Madeleine Akrich

Centre de sociologie de l’innovation, Mines Paristech


The Birth Plan: A « catch me if you can » radicalisation?

The Birth Plan is a written statement in which a pregnant woman “expresses [her] desires and what is important to [her] when [she] is in labor and giving birth. A birth plan describes the experience [she] hopes to have, and the ways [she] wants support or help from those who are caring for [her].” (“Writing a Birth Plan,” 2014)

The birth plan was promoted by the Associaiton of Radical Midwives in the UK and by American and British birth activists in the very end of the 1970s in response to the increasing medicalization of birth : the very idea of the birth plan was intended to set up a partnering relationships between « patients » and carers which extends until the discussion of medical procedures to be applied, and to allow for a personalization of care. Despite the fact tha the Birth Plan conveys what might be considered as a radical shift in the prerogatives of patients, from the 1980s onward, it has spread in many countries (USA, Sweden, Israel, UK, Switzerland, Australia, Uganda, Taiwan, Canada, Finland, France, Scotland, Germany, Japan, Spain, Ireland, Tanzania, Mexico, to cite countries in which at least experiments has resulted into an academic publication on this topic).

What can be concluded from this observation ? Is it that a very simple device suceeded in redefining care and patients – carers relationships ?

Drawing upon a number of spotlights on specific events and controversies, this presentation tries to capture the everything but linear and straightforward destiny of this innovation : it shows that the Birth plan underwent a number of transformations and reconceptualisations which might have lessened its radicality while facilitating its circulation. At least, I will demonstrate that each of these versions produces a specific meaning of personalisation and performs a normative definition of the actors, their expectations, their competences and their roles.