Introducing Birth Plans in Mexico: An Exploratory Study in a Hospital Serving Low-Income Mexicans

Authors

  • Eileen A Yam MPH,

    Corresponding author
    1. 1Eileen A. Yam is a Regional Program Associate and Sandra G. García is the Director of Reproductive Health at the Population Council’s Mexico Country Office, Mexico City, Mexico; 2Amy A. Grossman is an Independent Consultant in Albany, California, USA; and 3Lisa A. Goldman is a Doctoral Candidate in the Department of Epidemiology, University of California, Berkeley, California, USA.
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  • 1 Amy A. Grossman MPH,

    1. 1Eileen A. Yam is a Regional Program Associate and Sandra G. García is the Director of Reproductive Health at the Population Council’s Mexico Country Office, Mexico City, Mexico; 2Amy A. Grossman is an Independent Consultant in Albany, California, USA; and 3Lisa A. Goldman is a Doctoral Candidate in the Department of Epidemiology, University of California, Berkeley, California, USA.
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  • 2 Lisa A. Goldman MPH,

    1. 1Eileen A. Yam is a Regional Program Associate and Sandra G. García is the Director of Reproductive Health at the Population Council’s Mexico Country Office, Mexico City, Mexico; 2Amy A. Grossman is an Independent Consultant in Albany, California, USA; and 3Lisa A. Goldman is a Doctoral Candidate in the Department of Epidemiology, University of California, Berkeley, California, USA.
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  • and 3 Sandra G. García ScD 1

    1. 1Eileen A. Yam is a Regional Program Associate and Sandra G. García is the Director of Reproductive Health at the Population Council’s Mexico Country Office, Mexico City, Mexico; 2Amy A. Grossman is an Independent Consultant in Albany, California, USA; and 3Lisa A. Goldman is a Doctoral Candidate in the Department of Epidemiology, University of California, Berkeley, California, USA.
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  • This study was made possible because of the generous support of the William and Flora Hewlett Foundation, Menlo Park, California, USA.

Eileen A. Yam, Population Council, One Dag Hammarskjold Plaza, New York, New York 10017, USA.

Abstract

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. (BIRTH 34:1 March 2007)

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