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Subject:
From:
Susan Majoris <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Mon, 13 Oct 2003 09:37:09 -0400
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The topic of birth plans has been an ongoing issue among our staff - educators, physicians and nursing.  Because we emphasize planning birth in our classes we needed to find a way to make them work.  
We found they did not work for several reasons.  Some birth plans were "born" out of fear.  Some parents were drafting birth plans based on their fears instead of their identified preferences re: options for labor and birth management. We now address this in class and talk about preferences - also trying to work through the fear issues.  Parents who write birth plans/preferences have to make it a part of their personal fiber so it becomes them and excites them about giving birth.   If fear is the driving force and prevention of problems possibly the reason - it becomes a set-up.
Then there is the knowledge level of both nursing and physician staff to actually support with non-pharmacological pain management if requested. Some could not.  We had a labor workshop for nursing staff that was all day - that gave them the opportunity to try rebozzos, birth balls, position changes etc..  Now since the nurses basically run the place - this was an important step 
It is important to be open minded.  A couple might want to do a self assessment prior to labor and birth.  They may realize a doula is needed - to support their individual needs.   Penny Simkin's work on pain management is great -we use it in all of our classes.  
Birth Preferences need to be communicated to HCP prior to admission and to nursing staff on admission.  We recommend that after discussion with HCPs all birth preference lists go on the moms prenatal chart.  
The couples who are assertive and able to advocate for themselves -  USE THEM!  They are vehicles of change.  Consumer satisfaction in any organization is a big thing.  If they know they can help create change for others, it often makes them more passionate about their own needs.  
Criticism and complaints goes a very short distance.   Sue - Indiana Regional

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