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Introduction
The use of birth plans as a mechanism to communicate preferences, particularly in
labour and birth, is commonplace in contemporary maternity care. There is little evidence
regarding the role of birth plans in elective caesarean birth. This study aimed to
explore insights from women who utilised hospital-initiated birth plans for their
scheduled caesarean section and from the midwives who provided care to women using
the plans.
Methods
A cross-sectional survey was undertaken between September 2019 and July 2020; 294
women and 18 midwives responded. Quantitative data were analysed using descriptive
statistics and qualitative data were analysed using content/template analysis.
Findings
Women responded to a series of discrete choices such as music playing in theatre,
screen being lowered on request and skin-to-skin post-birth. Most indicated they received
the care requested. Qualitative responses provided insight into the utility of the
plan to facilitate communication with professionals, which improved women’s experience
of being in control, exercising choice and emphasising the importance of their special
day. Midwives indicated the value of the plan to provide advocacy for women’s choices;
while systemic factors that inhibited full implementation of a plan were highlighted.
Discussion
Using a formal plan to communicate requests when preparing for elective caesarean
birth has utility in supporting women to effect choice and control, especially when
not receiving care in a continuity model. A plan enables the responsibility for awareness
and implementation of each woman’s wishes to rest with the whole multidisciplinary
team.
Conclusion
Scheduled caesarean birth requires the same individualised approaches to woman-centred
care that is the hallmark of midwifery. Findings of this novel study are useful to
consider education, multidisciplinary practice changes and policy support for ways
of respecting the uniqueness of caesarean birth for each woman and her family.
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Copyright
© 2022 Published by Elsevier Inc.
