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Published 09.09.2008 | Permanent Link | Comments (17)
Your Baby:
You:
The Birth Plan
So. Does everyone have their Birth Plan written up yet? Have you typed it? Double-spaced it? Printed up back-up copies and filed one with the county courthouse and gotten one notarized?
Yes, I am a little bit snarky when it comes to the Birth Plan.
Not that I don't understand and agree with the logic behind a detailed Birth Plan -- I'm all for removing the fear from childbirth, for helping mothers feel empowered and in control of their bodies and the entire situation, and for doctors respecting their patients' desires to go natural or stay upright and out of bed or have immediate post-delivery skin-to-skin contact and breastfeeding or whatever the hell they want. All for all of that.
It's just that I've also seen the Birth Plan morph into something terrifyingly inflexible -- more like a woman trying to choreograph the birth down to the right song playing on the iPod. These ultra-detailed plans, with their high expectations and hopes for everything going so incredibly perfectly, sometimes seem more like the mother-to-be is trying to obsessively checklist her fears away rather than work through them with her midwife or doctor, or perhaps confront her instincts that her OB is not the sort who will respect even the most basic of her wishes. And even worse, anything that deviates from the Birth Plan will often get classified as failure.
Look, they don't give out medals in the maternity ward. There's no I Avoided The Episiotomy wall of fame bulletin board and they don't put little stickers on the babies' foreheads to distinguish whose mother had an epidural or not. (Although I do remember seeing a sticker on Noah's bassinet chart that read "I'm a breastfed boy!", but somehow I doubt the bottle-fed babies' stickers featured frowny judgement faces, or anything.)
Obviously, birth choices are personal. And important, to a degree. We all have our preferences and images of how we'd like childbirth to happen -- hospital, home, birthing center, water, dolphins, whatever. And you absolutely should voice your wishes and concerns with everyone involved in the experience. But like motherhood, childbirth requires a certain acceptance that you cannot control every aspect of it, and that sometimes you simply must stop and reassess things. Be it your own tolerance for pain or your baby's well-being. And you need to be able to reassess these things without feeling like you...gag...FAILED. Seriously, THEY DON'T GIVE YOU GRADES.
If you had asked me for a birth plan before my son was born, I would have probably started AND finished it with the epidural. I was certain I'd want it right away. I did not want to be miserable and in pain. Oh, that and breastfeeding as soon as possible. And I was pretty terrified of c-sections. So...let's try to avoid one of those.
Then I went into labor and discovered that I could handle the contractions after all, and that I found the whole thing incredibly amazing and empowering. I started thinking of going all the way unmedicated, but changed my mind at the very last minute (9 centimeters), when it was confirmed that the baby was badly positioned (occiput posterior), fairly large (macrosomia) and very, very high up in my abdomen. Lots of pushing in my future. I needed some rest.
So I reversed courses AGAIN and got the epidural after all and fell asleep for a little bit. Then I woke up and pushed and pushed, until alarms started going off and the baby wouldn't budge any further down the birth canal and his heartrate started to plummet with each contraction. Time to reassess again. C-section time.
As I breastfed my 9 pound, 15 ounce son for the first time in the recovery area, I did have a few minutes when I felt like I'd been hit by a truck. My childbirth experience was nothing like I had expected or planned for. When I tell the story to other women, it almost sounds like a worst-case scenario to them. But it really wasn't. It was amazing. I'm completely happy and at peace with how it went and how it ended. I did what I could. I experienced everything I really wanted to, but in the end, it was never about me and what kind of transcendent empowering experience I wanted. It was about a safe delivery of a healthy baby, full stop. And I got that. Oh, yes, I got that.
Oh Yeah, THIS: I'm done. I'm SO READY TO BE DONE. A few weeks ago the thought of being "done" was terrifying -- my due date was approaching much too quickly for my taste. I wasn't ready. I needed more time, GAH. I couldn't imagine feeling impatient and swore I would treasure every day of pregnancy because hoo boy, SO NOT READY TO BE DONE. And now I'm big and uncomfortable and awkward and just...just...DONE. Let's have a baby already!
New This Time Around: Oy, the heartburn. Nausea. Food aversions. All back in full force. If this keeps up until my due date, I'll have had exactly three months of NOT throwing up or suffering major gastrointestinal problems throughout the entire pregnancy. That is backwards as hell, and I would like to officially file a complaint with someone.
