Obstetrical outcome in women with self-prepared birth plan.

Objective: To determine whether introducing a pre-prepared birth plan upon labor admission has an impact on obstetrical outcome.
Methods: A retrospective study of all women who prepared an ante-partum birth plan, from 2007-2010. Outcome was compared with a control group consisting of women without a birth plan matched by age, parity and gestational week in a 3:1 ratio.
Results: 154 women were compared to a matched control group of 462 women. Women preparing a birth plan, were less likely to undergo an intra partum cesarean section (11.7% vs. 20.3%, p = 0.016). First and second degree perineal tears occurred more frequently in women preparing a birth plan (72.1% vs. 25.5%, p < 0.001). The utilization of birth plan was also associated with a higher rate of epidural administration (81.2% vs. 68.8%, p = 0.004) and a lower rate of intravenous analgesics use (1.3% vs. 10.2%, p < 0.001).
Conclusion: Women presenting with a birth plan, compared to an age-, parity- and gestational week- matched control group are less likely to undergo a cesarean section, more likely to have first and second degree perineal tears and more likely to use an epidural. The paucity of data and the mis-concepts of medical staff suggest that larger prospective studies are needed.