Store My Library

Rethinking Birth Plans: Communication and the Failure to Understand

Keywords: birth plans, informed consent, birth preferences, healthcare communication, obstetric care, birth experience, birth trauma, obstetrics, patient care, unconditional positive regard, healthcare relationships

 

In this conversation, Justine Leach, Ph.D. and Sarah Adelmann, L.M.H.C.,  discuss birth plans, emphasizing the need for a more holistic approach that incorporates the emotional and relational aspects of the birthing experience. Justine begins by sharing the findings of a recent article that asks whether the topics given to women on birth plan templates in Spain include what really matters to them. Justine and Sarah then critique the traditional focus on medical procedures and interventions, advocating for a shift towards understanding the feelings and emotional needs of birthing individuals. The discussion highlights the importance of informed consent, continuity of care, and the need for healthcare providers to foster a deeper connection with their patients to enhance the overall birthing experience. The conversation gets heated when Justine shares another article she read in preparation for the episode in which an obstetrician advocates for more flexibility from birth givers through creating birth preferences rather than birth plans. Justine and Sarah express their frustration with this obsterician's point of view and share their belief that his interpretation of the cause of challenging communication with patients and birth trauma is misplaced. The discussion highlights the significance of unconditional positive regard in healthcare and the necessity not only of creating better communication tools for birth givers to express their needs and concerns effectively, but also of providers understanding their role and responsibility in support birth givers in feeling seen, heard, and in control during birth.

 

Artieta-Pinedo, I., Paz-Pascual, C., Garcia-Alvarez, A. et al. Does the birth plan match what is relevant to women? Preferences of Spanish women when giving birth. BMC Women's Health 24, 42 (2024). https://doi.org/10.1186/s12905-023-02856-5

 

Mohan, R., Abdalla, M. A reflective practice on difficult communication: an obstetrician’s perspective on birth plan versus birth preferences. Discov Health Systems 3, 77 (2024). https://doi.org/10.1007/s44250-024-00129-y

 

Takeaways

  • Birth plans often overlook emotional and psychosocial aspects.
  • Informed consent should be a standard practice in obstetric care.
  • The structure of birth plans typically does not leave space for communicating emotional needs.
  • There is a need for curiosity from providers about patients' preferences.
  • It is not the responsibility of women and birthing people to be more flexible.
  • Communication about fears and values is crucial in birth planning.
  • The current system often fails to address the relational needs of patients.
  • A shift in mindset is needed regarding the purpose of birth plans.
  • Healthcare providers should prioritize understanding patients' emotional needs.
  • Many patients have experienced trauma related to birth.
  • Saying no to interventions does not indicate a difficult client.
  • The perception of normal birth can vary greatly between providers and clients.
  • Unconditional positive regard is a political stance in healthcare relationships.
  • Clients often feel powerless in the healthcare system.
  • Effective communication is key to improving birth experiences.

 

Sound Bites

  • "We should be communicating beyond just interventions."
  • "What do I want to communicate with my team?"
  • "The way we think about birth plans is missing a piece."
  • "Our clients want to be seen, heard, and in control."
  • "Having a client say no does not make them difficult."
  • "There's nothing normal about birth."

 

Chapters

00:00 Understanding Birth Plans: A Critical Examination

09:44 The Emotional Landscape of Birth Plans

20:14 Rethinking Birth Plans: From Procedures to Feelings

29:14 Understanding Birth Experiences and Communication

36:03 The Role of Providers in Birth Decisions

43:01 Unconditional Positive Regard in Care

47:47 Creating Better Communication Tools for Birth Givers

On the Resilient Birth podcast, Justine and Sarah explore the impact of trauma across the perinatal period, from trying-to-conceive to pregnancy, from childbirth to postpartum and parenting. Through an inspirational quote that drives our weekly conversations about trauma and healing, Justine and Sarah explore topics such as birth trauma, parenting as a survivor, and finding healing with vulnerability and compassion that support birthing people and birth professionals.

Each week, listeners leave with takeaways to utilize in their lives and/or clients. Justine and Sarah hold the stories they share with honor and respect with the hope to impart knowledge, increase understanding, and bear witness to this challenging topic.

Sarah is a licensed mental health counselor, educator, and mom of three. She walks with a story of trauma from before and as a result of her perinatal experience.

Justine supports survivors of trauma through perinatal coaching and childbirth education. As well as being a mother of three, she holds a Ph.D. on representations of consent and sexual violence.

Learn more about Sarah and Justine's course called Trauma Informed Fundamentals here: https://resilient-birth.mykajabi.com/traumainformedfundamentals