Expert opinion vs. patient perception of obstetrical outcomes in laboring women with birth plans

Abstract

Objective: To examine the differing views held by patients and medical personnel on outcomes of women with birth plans at the time of labor.

Study design: Antepartum patients who were at least 18 years old and English speaking, as well as physicians and nurses in the obstetric field, were asked to complete an anonymous survey on their opinions of the obstetric outcomes of women with birth plans.

Results: Sixty-five percent of medical personnel vs. 2.4% of patients reported that patients with birth plans had overall worse obstetric outcomes than patients without a birth plan. There were 65.7% of health care providers vs, 8.7% of patients who reported that women with a birth plan had an increased rate of cesarean section. In addition, 53.4% of health care providers vs. 9.9% of antepartum patients reported a perceived increased rate of chorioamnionitis for women with birth plans. Statistically significant differences were also found between health care providers and patients in terms of their perceptions of the effect of birth plans on operative vaginal delivery, postpartum hemorrhage, episiotomy and length of hospital stay.

Conclusion: This study revealed a large disparity between health care professionals' and antepartum patients' viewpoints on the obstetric outcomes of women with birth plans, including the rate of cesarean sections and chorioamnionitis.