How Obstetric Providers Can Use Birth Plans to Reduce Birth Trauma

This blog post written by Julie Paul, DNP, PMHNP-BC, CNM, PMH-C, FACNM, Head of Psychiatric Services at FamilyWell.

In today's healthcare landscape, birth plans have emerged as a pivotal tool in transforming the childbirth experience for expectant parents and obstetric providers alike. At a time when one in three women in the United States report experiencing birth trauma, understanding and integrating birth plans into prenatal care is more important than ever (MMHLA, 2023). Birth trauma, as defined by the Maternal Mental Health Leadership Alliance (MMHLA, 2023), encompasses the birthing person's overwhelming and distressing experiences during childbirth that have short and long-term negative impacts on their health, wellbeing, and relationships. This distressing statistic and the broader implications of birth trauma underscore the urgent need for strategies that can enhance the childbirth experience.

The Surprising Benefits of Birth Plans

First introduced in the 1980s, birth plans are documents that allow expectant parents to articulate their preferences, values, and desires for labor and delivery (Bell, 2022). Far from being mere wish lists, these plans are strategic tools that foster communication and shared decision-making between birthing individuals and healthcare providers. While some critics argue that birth plans can be seen as rigid or unrealistic, in reality, they serve as dynamic roadmaps that guide the birthing journey, enhancing collaboration and understanding between all parties involved.

Empowering Expectant Parents

One of the most profound benefits of birth plans is the empowerment they offer to expectant parents. In the domain of obstetrics, where the birthing process can often feel impersonal and overwhelming, having a birth plan enables individuals to take an active role in their birthing journey. This empowerment is vital, as it shifts some control back to the birthing person, helping to mitigate feelings of helplessness and anxiety that can accompany childbirth.

Enhancing Communication

Birth plans also catalyze essential conversations between obstetric providers and their patients. These discussions about the preferences and expectations outlined in the birth plan allow providers to gain insights into their patients’ goals and fears, setting the stage for realistic expectations and mutual respect. This open dialogue is the foundation of a strong provider-patient relationship, which is crucial for a positive childbirth experience (Bringedal, 2019).

Enhanced communication facilitated by birth plans extends beyond the dialogue between providers and birthing persons. It also involves the interaction among medical teams, where a birth plan communicates vital preferences to everyone involved in the delivery process, ensuring a coordinated and respectful approach to childbirth.

Reducing Birth Trauma

The capability of birth plans to reduce the likelihood of birth trauma cannot be overstated. By promoting informed decision making and respecting individual preferences, birth plans help ensure that birthing individuals feel heard, supported, and respected. This supportive environment significantly decreases the chances of traumatic outcomes and enhances the overall wellbeing of the birthing person.

Implementing Birth Plans in Practice

For obstetric providers, the implementation of birth plans involves equipping themselves with the necessary knowledge and resources to effectively support expectant parents. This might include providing educational materials, offering templates for birth plans, and ensuring access to ancillary support services such as childbirth education classes, doula services, and mental health resources.

If your practice has partnered with FamilyWell to integrate our mental health services, your patients will get support from our Perinatal Behavioral Health Coaches who are well-equipped to help guide them in putting together a personalized and evidence-based birth plan. 

Addressing Challenges and Misconceptions

Addressing potential challenges and misconceptions surrounding birth plans is also crucial. Providers must navigate the delicate balance between adhering to the birth plan and making necessary medical decisions when complications arise. It is important to communicate clearly and compassionately with birthing persons when deviations from the plan are needed due to medical reasons, ensuring they understand the rationale and feel involved in the decision-making process.

Training and Education for Providers

Training healthcare providers on how to work effectively with birth plans is another critical step. This training should emphasize the importance of respecting the birthing person's wishes while also preparing providers to discuss when and why it might be necessary to deviate from the plan for safety reasons.

Continuous Improvement and Feedback

The use of birth plans should be a dynamic process, with continuous feedback loops from parents and obstetric providers to improve practices. Encouraging feedback about the birth plan process can help obstetric teams refine their approach, making them more responsive and adaptable to the needs of expectant parents.

The Future of Birth Plans

In conclusion, birth plans are more than just documents; they are a fundamental component of modern obstetric care that can significantly enhance the childbirth experience. By embracing birth plans, obstetric providers not only empower their patients but also foster an environment of trust and respect, which are essential for a positive and fulfilling birth experience. As we move forward, let us continue to champion the use of birth plans and strive to create birthing environments that prioritize the mental health and autonomy of all individuals involved. With this approach, we hope to see a decrease in birth trauma and an increase in satisfaction and joy during one of life's most significant milestones.

References

• Ahmadpour et al. BMC Pregnancy and Childbirth (2022) 22:862 https://doi.org/10.1186/s12884-022-05199-5 

• Bell, C. H., Muggleton, S., & Davis, D. L. (2022). Birth plans: A systematic, integrative review into their purpose, process, and impact. Midwifery, (111), 103388. https://doi.org/10.1016/j.midw.2022.103388

• Bringedal, H., & Aune, I. (2019). Able to choose? Women's thoughts and experiences regarding informed choices during birth. Midwifery, Volume(77), 123-129.

• Fact Sheet Maternal Mental Health Leadership Alliance. (August 2023).