Alright, in this video we're going to talk about birth plans.

By the end of this video, you'll be able to discuss the evidence on birth planning

and talk about the research on how birth plans can sometimes create tension with hospital staff.

There's a lot less evidence on birth planning than there was on childbirth education,

so we won't have as many studies to talk about.

There's one randomized trial, I want to bring your attention

to several observational studies and a few opinion pieces. The main takeaway point is that you're

going to get different results with birth plans in different birth settings. The only randomized

trial I could find on birth planning came from Taiwan. This was a randomized single-blind trial published in 2007.

It took place at seven hospitals with 10 obstetricians in Taiwan. The researchers enrolled 296 first-time

mothers at 32 weeks gestation or greater. It's important to understand the culture and atmosphere in

Taiwan. The author described that women are passive and not likely to speak up to their doctors

because that would violate cultural norms.

The birthing environment in Taiwan, there are no midwives, very restrictive hospital policies,

a 33% cesarean rate, a culture of routine interventions, and a culture of respect for doctors.

In addition to that, women must have their pubic hair shaved before the birth, have enumas

when they come to the hospital, they're required to have IV fluids and continuous electronic

fetal monitoring, they must give birth in the lithotomy position, and they must have an

episiotomy.

Women in the intervention group in this study were given a generic birth plan with a list of

options that they could choose, such as shaving or no shaving, enema or no enema, shower

or no shower, freedom to eat and drink or not, etc.

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