Check out this post on birth plans from the Rebirth blog. She brings up some important points about why birth plans are so often treated with derision.
What resonated most with me was this:
And then I've seen very inflexible birth plans that request things like no fetal monitoring (absolutely impossible in the hospital) which basically ask for things that are better for a home birth. These types of birth plans I have no problems with in regards to what they want or not want, but often scratch my head wondering if these couples have taken into account that they are giving birth in a hospital. As much as I feel continuous fetal monitoring or even IVs are not necessary in every birth, some hospitals have environments, protocols, etc that don't "allow" for this. I really think those who want to avoid all interventions look into alternatives to birth sites because the second you step into a hospital you give up some things, like complete control. I wish this wasn't the case, and try very hard as a nurse to let women know about informed consent and choice, but there are very few hospitals I know of that go with any request a woman has.
It's so important that women realize what is and is not realistic in hospital birth. For more on this, read You Buy the Hospital Ticket... You Go for the Hospital Ride. Giving birth in a hospital is different than giving birth at home. Wonderful, fabulous, and low-intervention births happen every day in hospitals, but they are still hospitals. Why would you go there if you basically want to have a home birth? Walking into a hospital in labor and announcing that you reject all its care is a recipe for disappointment -- and possibly a terrible birth experience, because your expectations and reality will be so different. Why set yourself up for this?
If you're planning a hospital birth, find out what the standard procedures are. Then talk to your doctor and your doula about how you are work with any aspects you want to avoid (i.e. a saline lock instead of being hooked up to an IV). Going in with realistic expectations -- and a realistic, well-researched birth plan -- will greatly improve your odds of having a satisfying experience. And isn't that what we're all looking for when we write these plans?