I 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: Natural Birth mommies opinion wanted: anti-birthplan doctor?!
The letter does not sound harsh to me at all. It sounds clear and it sounds like it sounds like it's coming from a doctor who is intouch with the reality of labor and delivery and responsible medical practices.
My husband and I did hypnobirthing. We ultimately ended up having to be induced but, the original plan going in wasto go completely med free and my doctor supported that 100% right up until the point that my life and the life of my child was on the line. She did not at any time have any interest in getting a written birth plan though. In fact, when I asked when she wanted my birth plan she flat out said, "I don't." She followed that by asking me what concerns or desires I had that we had not already discussed, and then we discussed them. Her philosophy was very much in line with mine but, she wasn't going to lie to me or let me kid myself that I had any real control over how labor progressed or delivery unfolded.
You are going to need to talk to this doctor about your labor and delivery and then decide if this is the practice for you. YOu may actually be pleasanlty surprised. Don't write them off out of hand just because they practice medicine responsibly and won't alow themselves to be pushed around by undereducated mothers who think that just because they watched some biased documentary produced by a fat, has-been ex-talk show host (with no backgroubnd in medicine or biology what so ever) that they all of a sudden know more about the practice of medicine than any physician possibly could. (See, THAT was harsh. His/her letter was actually quite professional).
I'm all for natural birth and moms having the birth experience they want, to a point. I also completely get why OBs are getting cranky about birth "plans." The ONLY plan that matters is the one your baby has, and he or she isn't going to clue you in ahead of time. A good doctor knows this.
Talk to this doctor. Hopefully you will discover that you can both agree that a good plan is to have a healthy baby safely. If, for some reason this doctor is one of the crazies who is going to schedule your induction around his golf tee time, no matter what you want, then by all means, you should run screaming far and fast. Give them a chance and at least have the discussion, that's the only way to know for sure.
I absolutely love my doctor. She didn'[t take a birth plan last time, she's not going to this time and I have absolutely no worries that, as far as it is safe for me and little one, that I can have any sort of birth that is comfortable for me. I trust her, we communicate well and have worked together for years. Good communication is worth a lot more than any list you can type up. Good luck
I hope you get everything you want from this doctor
I'll admit, the letter throws me off a bit, especially since it's such a lengthy crap-all-over-birth-plans diatribe.
That said, my OB has a reputation for being extremely natural birth friendly (confirmed by several doulas). When I initially interviewed him and we discussed my desire for a natural birth, we discussed all of the usual things like hep locks, movement, doulas, low c/s rate, etc. At the end, he did come out and say he would discourage me from bringing a birth plan. His explanation that birth, by definition, does not follow any sort of plan and would just serve to make things more stressful when things probably *didn't* go according to plan did make sense to me.
So, I wouldn't dismiss your new practice right off the bat, but I would definitely bring up the natural birth discussion ASAP to make sure that their feelings on natural birth align with yours.
Hmmm-- Well while I do understand that lots of women assume that b/c it's in their birth plan it WILL happen and don't acknowledge that they have to be flexible and prepare for what happens and we as women do need to trust out dr's BUT my Dr/midwife has to EARN that trust by proving to me that they are not going to push unnecessary interventions etc, try to use scare tactics (i.e big baby,) to push an induction simply b/c it works better for their schedule....
Long story short before you commit to this practice I would ask ALOT of questions.
We moved since my last baby and I pondered the idea of switching to a different practice that delivered at a hospital that was closer to us but after asking a doula friend of mine and interviewing a few of the practices I realized that NONE we're going to support the natural birth I wanted like the midwife practice I'm already with and in the end I care more about my birth EXPERIENCE than my birth LOCATION.
So I would definitely think hard about changing drs. Personally I think location should not be a determining factor in choosing a care provider for the birth of your child.
Run. Seriously.
~Working Mom~Breastfeeding Mom~Cloth Diapering Mom~BLW Mom~
Blog - No Longer on the DL ~ The Man Cave
Shawn and Larissa
LO #1 - Took 2 years and 2 IVFs ~ DX - severe MFI mild PCOS homozygous MTHFR (a1298c)
LO #2 - TTC 7 months, surprise spontaneous BFP!
