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. This gives the patient time to consider and consent to different emergency options. Although 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.