Finished with the Pregnancy Calendar and want more? Visit Amalah's postpartum weekly column, Bounce Back. Bounce Back is about the postpartum experience -- the good, the bad and the gory.
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Zero to Forty is a week-by-week guide to the miracle of pregnancy and all the various indignities that come with it. The calendar follows the forty-week model and is complete for now, though the author plans to come back and add some more articles soon.
The follow-up to this column, Bounce Back, is about the postpartum experience -- the good, the bad and the gory. There Amalah is covering everything that happens to your body, mind and circadian rhythms after you have a baby, and (hopefully) help you make sense of the New Normal. You must go read that too!
The column is well-researched but not written by a health care professional. Consider it your internet BFF pregnancy guide. See our legal disclaimer below.
Amy Corbett Storch, aka Amalah, is a freelance writer and professional blogger from Washington, DC. She has since had this baby. His name is Ezra, he was born in October of 2008 and is delicious. Amy's first son Noah is in preschool and he's pretty edible too. NomNomNom.
Amy also writes Alpha Mom's Advice Smackdown.
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Comments (17):
Katelin said:
Thank you for writing one of the first real things about a birth plan. I was one that semi-micromanaged my birth. Not a single thing happened that was on my birth plan and after all that I had read and was told, I felt like a miserable failure. It took me a while (yay, severe post-partum depression) to realise the fact that I had my baby and she was utterly perfect was all that mattered.
Thank you again. I hope your own experience and the wonderful way in which you put it into words will help some future mom not feel like shit when it all goes to the ducks.
You rock.
Posted on September 10, 2008 06:39
Hilary said:
I wonder how many non-pregnant women read this because I have enjoyed every week of it. :) Also, this seems TOTALLY real to me, this "Birth Plans kind of not always 100% happen that way" kind of deal. You have eased a lot of my fears for what I hope to one day experience. Thanks!
Posted on September 10, 2008 11:07
Arwen said:
I didn't have a birth plan, aside from a general wish to avoid interventions as much as possible. Due to some minor complications (including delivering at a completely different hospital than I'd planned) I ended up with IV fluids, constant monitoring, and an episiotomy - all things that would have been on my "I'd rather not" list. Still, I felt good about my birth, and I'm not sure if it's because I did get what I really wanted (to avoid a c-section) or because I understood all the interventions I had and accepted them as necessary.
At any rate, it seems to me that you've hit on something with your comment about women possibly making ultra-detailed birth plans because they're afraid their doctors won't respect their wishes. On that front, it seems like the solution is to find a caregiver who's on the same page as you are. (Even though I was happy with my birth last time, I'm going with a midwife instead of an OB this time around because of my natural-birth preferences.) I highly recommend Moxie's piece on Ask Moxie about how to have a good birth (www.askmoxie.org/2006/02/preventing_ppd__1.html) - she covers this stuff and makes some really good points, I think.
Posted on September 10, 2008 11:12
Amy in StL said:
Okay, I'm not pregnant but I've been glued to every week of this. It's funny and insightful. Plus, someday when I am pregnant it'll be good to remember some of this so I don't think I'm the only one.
Posted on September 10, 2008 11:43
Ruth said:
Ooh, thanks for that link, Arwen. I love Moxie, but I don't remember having read that post. I think Moxie's point about a good birth being one in which you feel respected as a person is important. Clearly, Amy, you felt respected and affirmed in Noah's birth, regardless of the fact that it wasn't as you had imagined it would be. (And not so much with the affirmed and respected in the post-birth lactation consultant phase, if I remember your experience correctly.) It is when people lose sight of this right of the mother for respect and when they insist that as long as the baby lives and is healthy, that is all that matters that I get upset. How the mother feels matters too. I am due to give birth in late November, and I know that I can't control how the process unfolds, but it is very important to me that I feel respected as a human being during that unfolding.