I totally disagree with most of this. True that birth can't be scripted and that baby's plan is the most important, but it's ok to have preferences and there are a lot of things that you do have a say in and it's good to let your doctor know what your preferences are. Sure, having a written document is a little hokie, but that doctor has lots of patients and will never remember what all of your preferences are (besides we were able to give something consistent to the hospital as well).
There are reasons to not want what is standard and what is standard is not always what's best. It's ok to have preferences and to want to be treated as an individual.
And having a healthy baby safely isn't the only important thing. Protecting mom and her well being is also important and a lot of standard procedures make things easier for the doctor but make for a rough recovery and delivery for mom.
~Working Mom~Breastfeeding Mom~Cloth Diapering Mom~BLW Mom~
Blog - No Longer on the DL ~ The Man Cave
Shawn and Larissa
LO #1 - Took 2 years and 2 IVFs ~ DX - severe MFI mild PCOS homozygous MTHFR (a1298c)
LO #2 - TTC 7 months, surprise spontaneous BFP!
Be sure to do this with EVERY doctor in the practice.
~Working Mom~Breastfeeding Mom~Cloth Diapering Mom~BLW Mom~
Blog - No Longer on the DL ~ The Man Cave
Shawn and Larissa
LO #1 - Took 2 years and 2 IVFs ~ DX - severe MFI mild PCOS homozygous MTHFR (a1298c)
LO #2 - TTC 7 months, surprise spontaneous BFP!
This!!!!!!
"F U" and go find someone else. Find a CNM if you can! I am amazed that they actually take that position. Actually, I think I'd find some way to publicize it - send it to the newspaper, or a news channel! Not to mention they don't apparently know the difference between "insure" and "ensure". But seriously. Write them a letter back, say thanks, but no thanks, and find a new practice that actually believes in a woman's body's ability to birth a baby. Medical advice is for a medical situation - if one comes up, then you need a doctor. Birthing is not by definition a medical event!
I would run.
This letter actively discourages patients for doing their own researching and educating themselves. Statements like "pre-written birth plans frequently contain instructions that are counter to good medical practice" is vague and I think just untrue. If the practice was REALLY concerned with making sure you had realistic expectations they'd outline specifically what are good vs. bad elements to include in a birth plan to help EDUCATE you, not simply say you need to "trust in your physician."
I did Hypnobabies with my first DD and not one element of my birth plan "countered good medical practice." My OB encouraged me to write it and then went over it with me. If there were elements he was concerned about he talked about them with me and explained why it was a better idea to change them, which we did. I left feeling both heard and empowered and more confident about my birth experience. Everything did not go exactly according to plan during the birth, but I also expected that, and I still felt like I had a good birth experience because I was involved and understood why elements changed.
Finally, birth plans aren't just for your physician - they help nurses too. Every nurse who worked with us read our brief birth plan and expressed that it was helpful to know our preferences.
Perhaps you don't live in an area where traffic is a real problem. A friend of mine chose to deliver at a hospital that's about 30 minutes away--except she went into labor on a Friday afternoon, and it took them over 2 hours to get there. Living in the DC area, location is a factor in every decision! Perhaps the OP deals with the same kind of situation.
I think it does come across a little harsh, but am assuming there's some kind of precedent behind it. Likely something where they have receive a few too many extremely detailed birth plans from mothers who later complained that things didn't go exactly how they requested.
Having ideas about what an ideal birth would be like is a good idea, but it's also important to recognize that things really don't always go according to plan. If the practice seems open to natural birth in general, I wouldn't freak out because they don't allow written plans. This is why you need to have an advocate with you during labor, who can help vocalize your wishes when you aren't able, and work with your hospital team instead of assuming you are two different sides of a battleground.
My doctor is like this. He didn't give me a letter stating that but at my first appointment we had a long conversation about birth plans and he told me, basically, that he wants to know what I want, he wants me to tell him what I want but a written birth plan isn't necessary for multiple reasons - one being if something goes wrong in a normal every day delivery, he's probably not going to have time to "refer" to the plan. That makes sense to me. He also told me that in the past, when he DID accept them, most of them were crazy (he gave me a few examples of things people wanted, I honestly can't remember them but at the time thought "what was WRONG with those women???" - the only one I can remember was something like "If I need a c-section I want to be awake but I will not allow you to give me any drugs." Um, what???). He said in two instances when he had to deviate from what the mother wanted, they tried to sue him, even though they and their children were perfectly fine.
