European Journal of Molecular & Clinical Medicine

Abstract

Birth plans have received a positive response in most developed countries as a way to bridge gaps and enhance relationships between the subject and the care giver, but in some countries, they have been subjected to skepticism as it led to friction between the doctor and the subject. In India educational status is a great determinant of child birth planning. Most women lack formal education about process of delivery, its risks and complications, hence, in Indian scenario birth plans are still a neo entity. This study was conducted in order to assess awareness of birth plan in Indian women, awareness regarding the process of child birth, the mother’s preferences and choices regarding mode of delivery, and patient satisfaction post-delivery.
Methods: A questionnaire was developed that assessed parameters such as educational status, parity and awareness of birth plan in women in their third trimester attending the antenatal clinic and a post-partum questionnaire was administered within 2 weeks of birth or at post-partum visit. Patient satisfaction was then assessed based on the data collected.
Results: A total of 220 women completed the questionnaire, of which 1.4 per cent (n=3) were aware about a birth plan while the others (n=217) which included women from all strata of society and varying education levels, had no awareness of the concept of a birth plan. Although 98.6% of women were unaware of a birth plan most (77.3%) opted for a vaginal delivery and 22.7% opted for an elective cesarean section. While all the women (100%) requested for any form of pain relief intra and post-partum, only 87.7% (n=193) were satisfied with the pain relief they received. Women whose mode of delivery was as planned reported higher satisfaction rates. Overall 88.01% women (n=194) who were not aware of birth plan still had positive satisfactory childbirth experience while 11.98% (n=26) reported negative experience.
Conclusions: Though 50.50% of women in the study were educated up to higher secondary level only 1.4% were aware of the concept of a birth plan. Hence, education is not a sole determinant in the lack of awareness of planning for a birth. Other determinants that seemed to play a role in the mother’s satisfaction rates were mode of delivery, management of labour and post-partum analgesia and cultural beliefs such as sex of the child.