Marjorie Greenfield—

I may have gotten myself in trouble this week. I have written a lot about birth plans, but I don’t think my obstetrical colleagues read much of what I write. This week, though, I was quoted by the Cleveland Plain Dealer, saying that if you have special desires about your birth you are better off choosing care with a midwife. What I should have said is that you should choose a doctor or midwife practice and a birth location that will support your desires, rather than trying to make them practice your way with a written birth plan. I hope that anyone who reads the Plain Dealer article and worries that I am badmouthing doctors gets the context by reading some of my other writings about birth plans, such as on Yahoo! Health and drspock.com. I am just telling it like I see it, and trying to help mothers (and fathers)-to-be come to the birth process with optimistic but realistic expectations.

Birth can be a beautiful natural experience for those who want it that way, provided all is going well, although it is tricky to avoid medicalizing the experience when you give birth in a hospital. But having babies in the 1800’s wasn’t as safe as it is today, and some of that progress comes from the technology we have available to watch mom and babe.  If something isn’t going well, I hope you would want your doctor or midwife to recognize the problem and take care of you both, in a respectful, collaborative, and professional manner.  When everything goes well, you should be able to give birth without interventions from the care providers, and your birth experience can be the most important priority.

For an interesting discussion of this from a home birth perspective, check out the blog mama mid(wife) madness (and don’t miss the series of comments on the post from 3/25 called “Strong Feelings Anyone?”).

Marjorie Greenfield, M.D., is a practicing, board-certified obstetrician-gynecologist, a fellow of the American College of Obstetrics and Gynecology, and associate professor of reproductive biology at Case Western Reserve University School of Medicine. Dr. Greenfield has written hundreds of articles for the Web and currently blogs about pregnancy for Yahoo.com.

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