So the birth plan he and I talked out? I get drugs. If one of my babies is breech, I get a c-section. And if he, who has 35 years in L&D experience thinks something is in my best interest, he will do it. I have 0 experience so I'm ok with that.
I get along with my OB fine and we communicate well but she doesn't take birth plans either. She's never handed me a letter...it's actually never come up. The friend who recommended her told me she doesn't take them. I'm betting she found out because she tried to give her one herself. She wanted to go natural but her children were all breach babies. In spite of it all, she loves her OB.
I wouldn't be surprised if she was also trying to avoid getting sued for doing her job properly. The malpractice insurance for OBs here is so high that a good number of doctors (good doctors) just don't do obstetrics at all anymore.
While I don't like the tone of the letter, I think they're simply telling you that they don't work with birth plans. That letter does NOT say they are against natural births, or that they're unwilling to have a conversation with you about options, procedures, side effects of drugs, etc. They are being up front with you, so now you have the opportunity to be up front with them. Engage them in a conversation about what you want, and if after that they seem unwilling to work with you, then you may want to find another practice. Or see if there are any midwives who have privileges at that hospital.
I think of birth plans as an opportunity for DH and I to discuss labor and delivery, drugs and their side effects, possible scenarios, standard procedures, etc. I do not plan to submit a birth plan, nor do I expect every person who walks in the room to know what I want. I do however expect DH to speak up for me and question every single thing that they want to do with me.
Good luck!
*wow* shocked by that letter! I agree it sounds condescending and downright rude.
I see the point that there is no way a birth plan can be followed to the "tee", but many or most women realize that before going into it. I would hope that most women would have a chance to speak with their doctors before delivery about the birth plan and THAT would be the opportunity for a doctor to say "well, i'm concerned about this one part of your plan: yadda yadda yadda, how can we comprimise so that this is good medical practice and makes you happy?"
So sorry girl! Any chance of switching back?
This. There is no way I would stay at a practice that said this.
I would be personally offended if my OB gave me this letter. I agree that at the very least it does nothing to encourage women to educate themselves on what happens in labor and delivery. I would not go to this practice because I'd want a dr who at least would listen to my wishes and take them seriously - these doctors wouldn't based on that letter.
Now, I see a midwife practice at a hosptal. When I called them at 4 weeks pregnant one of the first things she said was we give you a birth plan paper to fill out and go over with us so we know exactly what YOU want! I was shocked and said you are the one for me! Now, midwives can generally only take low risk pregnancies so this doesn't work for everyone but for me it is invaluable to have a medical professional believe in this amazing journey my body will go through.
They also work with an OBGYN group and gave huge praises to the OBs who might intervene if there happens to be an emergency in delivery. I totally trust them and their advice. My advice - if something doesn't set well with you try to find a doctor that you trust and feel comfortable with.
Unfortunately where I live I do not have access to birthing centers or natural birth centers. It is just hospitals. So I figured the lesser evil of choosing a hospital would be choosing one close to home so I can do the majority of my laboring at home and then get to the hospital. From what I can see the hospitals I have checked out all have the same attitude favoring medical intervention and looking down on mother being in control of how her birth plays out. Home birth is not an option for me. I don't know what to do. This latest hospital I have switched to is close to home, and they DO have good statistics as far as lower cesarean rates, etc. However, I am still worried that they will not like my preferences. Which is basically no Pitocin, no epi, natural birth with preferred no episiotomy. I also refuse the Vitamin K shot and eye ointment. I did it with my first son, but they gave me a really hard time about it at the hospital to the point they had many people in my room who were trying to talk me into it. I know it is my right to just sign a waiver form. Sorry for rambling. I already have a feeling this new hospital is going to put up a fight, so I want to get it all out of the way ahead of time and have a peaceful birth.
As far as the letter, maybe "angry" wasn't the right descriptive word, but a couple of your replies gave me the words I was l was looking for. "Condescending" and "Inflexible". I just think its a bad tone to start right off the bat with. I still understand and accept the refusal of written birth letters, but the way it is worded makes it sound like "we know everything and you know nothing".
