Patients presenting with birth plans in a military tertiary care hospital: A descriptive study of plans and outcomes

Objectives: This study evaluates what type of patient prepares a birth plan, identifies common requests made, and determines how closely these are followed during labor. Methods: Patients who were admitted in labor with birth plans during a 3.5-year period were identified. Birth plans were analyzed, and common requests were recorded. Delivery records were reviewed, and outcomes were recorded. This study was approved by the hospital institutional review board. Results: Sixty-seven birth plans with delivery outcomes were available for review. The mean maternal age was 31 years, the median parity was 0, and 70% of patients had a college degree. The most common requests were to walk during labor (84%), to avoid episiotomy (82%), and to have no epidural (62%). Seventy-five percent of patients had spontaneous vaginal deliveries, and 19% had cesarean sections; the epidural use rate was 59%. Conclusions: Patients with birth plans were generally older and well-educated and, despite plans to avoid an epidural, most patients changed their minds.