Wishes, Preferences, and Birth Plans Aside …

”One cannot actively help a woman to give birth. The goal is to avoid disturbing her unnecessarily.” ~Michel Odent

Wishes, Preferences, and Birth Plans Aside …

Often the language women use in birth plans is designed to diffuse conflict with care providers. Words like “preferences” or “wishes” are frequently favoured over direct language like ‘I DO NOT CONSENT TO …..”.  Then, rather ironically, when women speak openly about being mistreated by care providers, they are told that they didn’t use the right language. They should have said “I DO NOT CONSENT, I want to see that policy in writing. Get me your legal department.”

So which is it? Must women be assertive or must they constantly attempt to soothe and mollify service providers?

Perhaps the problem isn’t with language nuances. Perhaps the problem is the way maternity care providers view their jobs. Furthermore, it’s possible that there is a major problem with the way society (obstetric culture) blames women for things that are beyond their control – like the behaviour of other people.

The jokes about irrational pregnant women are so prevalent that they’re not really jokes anymore, they’re a kind of misogynistic urban mythology.

Husband: My wife is five months pregnant. She’s completely irrational!

Doctor: So what’s your question?

Being hormonal doesn’t make you crazy, and it certainly doesn’t make your feelings any less valid, or the things you want unimportant. Somehow or other it became the job of pregnant women to become caretakers for everyone else though… even though they’re too irrational to know what to order for lunch.

The pressure is on! Women should never inconvenience anyone, especially not care providers. They are busy and important!

Women on the other hand are just silly and inconvenient, not to mention irrational. They are most certainly not in a position to know what’s best for them, let alone their babies  ….

A woman shouldn’t be concerned that the language she uses in HER birth plan, requests she makes for her healthcare, or the wellbeing of her baby, will upset the people who are earning money to look after her. A plumber must do the work requested or they don’t get paid, and the same goes for maternity care providers.

Whether her birth plan had Wishes or I DO NOT CONSENTs, is irrelevant. Both are perfectly articulate, and how the care provider feels here isn’t really important. What matters is that the woman feels safe and respected when she is giving birth

It is true that care providers feel shocked and saddened when a woman or baby dies in their care, but that is not a license to override the woman’s wishes. This is written in law so there’s not much else that needs to be said. The law deems pregnant women – hormones and all – to be competent decision makers.

Women take many things into account when they make a plan, including the possibility of things going awry. Claiming that birth plans are not legally binding is a moot point, it’s playing semantics. Consent or refusal, whether it’s written in comic sans or in RED CAPITALS, whether it’s whispered or shouted, is black and white.

The truth is that hormones do make pregnant women more vulnerable to emotional distress, but the only noble response is ….. SYMPATHY.  It’s mind blowing, right? Imagine responding to vulnerable or distressed humans WITH KINDNESS!?

This is especially true for the care providers, because you can not call yourself a CARE provider and then actively or thoughtlessly disregard woman’s wishes, pompously believing that you know better than she knows about what’s good for her. It’s time for the law to develop a little bite to go with the bark, or yapping that accompanies informed consent in maternity care.

“Whenever and however you intend to give birth, your experience will impact your emotions, your mind, your body and our spirit for the rest of your life.” ~Ina May Gaskin

Pregnant women don’t need to alter their behaviour, or the language in their birth plans to appease other people. They don’t need to write wishy-washy birth plans. They need to push a baby out whilst care providers actively and unquestioningly CARE.

Whether they like her and her plan or not, they don’t get a say in the matter. No more than a vegan checkout chick at woolworths gets to tell customers not to buy steak. It’s time to stop focussing on risks, because birth is not actually all that dangerous for the vast majority of women. It’s time to bring the focus back onto the woman, and her rights.

Her RIGHT to informed decision making

Her RIGHT to bodily integrity


Not the risk that a nurse, midwife, or surgeon might be sad if a baby dies, because if there is any guarantee in life, it’s this: No one grieves the loss of a baby quite like the mother.

When there is a tragedy in birth, the greatest comfort a care provider is entitled to, is knowing that they truly worked with the mother, they respected her RIGHTS during the birth, they upheld her bodily integrity, and that although she is grieving, they did their very best to minimise her trauma, because trauma and grief are separate emotions, and cruel bedfellows.

Colourful eggs in a nest
A birth plan isn’t putting all the eggs in one basket
License: Creative Commons CC0.

Birth is a complex set of events, it’s a physical and emotional transformation. Our culture has come to view it as a purely physical event, something that women are passengers in, rather than drivers. This approach to birth is leaving everyone else in charge, with women and babies at the bottom of the heap. This is apparently justified by the callous and misinformed perceptions of the competency of women during pregnancy, but ethically and legally there is no justification.

If the greatest achievement a care provider can boast, is that their clients all had a pulse at the end of it, then they aren’t providing much care. As with all businesses (and obstetrics is a GIANT business) customer satisfaction is paramount. Homebirth and freebirth numbers are increasing slowly but surely. That’s not because women are crazy and irrational, it’s because their voices can not be heard over the din of control and regulation in birth politics. The birth of a baby isn’t about creating ease and comfort for care providers, it’s about forging families.

“Birth is not only about making babies. Birth is about making mothers. Strong, competent, capable mothers who trust themselves and know their inner strength.” ~Barbara Katz Rothman

One Response to "Wishes, Preferences, and Birth Plans Aside …"

  1. Lisa Morgan
    Lisa Morgan  29 January, 2016 at 1:20 pm

    testing the comments system


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