@MommyErica I disagree with what you said. You say you wanted to have a natural birth too. But were you keeping natural birth open as an equal option to anything else, or were you 99% sure you wanted no Pitocin, no epi, etc? Because I am 99% sure. With the 1% chance that there is some type of medical emergency that occurs. And I'm sorry, but my labor "not progressing" fast enough for the hospitals liking is not going to convince me this time that my baby is in danger. I know good and well it just has to do with their time table not me or my baby's health.
I don't believe that labor & delivery is a medical or high risk condition for the majority of patients. And I don't want to be treated as such, unless something out of the ordinary occurs.
@smileari & b.heather I like what you said.
I hope and pray to find a way to have a natural birth with doctors who will be more understanding of my wishes. I know they will see me as difficult, but I don't think I am really asking that much!
I think my course of action would be to find a good doula and see what their opinions were of the doctors in the area. They've typically worked with a lot of them and can tell you how pro-natural birth they really are.
I know that my doctor talked a good talk last time but when push came to shove, he wasn't even the one that was there, and other members of his practice didn't talk such a good talk. Even if this one doctor is pro-natural birth, this letter presents the practice as being kind of anti-natural birth and I think it's important to be comfortable with every single person in the practice that you're using.
You know, we all have to be reasonable and understand that things don't always go as planned and that yes in those situations it's important to trust your doctor. But, at the same time you've got about a 90% shot at an uncomplicated birth (assuming you are healthy and all) in which case you have options and you absolutely have the right to say that you're ok with your labor lasting longer than 12 hours and that you'd really like to let your membranes rupture on their own and that you'd like to wait a minute to cut the cord, or whatever your preferences may be.
~Working Mom~Breastfeeding Mom~Cloth Diapering Mom~BLW Mom~
Blog - No Longer on the DL ~ The Man Cave
Shawn and Larissa
LO #1 - Took 2 years and 2 IVFs ~ DX - severe MFI mild PCOS homozygous MTHFR (a1298c)
LO #2 - TTC 7 months, surprise spontaneous BFP!
I think this is more of nurse's opinion and not a fact. What "combative" and "difficult" means to me is that the mother is not willing to follow protocol that may not be right for her individual needs.
I also feel that most women who do come in with a plan have HIGHLY researched and educated themselves on the topic, not just printed something out willy nilly and came in ignorant. But the doctors and nurses feel that these women are the latter, because they don't have a medical degree.
I am a reasonable person and trust in doctors, and I do not expect everything to be 100% according to my plan. But I have faith in natural ways, and it would help to be in an environment where the staff agrees with that sentiment.
Also, I had a similar experience with having my son, who is now 3 to what you mentioned. The doctor I saw on a regular basis did not even end up delivering my son, and everybody else was not familiar with our wishes. It was a shame. They all looked at me like an alien with 2 heads and they jacked me up with Pit to the nth degree even though I fought it everyway. It was not a horrible experience. Just could have been better. Anyhoo. I will keep you posted. Any advice is welcome. Thank you again to everybody for the response
Our last doula was free because she wasn't certified yet, but a brand new doula might be less useful in things like recommending doctors.
~Working Mom~Breastfeeding Mom~Cloth Diapering Mom~BLW Mom~
Blog - No Longer on the DL ~ The Man Cave
Shawn and Larissa
LO #1 - Took 2 years and 2 IVFs ~ DX - severe MFI mild PCOS homozygous MTHFR (a1298c)
LO #2 - TTC 7 months, surprise spontaneous BFP!
This is exactly how birth plans should be handled.
This is ridiculous. Birth plans are not a list of demands that must be followed at all costs. A birth plan is a wish list - what you would LIKE to have happen if at all possible. Any doctor who would flat out refuse to take one is probably afraid of those women who think that birth plans are marching orders. I would run away from this doctor. Most doctors will sit down and discuss what's possible and what's not. Most importantly, educate yourself. Understand that yes, if you speed to the hospital after your first contraction or the second your water breaks that you are basically asking for interventions. Learn about laboring at home and the benefits of natural birth. Take a class and prepare yourself. We rely way too much on doctors to guide us through these processes. They are human. That's why c-sections spike a dinner time. They're just people. You have to work hard to get the birth that you want, and choosing a practitioner who gives a damn what that might be is step 1.