Posted on September 10, 2008 12:14
Kelly said:
I am not a mother and have never been pregnant, but I read this every week. Amalah cracks me up to no end, plus she talks about the real and not-so-glamorous things about pregnancy that no one else wants to talk about. I work on a Mother/Infant unit, where I interact with antepartum and postpartum women. It is nice to hear someone say that it is ok for things to go differently than originally planned during birth. I can't tell you how many times I have been with a patient and her partner, where they cry and cry, wondering where they went wrong, why their birth plan was changed, etc. I wish that more women would understand that, although there is nothing wrong with having a birth plan, labor is one of those things we can't control. All you can do is roll with the punches and accept how things progress. Amalah said it best - the goal and the "best" outcome should be a healthy baby. I can't see how a woman has "failed" if she successfully brought a healthy baby into the world, no matter how he/she was delivered!
Posted on September 10, 2008 15:17
Mouse said:
I'm another who had to make peace with a wildly different birth than planned. I was sure I didn't want an epidural and told my OB; the best thing she said to me was, "Just keep in mind that sometimes plans have to change, so don't completely exclude the possibility in your mind." She wasn't dismissive of my desires, just injected a little realism. Good thing she did--I wasn't progressing and was headed towards 24 hours after my waters broke, so they were talking about c-section. Since I knew (shout out for pre-natal education!) that I would end up with a spinal if I didn't already have an epidural, I asked for the latter. In the end, I started to progress after the epidural and my son was born, with the help of forceps, a few hours later.
Posted on September 10, 2008 16:54
Tara said:
Looks like someone read the Girlfriend's Guide. I have to tell you, I am 34w as well, and I have really enjoyed having you along for this ride with me. Let me take this opportunity to say thanks for the laughs!!!
XXX!!!
Tara
Posted on September 10, 2008 19:44
psumommy said:
Something else that's never talked about is women who fully intend on having an epidural and never even consider the possibility that they might give birth drug free...not common, surely, but still. Definitely something I'd never thought about until my neighbor, who volunteers at a clinic, said something to me about it the other day. She had to deal with 3 women who had never even considered that they might not get what they wanted, and so entered into a drug-free birth completely unprepared and terrified- which makes for a *horrible* birth experience.
Just thought I'd throw that out there since you're talking about birth plans this time!
Posted on September 13, 2008 01:15
Binary Blonde said:
I am pregnant (34 weeks this Friday) with my first baby (it's a boy) and read this every week. I find it incredibly helpful, especially because she expresses humor with all the not-so-fun things about pregnancy. In the end, that amounts for a lot in my book!
I love this weeks a whole lot because I am facing a c-section if my boy doesn't turn around before 39 weeks. Seeing as I am birthing with midwives at a birthing center, a c-section is not something I want.. AT ALL. But, I've come to accept that if it was meant to be that way, then I should just relax and accept it. :)
This weeks post really made it all seem okay, no matter what the outcome. So, thanks!
Posted on September 17, 2008 13:19
Mel said:
This was my birth plan: walk into hospital, have csection, be pushed out in a wheelchair with carseat/baby combo in lap. Lots thought I was crazy for having a planned csection with my first...then they all had babies themselves and 1/2 had to have emergency csections. That shut everyone up. I'm not advocating a csection for everyone, it was a good (and ob-endorsed) plan for me and I couldn't be happier with it. #2 will be delivered in the same fashion.
Posted on May 6, 2009 12:57
professormama said:
So I had a list of things I wanted to have happen at my son's birth and things I did not want. You can't really plan a birth, this is very true.
But it's important to go into what will likely be the most intense experience of your life feeling empowered about what you want and don't want so you are not bullied by doctors, nurses or midwives, all car providers are there to give care, but they are also on a schedule and often over worked, they can and do make mistakes in being to pushy and not always respecting a vulnerable feeling (and tired) mother's wishes.
Having a list or plan that your partner and care giver are aware of can help to make decisions that otherwise might seem confusing during labor.
I had a great natural and uncomplicated birth, partly because the people around me were aware I wanted to be free to move around during labor, and to avoid any and all intervention possible as long as the baby was ok, (I had a looooong labor, and my water didn't break for 2 hours of pushing).
I was able to hold my baby and breast feed before the cord was cut, and the midwife allowed time to let all the cord blood make it's way into the baby before cutting- because we had requested this.
In some ways it doesn't matter what your plan/list contains so much as that you go into your birth with confidence. I know too many women that ended up feeling like they got steam rolled in order to move their birth along, and that is not ok unless it is truly a medical emergency.
