It is particularly important that the physician and patient discuss what will
be done if an emergency arises or something does not work out as hoped. A woman
who wants a large family may be very upset if a cesarean section becomes
necessary during her first delivery. If she has not been prepared for the
possibility, she may become angry with the physician who is doing the surgery.
If the reason for the cesarean section leads to a birth injury, this family is
primed to sue. In contrast, if the woman understands that cesarean delivery is
necessary if the fetus is in trouble and that it does not necessarily lead to
repeat surgery and limited family size, then she is better prepared for the
surgery and the possible adverse outcome in the baby.
The physician should document how the birth plan will be modified for different
emergencies to obviate the emotional turmoil that occurs when the patient's
expectations are suddenly disappointed. The patient has time to consider and
consent to different emergency options. While the patient retains her right to
change her mind after the birth plan has been signed, the process of preparing
and negotiating the plan should reduce the probability that she will become
dissatisfied with her decisions.
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