Here are some comments from a forum on the topic of birth plans:

" In fact, it is also legally binding. So if, for example, you have stated that you do not want an episiotomy, then they must be able to give a plausible explanation as to why one was done."

"It would be important not to use a continuous CTG: it is only a snapshot. You know best when the contractions start and push based on how you feel and not on what the machine tells you. There is a mobile device during the contractions."

“Free movement! Just don’t lie on your back.”

“Quiet, no hectic running back and forth.”

“no unnecessary checking of the MM.”

"When the baby is here, there will be enough time for cuddling and the umbilical cord to stop pulsing! Very important! The blood belongs in the baby! No pulling on the umbilical cord so that the placenta comes faster - it will come, you just need patience"

Based on these statements, you get a good feeling for what things are being discussed online in connection with the topic of birth plans and on what emotional level this takes place.

However, if you now go into the Story If you go back a long way, you realize that births have always been planned by women. At that time, it was more about practical things, such as when to call the midwife, who is responsible for what, who cooks, etc. Originating in the USA in the 80s, the birth plan is now a way for those affected to communicate their wishes and ideas and to help shape their own birth.
The current trend in obstetrics, This is my impression over the last 25 years, and it is still moving in a very medical direction. Although in professional circles there is a greater focus on returning to nature. However, this is countered by research, statistics and, not least, the increasing willingness of patients to sue.

So where does recommendation, guidance through the birth and responsibility of the midwife and doctors end and where does personal responsibility, right to have a say and self-determination begin?

In 2002, the anthropologist Robbie Davies-Floyd described two care models:

• The technocratic medical model
• The humanistic, unifying model

In the medical, technocratic obstetrics the female body is considered uncontrollable because it is under the influence of nature. They believe that this requires monitoring and control - the "improvement" of birth (in comparison to "wild" nature), so to speak. Responsibility for the woman giving birth and her child is transferred to the doctor. The woman herself is hardly allowed to have any say in the matter of her body and becomes a recipient of orders.

In complete contrast to this is the humanistic model to understand. Here, the connection between body, mind and psyche, but also the family circumstances, the past and the culture are considered important. It is an individual birth assistance, which normally corresponds to the work of a midwife. This model also sees the personal responsibility of the woman giving birth as very important.

This is where the birth plan comes into play…

... it should clearly present the most important ideas and wishes and serve as an aid for midwives and doctors to assess the woman more quickly and easily. Numerous studies show that the feeling of self-determination and participation goes hand in hand with comprehensive satisfaction with the birth experience. One difficulty, however, is that the woman needs appropriate information in advance and very good birth preparation in order to take a serious birth plan. Otherwise, statements such as those presented above often lead to disagreements, mutual incomprehension and even conflicts in the delivery room.

In this country, hospital staff still view birth plans with scepticism. They often see them as interference and a questioning of medical and professional competence.

"The common goal must therefore be to achieve individual, as natural as possible, birth assistance that nevertheless takes place under safe, medical conditions."

In general, I can report from my experience that both doctors and midwives are very open and willing to learn. It just depends on how you approach people. In general, it works very well to get the woman on board with her self-determination and personal responsibility. This can of course be done through appropriate conversations during the birth. Women giving birth and their partners can assume that the medical staff in the hospital are generally well-disposed towards them. Everyone involved wants the same thing – healthy women and children.

Of course, most measures can be viewed from two perspectives, so even in medicine there is rarely an absolute black-and-white way of thinking. It is important to have not only your own ideas but also trust in the expertise and experience of the midwife and doctors.
This makes it all the more important to have a good birth preparation session or a midwife consultation before creating a birth plan in order to gather useful, individual and important points. In my opinion, the classic and generic birth plans, which often contain points that are standard from a medical point of view these days, make little sense.

I usually encourage women to first write a birth plan for themselves or simply think about what they can prepare themselves to ensure the birth goes as smoothly as possible.

Examples of this would be

• breathing exercises
• Healthy and preferably sugar-free diet and sufficient drinking
• get your digestion going
• Daily exercise in the great outdoors and learning to build self-confidence and trust in your own body
• Acquire knowledge about birth and thus reduce fear of it
• Midwife discussions about the individual birth mode and other options

I am confident that the path to ever better, individualized obstetric care that respects nature is a shared one! Both the women giving birth and their partners, as well as midwives and doctors, have the goal of making birth a special and beautiful experience.

To achieve this, it is important to treat the woman's body, her psyche and the feelings of the unborn child, as well as the people accompanying her, with respect. This same respect should also be shown to the people providing care. They use all their knowledge and experience to help pregnant women and young families every day and do so with complete conviction. Possible forms of the birth plan can include a point plan or a letter.

Possible forms of birth plan:

1.The points plan :

The following considerations regarding pregnancy, birth and the postpartum period can be taken into account.

Pregnancy:
– Which midwife(s) do I want or need to look after me?
– Do I feel in good hands with my gynecologist if I become pregnant?
– Where do I get my information from? Who do I ask about which topic?
– Where can I get good birth preparation?
– Where do I want to have my baby?

Birth:
– What birth positions are there?
– What painkillers are available and what medical issues can I usefully have a say on?
– What can I do to ensure a positive birth process (e.g. preparation, breathing, etc.)?
– Who should accompany me to the birth and in what form?
– Am I more of a natural type or do I trust more in conventional medicine?

For the postpartum period:
– Do I want to give my baby vitamin K?
– Collect information on topics such as the use of pacifiers, supplementary feeding, other measures, etc.
– Which midwife will take care of my aftercare outside the hospital?
– Which care points are particularly important to me?

2.The letter:
This approach to a birth plan can be a kind of memory aid. Above all, very important, possibly medical or cultural peculiarities are listed here again and ideally also discussed with midwives and doctors in the delivery room. The letter format helps to make everything available to everyone involved in a clear and concise manner and to avoid problems as much as possible.