Posted on June 9, 2009 12:34
Della said:
That whole "Oh yeah, This" section? That is ME RIGHT NOW. And was me two weeks ago. If you are reading ahead and you're at, like 20 or 25 or 30 weeks, oh geez, please don't panic. You have a LONG TIME TO GO and no matter how easy it is (this pregnancy has been a breeeeeeeeeeeze for me), you are going to be READY way before you are actually ready. Hang in there.
Get stuff done at that 20 weeks because by 35 weeks you're going to be going "uuuuuuggggghhhh." Not to say you'll be miserable or something, but that being sick of being pregnant, even if you're feeling fine, may give you a week or two (or seven) of mental block, of "if i feel like this now, how am i going to make it for two more months... i need to sit down!"
Also about birth plan... after 33 hours of natural labor and at least 6 horus of being stuck at 6 cm, I realized that if I wanted to give birth on my own, I needed a boost of pitocin and an epidural. At the time I felt like I was failing. Now, I'm SO glad that I was willing to make what was the right decision at the time (it kept me from forcing my body into a c-section).
Posted on July 22, 2009 00:01
Ashley F said:
Oh god Della - I am RIGHT there with you. WHEN WILL THIS BE OVER? I haven't had a terrible pregnancy, but honestly? I'm just not a fan of being pregnant. I WANT MAH BABY. :-) I"m so ready and so excited for him to get here and honestly... 6.5 more weeks are you KIDDING ME? UGH.
As far as the birth plan goes... my plan is to have healthy baby at the end of it, with relatively little mental anguish for Mom. So, I'm a roll with the punches kind of gal. If I can make it without the drugs for a while? I rock. If I need to have the epidural right away (my husband actually told the childbirth class instructor I'd be the woman who wanted the epidural at the house before the pain even started ;-) twit) I rock because I'm PUSHING OUT A KID. Whatever... I'm flexible. I"m just over being pregnant.
Posted on August 7, 2009 13:26
LMK said:
Oh the joys of pregnancy, I think this week was a turning point. I've noticed I can no longer touch my toes or put on my shoes. The baby hiccups so many times a day that it's actually annoying to me now. I am starting to swell and look fat despite eating healthy and exercising 5-6 days a week. My backs hurts all the time, standing, sitting, sleeping.. ALL the time! My tailbone hurts too. I have a terrible pain in my right rib, i think the baby lays with her foot just wedged in there. I cant breathe, so just sitting here i am out of breathe, again- despite working out 5-6 days a week! I am starting to get very tired again, but who has time to actually nap? I sure cant sleep at night either! The days are dragging and my sleepless nights fly by.
I keep wondering why pregnancy has to be 40 weeks, I think if it was only 35 and i was due in a few days i could take it.. but almost 6 more?? Are you kidding me?? What kind of SICK joke is this!?!
I keep praying that somehow I am further along that the doctors think and that i will get some relief soon.... wish me luck!
Posted on December 16, 2009 11:52
Kim said:
Oh, the leakage. The horrible leakage. I caught my husband's cold, and now all I do all day is cough and projectile pee, cough and projectile pee. I could barely get a sample out at the OB's- most of it was in the Depends pad. Because that is what this child has brought me to.
But - having given birth at 35 weeks after 2 weeks of bed rest with my first, I am not ready to be DONE. This baby has turned, I'm getting kicked in places I've never been kicked before, and she refuses to let me slouch. It's all new territory, and exciting if uncomfortable. Amy's right - tell the babes to stay where they are - NICU stays are awful. Going home iwthout your baby is awful. This one can be late, for all I care.
Posted on December 17, 2009 00:11
AShley said:
I agree wholeheartedly with how ProfessorMama put it!
Duh, I know I can't control the unexpected things that may happen during labor, and I know that if something pops up and it means the life or death of me/my child---I will take whatever means necessary for a healthy delivery. BUT, at the same time, I don't want to be pushed into unnecessary procedures just because the Dr.'s late for dinner, etc.
My Birth *wish* is for things to take their course naturally, for me to hold my baby and try to feed her ASAP, for her to get all of *her own blood* back before cord's cut, and for her to not receive any vaccines. And if something in my "birth wishes" isn't understood, or possible, I would appreciate it being respectfully discussed and explained to me and Daddy before things are done....is that too much to ask?
Posted on February 3, 2010 11:42