the value of communication and the infantilization of women

graphic birth plan

The graphic birth plan is a growing trend we find particularly concerning. Templates are available for free on many sites or they can be customized on sites like etsy. Don’t get us wrong - we LOVE great graphic design and believe in the power of images in marketing and simple communication (like the road is curvy, this is a bathroom, or hey! that’s poison) - but we are very concerned about the implications of pictorial communication, what this trend could mean for birthing people, and the harmful impact it can have on an individual’s birth and postpartum.

A Birth Plan is not a contract, but is a tool for communication with a birthing person and the care team responsible for ensuring the safety of the birthing person and baby. This birth plan holds in it important information that is critical for the birthing person to receive optimal care. Items often communicated are a person’s desire for a medicated/unmedicated/cesarean birth, wishes for medical treatment, pain relief, communication, vaginal exams; and who is a part of and who is excluded from the care team (residents/students?), just to get started. At BEST we recommend in the Preparing for Birth curriculum that a birthing family write a plan A, a plan B, and a plan C. This means that they are writing their ideal birth plan, an induction or alternative birth plan, and a cesarean birth plan. They are also writing a plan for their baby’s care where they are communicating how they wish their baby be cared for. This may include choices in pediatrician, rooming in, feeding, bathing, vaccination, vitamin K, antibiotic eye ointment, and circumcision, just to get started. Birth plans should be used prenatally to foster communication between the birthing people and their chosen care teams and become a point of reference during labor, birth, and postpartum for anyone new to the care team like on-call physicians and nurses.

The information in a birth plan should be written concisely and clearly. The use of superfluous images detracts from the value of the written word and sends a message about the individual using pictures to communicate. It sends the message that she does not understand her words. Or those of the health care team. They speak a language of medical jargon that she is not privy to and that she cannot or does not wish to understand. It shows that her priority in birth is that things be sweet, cute, simple, and look nice.

Does a picture convey 1,000 words? yah. def. But maybe not the 1000, or even single word you mean to convey. Does a birthing person really want to leave their care up to an individual interpreting an image in the way they intentioned? Pictorial communication is used as a standard when it is important to communicate with persons of any reading ability or inability - think again about street signs, bathrooms, and poison warnings.

The hospital (or birth center) staff is not illiterate. They must all be able to read, write, and type. Good grief, nurses must be able to read orders written in some pretty terrible hand writing sometimes. Nurses, midwives, and doctors must be able to navigate some not-so-intuitive medical charting systems - with words. Midwives, doctors, and nurses do NOT chart with pictures. It is so imperative that communication be clear between health care providers that many abbreviations once common in medical charting are no longer accepted or advised.

At a time in the US when maternal mortality rates are higher than any other industrialized nation, we cannot afford to take any steps away from patient advocacy, autonomy, or communication. Every patient has the right to informed consent and refusal in their preferred language. So, unless a person is otherwise limited to pictorial communication, this must be provided in either spoken or written language. If everyone in a care taker role is communicating in written or spoken language, what does it say about the birthing person who is communicating in pictures? Picture books are written for children. Pictures are used to communicate when words are not an option (illiteracy and language barriers). What risk do we run in infantilizing women?

birth plan graphic how to

The infantilization of women, or birthing people, removes power. It communicates that we want things to be cute, sweet, and pretty. When in real life, decisions about our health care, especially in birth are hard, real, and even uncertain. Birthing people are powerful and capable of understanding options presented to them and making decisions in their health care. Without pictures. It is equally wrong to use the vulnerability of birth to elicit fear to manipulate decision making as it is to use pictures, smiley faces, pretty colors, and gimics to create reason for treating a birthing person as if they do not understand medical jargon or circumstances of their case - and this is a created risk. How can we as birth workers, understanding the rates of women dying and the manipulation and violence they face in birth, recommend our clients degrade their communication from words to pictures? In actuality, what we must do is help facilitate communication and demand that the words of birthing people be heard.


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