title: Introducing birth plans in Mexico: an exploratory study in a hospital serving low-income Mexicans.
abstract: BACKGROUND
  Increased medicalization of childbirth in Mexico has not always translated into more satisfactory childbirth experiences for women. In developed countries, pregnant women often prepare written birth plans, outlining how they would like their childbirth experiences to proceed. The notion of expressing childbirth desires with a birth plan is novel in the developing world. We conducted an exploratory study to assess the feasibility and acceptability of introducing birth plans in a hospital serving low-socioeconomic status Mexicans and to document women's and health practitioners' perspectives on the advantages and barriers in implementing a birth plan program.
  
  
  METHODS
  We invited 9 pregnant women to prepare birth plans during their antenatal care visits. The women also participated in interviews before and after childbirth. We also conducted in-depth interviews with 4 women who had given birth in the past year, and with 2 nurses, 2 social workers, and 1 physician to learn about their perspectives on the benefits and challenges of implementing a birth plan program.
  
  
  RESULTS
  All 9 women who completed a birth plan found the experience highly satisfying, despite the fact that in some cases, their childbirths did not proceed as they had specified in their plans. Interviewed practitioners believed that birth plans could improve the childbirth experience for women and health care practitioners, but facilities often lacked space and financial incentives for birth plan programs.
  
  
  CONCLUSIONS
  Our findings suggest that birth plans are acceptable and feasible in this study population. Facility administrators would need to commit to provide the physical space and financial incentives necessary to ensure successful implementation.
authors.affiliation: Population Council's Mexico Country Office, Mexico City, Mexico.
authors.forename: Eileen A
authors.initials: EA
authors.lastname: Yam
authors.forename: Amy A
authors.initials: AA
authors.lastname: Grossman
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Goldman
authors.forename: Sandra G
authors.initials: SG
authors.lastname: García
mesh_terms: D005193:Family Planning Services / Q000458:organization & administration*; D005260:Female; D006786:Hospitals, Urban; D006801:Humans; D007743:Labor, Obstetric / Q000523:psychology*; D008429:Maternal Welfare; D008800:Mexico; D009035:Mothers / Q000523:psychology*; D033262:Narration; D010358:Patient Participation / Q000523:psychology*; D017060:Patient Satisfaction; D011203:Poverty; D011247:Pregnancy; D011295:Prenatal Care / Q000379:methods*; D012944:Social Support; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires