title: Obstetrical outcome in women with self-prepared birth plan.
abstract: 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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Helen Schneider Hospital for Women, Rabin Medical Center, Petach Tikva, Israel.
authors.forename: Eran
authors.initials: E
authors.lastname: Hadar
authors.forename: Oded
authors.initials: O
authors.lastname: Raban
authors.forename: Bracha
authors.initials: B
authors.lastname: Gal
authors.forename: Yariv
authors.initials: Y
authors.lastname: Yogev
authors.forename: Nir
authors.initials: N
authors.lastname: Melamed
mesh_terms: D000328:Adult; D015360:Analgesia, Epidural / Q000706:statistics & numerical data; D016362:Analgesia, Obstetrical / Q000706:statistics & numerical data; D002585:Cesarean Section / Q000706:statistics & numerical data; D015331:Cohort Studies; D036861:Delivery, Obstetric / Q000379:methods* / Q000706:statistics & numerical data; D004841:Episiotomy / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007743:Labor, Obstetric; D010043:Outcome and Process Assessment, Health Care; D010358:Patient Participation / Q000379:methods*; D010502:Perineum / Q000293:injuries; D011247:Pregnancy; D012189:Retrospective Studies