It’s Not a Preference

I try not to be triggered by words. Especially one as harmless as preference, and yet here I am. Angered by a word.

It started when I was first in trouble with the hospital. I would say the family had this on their birth plan. My manager would correct me, “It’s called a birth preference”. You see the word plan implies families will be respected and honored. Someone having a plan is in charge of that plan. Preference takes just enough power away from families. “They need realistic expectations, sometimes plans can not be accomplished.” Anyone having a baby knows that sometimes plans change.  We can plan and dream about best case scenarios, we can be aware of potential complications while verbally refusing to let them in our rooms.

We can treat families like they are normal and routine, until something comes up. Instead of treating them like a ticking time bomb of potential emergencies.

Life plans change all the time, look at me, I thought I would retire as a nurse. We don’t tell a bride that her plans are great preferences, when you go to a restaurant you don’t say I would prefer no ice. Preference is a passive word, where plan is an active one. Some families are ok being a more passive participant in their birth. They want everything their Dr has to offer, their birth plan really is more of a list of preferences, and thats ok. We can honor that, and those families, still giving informed consent and encouraging shared decision making. This is for the other families, the ones who have thought out and researched every aspect of their care. Those who really want something a little different than the standard hospital birth.

It became a thing at my meetings with HR. I would say birth plan and defend that the family and the community call it a BIRTH PLAN. And my manager would get more and more triggered as she corrected me.

It happened again at the hospital birth I just attended. Changing the word plan to preference in an attempt to take power away from my sister. “I realize that this is your preference, but it is not allowed.”

It seems trivial, maybe I’m overreacting, but it feels like a very big deal to me. Changing the word plan to preference takes mom from boss of the birth to participant. It means that although she’s lovely thought out this plan the hospital is in charge.

The law is clear, the patient is always in charge, we always need consent before medication, intervention and touch. My plan for my own hospital births was not a preference.