Preparing for childbirth typically involves being well informed about the progress of labor and the reception of the child. But some parents wish to take this reflection further.
What is a birth plan?
Parents want to participate more in choices related to birth conditions. They then write a birth plan. This approach is still uncommon in France, although it has been widely used in England since 1993.
Write your wishes down
The birth plan is not not a legal document putting families and childbirth professionals back to back, but rather a letter, a kind of moral contract, in which the parents’ requests for how to bring their child into the world are written down.
A project that must be well understood
The birth plan goes in the right direction to change things, provided that it is well used by the parents and well understood by the medical team. And that it is part of a normal childbirth.
The birth plan is an exchange of information and prior consent what can or should be done during a normal birth.
It is therefore not a requirement, but rather a mutual demand for respect. A project thus developed is a realistic, acceptable and applicable synthesis of the patient’s desires.
The birth plan, a tool for dialogue
The birth plan is based on a real reflection that requires documentation, discuss certain aspects with your gynecologist or midwife. The whole difficulty for couples wishing to write one is to be sufficiently informed without ever losing confidence in the medical team.
We must never lose sight of the fact that the wishes must remain compatible with the progress of the childbirth, the security conditions and the unforeseen inherent in a childbirth. It is not about no time to refuse all acts.
The first half-hour of monitoring after arriving at the hospital is therefore essential for monitoring labor.
A questioning of routine practices
Discussed and accepted, the birth plan can participate in the development of certain professional practices. Certain gestures are still practiced systematically today, although they are denounced in reports from the Ministry of Health, the High Authority for Health (HAS), the WHO, or even in the Health Code. public or the Hospitalized Person’s Charter.
A rate of episiotomy still high in France
A flagrant example denounced for more than twenty years by the WHO: the rate of episiotomy. In France, 30% of women over the period 2010 – 2013 had one. However, as early as 1990, the WHO recommended not to exceed a rate of 10%. Moreover in the United Kingdom, it is only 13%, and in Sweden of 6%.
Read also: Episiotomy is not mandatory during childbirth
WHO also denounces systematic infusion during labor, the use of the supine position during childbirth, the untimely administration of trigger hormones before childbirth, continuous monitoring of the fetus which prevents women from wandering… And yet these practices continue.
Read also: Women want to choose their childbirth
The birth plan, a positive impact on the medical team
The birth plan can also have virtues on the work of the medical team. This document reminds the medical team that it must inform patients about the planned acts so that they are understood and accepted, and not constrained.
Better respect the wishes of the pregnant woman
It also reminds all those who will take charge of the woman who gives birth that it is necessary, as much as possible, to respect her wishes. We must make sure that we offer each patient effective care, that is, validated for their benefit.
Points to discuss with the medical team
Some points on which it is possible to reflect with the midwife or the obstetrician-gynecologist, provided of course that the pregnancy is proceeding normally:
– Will it be possible to attempting a childbirth without an epidural ? Even if the medical teams indicate that the choice of the mother takes precedence over this question, this technique of locoregional anesthesia is sometimes imposed systematically. In some maternities, its rate can reach 95%.
Also watch: Episiotomy is not mandatory during childbirth (video)
– Can you walk around or use a ball to help the baby’s descent?
– Will you be able to give birth in another position than on the back?
– Will it be possible to refuse a routine episiotomy ? Two thoughts must be linked to this refusal: Do you accept the idea of the tear? Do you differentiate between emergency episiotomy due to fetal distress and routine episiotomy?
– Could I stay with my baby for a long time at birth before first aid is given?
A realistic birth plan
Always remember that a sensible birth plan is a realistic plan. This can be a great initiative, provided it is not imposed at the last minute by parents.
It could then be felt by the medical team as a questioning of their usual practices and produce the expected opposite effect. The birth plan is in no way a tool for hostile demands, it must remain a tool for dialogue and cooperation.
The stake is to bring together the parents’ wish to experience a birth with a human face, with obligations, especially legal and security, professionals under enormous pressure.
Avoid two pitfalls
– Give up trying to control everything. Know how to be humble facing the daily practice of medical teams.
– Do not overly idealize childbirth, as you risk being disappointed. There is always an element of the unknown.
If the going gets tough …
Each childbirth is different and unique. Unexpected events can occur, and we have to accept it. Learn to reconcile your wishes with reality.
In certain situations, the use of suction cups, the practice of a cesarean section, an episiotomy, the prohibition of ambulation or the installation of continuous monitoring are necessary for your good and that of your child.
It’s all a question of the risk mix. The medical responsibility of the obstetric team must always be respected with regard to safety and decisions imposed by medical facts.