Patients presenting with birth plans: A case-control study of delivery outcomes

Shad H. Deering, Jessica Zaret, Kristen McGaha, Andrew Satin

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: To determine if labor management and outcomes, specifically epidural use, cesarean section and episiotomy rates, are different between patients presenting with formal birth plans and matched control patients without plans. STUDY DESIGN: Patients admitted in labor with birth plans over a 3.5-year period were identified. Patients were excluded if they required a cesarean section prior to labor or if they delivered outside the institution. For each birth plan patient, 2 age- and parity-matched controls were identified. Birth plans and medical records were reviewed for all patients and delivery outcomes recorded. Statistical analysis was performed utilizing χ 2 and Fisher's exact test as appropriate. This study was approved by the institutional review board. RESULTS: Seventy-one patients with birth plans were identified, with complete information available for 68. Sixty-four met the inclusion criteria, and for those 128, matched control patients were identified. There was no difference in the cesarean section rate (17% [11/64] vs. 22% [15/128], p=0.30) or episiotomy rate between patients with and without a birth plan (25% [13/53] vs. 23% [26/113], p=0.83). There was a significant difference in the epidural use rate in patients having a vaginal delivery, with birth plan patients receiving an epidural less often (57% [30/53] vs. 78% [88/113] p=0.005). CONCLUSION: As compared to age- and parity-matched controls, patients in our study with birth plans did not have an increased incidence of episiotomy or cesarean section but were less likely to receive epidural anesthesia during labor.

Original languageEnglish (US)
Pages (from-to)884-887
Number of pages4
JournalJournal of Reproductive Medicine for the Obstetrician and Gynecologist
Volume52
Issue number10
Publication statusPublished - Oct 2007
Externally publishedYes

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Keywords

  • Birth plans
  • Obstetric delivery
  • Pregnancy outcome

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Reproductive Medicine

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