, pre-written birth plans frequently contain instructions that are counter to good medical practice and leads to unrealistic expectations. "
I would want to have a lengthy discussion around this statement of theirs.
What are there specific examples of this? Do they mean not having an epidural? Requesting skin to skin contact immediately after birth?
I've seen plenty of birth plans that detail a lot of requests that were things I simply didn't care about, or things that I would not choose for myself purely because of my own personal wants, but I have never seen a birth plan that involved anything I considered counter to good medicine.
I understand I'm not a medical professional, which is why I would want their view explained to me, and I would listen very carefully to their answer because quite frankly I call BS on that statement.
But yes I agree that they sound very confrontational and angry and the entire tone counter's their claims that they want to provide a fulfilling birth experience.
ETA:
If they really cared about your wants but they had had some negative experience with birth plans, their letter would read something along the lines of:
"Sometimes birth plans do not reflect best practice, and some mother's have expectations we are unable to meet; for this reason it is important you discuss your birth plan with us well in advance.
This way we can discuss your concerns before labour and create the best plan as a team."
Elizabeth 5yrs old Jane 3yrs old
"Bad medicine" is not using your patient as your guide. Screw that place!
Pregnancy # 6
4 missed chances
2 loving children
1 on the way
I would switch right away. If they are handing all their patients this letter, there really is no wiggle room for discussion.
::sigh:: What really kills me is that most of their patients probably don't even question this practice. Sad.
Yet another example of how doctors have made the natural process of giving birth a medical process. You are not sick, you do not need to be delivered. You want to give birth.
Dump the doc. This is bad news.
They are saying that they know whats best for you and that you don't know jack. This doc doesn't want his ego being messed with, RUN. RUN away now.
DS2 - Oct 2010 (my VBAC baby!)
Breastfeeding and pregnant!
I like this. you summed up how I felt when I was reading it. I need to talk to somebody at the hospital about this letter, because without a person to person talk, at the end of the day I dont even know who at the practice WROTE this letter, but whoever it was seemed to have meant what you put "in between the lines"
If you do choose to stay with this provider, I think you owe it to yourself to let the doctors know how you fundamentally disagree with their letter and the tone in which it was conveyed. They need to know that you will not be a patient who will allow them to make the decisions. YOU will make the decisions after discussion with them, not the other way around.
If you are determined to stay with this practice I would encourage you to do two things:
1) Talk to your doctor about this letter. Let him/her know how much the tone of it has turned you off. Start off by saying that you completely understand that birth cannot be planned or scripted, but that you feel comfortable and empowered as a patient by including a small checklist of birth preferences. There is a world of difference between "No Pitocin" and "I would prefer my labor to remain unaugmented unless there is a medical indication and I am given time to discuss other methods with my provider". It might not hurt to bring in a early version of what you want on your birth plan to an appointment to gauge how your preferences mesh with your OBs (I'm guessing that there will be a lot of disagreement).
2) Hire a doula and share your birth plan with her. She can't make decisions for you when the time comes, but she can help to remind you (and your doctor) of your preferences.
If neither of these options appeal to you, I would seriously consider switching practices.
Pretty much every bullet point on my birth plan started with "In the absence of medical necessity, we would like ..." Hardly bad medicine or dogma there.
That letter really makes me nervous. I suppose it would be worth a conversation with the OB ... go in with a birth plan template and see how it goes. I don't understand what their opposition is. They allow you to have preferences but don't want you to put them in writing? It's not like your OB has to sign your birth plan in his own blood. It just really sounds like an office who doesn't want to be inconvenienced by your birth preferences. They don't want any push back when they schedule you for your 41-week induction, they don't want you to be laboring in the hospital for longer than "appropriate," and they don't want you to be one of those people who wants to move around during labor, eat/drink and just generally get in the way. There have to be other options for you. If not, I'd drive somewhere to have better options, honestly.
I'm quoting my parents who are both midwives with years of experience in both hospital and birth center settings...
"Run from this practice! It is beyond ridiculous that they refuse to accept or discuss a birth plan with patients. Birth plans should be a tool for negotiation and discussion. This is your birth. It is not about what they will PERMIT you to do. There is absolutely no evidence that birth plans are bad medicine. Doctors with attitudes like this want to be able to tell you what to do and dictate how your labor will go without having to discuss every option and risk/benefits with you. Run. Seriously."
Hope that helps.
Wow. Honestly, as a patient, I'd be really offended by that letter. Saying that what I'm going to put into my birth plan is "bad medicine"? Telling me what it means to be a parent? Yeah, I wouldn't want to work with a doctor who was so disrespectful.
I totally understand wanting to limit people's three-page "I want a masseuse and a labor which is exactly six hours long and painless" (aka unrealistic) birth plans, but do they really not want people to think about things like pain management or newborn bonding ahead of time?
Boo that! My dr is very proactive about doing what's best for the baby right away. I've been rushed off from regular appts to surgery, but even he is open to the ideas of midwife births and natural plans. He (and my hospital) requests a birth plan from patients and have statements they do their best to make sure you have as close to the experience you want as possible. There are true emergencies though and you do have to trust your dr in some degree to take care of you then. But to me It sounds like this place doesn't want to take the time to fool with your birthplan which to me indicates they won't take time even try to meet the expectations you had planned. My dr sits down with patients and discusses their birth plans far in advance. So were there any "unrealistic expectations" we would work those out then.
Everyone has to understand that birth plans are just that, a plan, not a rule written in stone. Situations do change but that doesn't mean you shouldn't have a plan. I would be very concerned about this letter and using this practice, natural birth or not.
Delivering with this doc spells trouble!! I'd run away, and fast.
But, let's say they are the only doc in the area. My first question at the next appt would be "I read your letter addressing birth plans and wanted to find out what "instructions" you have come across that are counter to good medical practice?" Their answers will be very illuminating. And if they give a vague answer, I'd specifically ask about the 3 or 4 most important things that would be on your birth plan. If they think refusing pit is counter to "good medical practice", I would RUN away. If they think that refusing a hep lock is unacceptable, I'd consider if taking a hep lock to appease your doc is a major hindrance to your birth (It was not for me, and I feel is a bit of a gesture of good faith that I'll try to be a cooperative crunchy birthing mama).
It's the use of condescending terms like "lovely and idealistic" and "bad medicine" that are most alarming to me. I didn't need any medicine or medical care in either of my births. Insurance wanted me to have an OB or MW catch my baby, so I let someone do so. However, medical care didn't enter into the equation.
Make a pregnancy ticker
221_-6_Little Charlotte is.png" alt="baby" border="0" />
Got Swag?
That would be a no-go for me. It feels like my rights as a patient have been taken away before I have even started.
I appreciate the honesty but that would be a red flag for me that this it he direction I personally would not want to be heading.