... encouraging women to complete birth plans simply reinforces the assumption of incompetence. The implicit message is that, while women may be deemed competent at the time they complete the plan, at the onset of labour and delivery they will no longer be so. This is an essentially questionable assumption that lacks foundation, but one that is clearly shared by many midwives.
"The ideal time to discuss birth options is the antenatal period when there is adequate time, rather than in labour when pain and anxiety are likely to detract from the woman's ability to make in formed choices (p.54)**"
Birth plans are a relatively recent preoccupation, undoubtedly intended to help to meet women's needs, but those clinician and midwives who congratulate themselves on encouraging women to make birth plans have rather missed the point. It is indeed difficult to think of another area of health care in which patients have to note down all those procedures and interventions they do not wish to have, prior to coming into hospital.
I'd never thought about it that way before, but that is, in no small part, what I love about homebirthing, you don't have to deal with making the "plan".
Source: Cahill, H. 1999. Court ordered caesarean section and women's autonomy. Nursing Ethics, 6(6). 494-505.
**Source: Judge, E. 1997. Choice in intrapartum care. Nursing Times, 93(10), 54-55.