Birth Plans: Then and Now

When I was pregnant with K, I was swimming in birth plan information. Between our prenatal classes, meetings with my doula, and appointments with the midwives, I didn’t know where to start. I knew it was important to advocate for myself, but I didn’t want to be pushy. According to message boards and books, nurses and hospital staff either loved birth plans or hated them. It should be either formally typed and laminated, or mentioned casually at hospital check in. I should make preferences well known to everyone, or just voice my opinions to my doula. I wrote pages and pages of plans; bullet point lists, full essays, and everything in between. I was confused, overwhelmed and completely unprepared (despite all of my preparations).

So, gathering all of the information I could, and armed with a checklist much like either of these (Baby Center checklist, Healthy Baby Network checklist), I sat down and drafted an outline of what I hoped for on the birth front.

1. As few interventions as possible: I hoped to go epidural-free, but I also hoped that I wouldn’t need my water broken, wouldn’t need antibiotics or Pitocin, and wouldn’t wind up with a cascade of interventions that led to an unnecessary c-section (something presented as a very real possibility in my prenatal classes).

2. The ability to move around in labour: I was hoping to labour at home for as long as possible, walk around and use my exercise ball once I checked in, and spend time in the labour tub and the shower. The idea of being confined to a bed when I was in pain wasn’t appealing at all.

3. Support personnel: I wanted my midwife, doula, and husband present, and that was all. No family popping in to say hi, no unnecessary visits from anyone.

4. Comfort: I wanted to bring my own music, labour in my own clothes for as long as possible, fetal monitoring only as long as it was necessary, cervical checks only when needed.

5. Other: I was also hoping for delayed cord clamping, immediate skin-to-skin contact (for at least an hour), no supplementing with formula or a pacifier, and discharge from the hospital as soon as was possible (with the midwives, this meant 4 hours after birth as long as all went well).

How it went:

I was in early labour for about 36 hours; I certainly got my wish to labour at home and move around. By the time I called my midwives and doula to come to the house, I was dilated to about a 7. My hospital bag was chock full of all the comforts of home to make my hospital room more homey, but since I was in full-on active labour by the time I was checked in, everything stayed in the car. My wishes for support personnel were granted, though my whole family popped in for a quick hi when they arrived at the hospital. Thankfully, everything was such a blur that I didn’t have time to get annoyed.

By the time I hit 40 hours of labour, I was completely worn out, and really didn’t care about the dreaded ‘cascade of interventions’.  I’d been eating and drinking to keep my energy up, but I hadn’t slept in days. My  doula was applying counterpressure to my back to help with the back labour, but it was fairly useless. I received nitrous oxide through a mask to help with the pain, but when my blood pressure dropped rapidly because I was inhaling too much, they put a stop to it. I even had sterile water injections (more on those in another post) to see if it would help. But by that point, my pain was so intense, and I was so exhausted, that I begged for an epidural. Forty minutes after the epidural was placed, K was born. They delayed the cord clamping, gave me almost-immediate skin to skin (after the respiratory therapist checked her airways to make sure she hadn’t breathed in meconium), didn’t supplement or give a pacifier, and I was discharged within about 10 hours.

So that was no to item 1, yes to 2, sort of to 3, maybe to 4, and yes to 5. Not too bad, for the first time.

The Second Birth Plan:

This time around, we aren’t hiring a doula (I don’t think), and we’re not taking prenatal classes. I’m feeling less and less confident about what I do and don’t remember about birth. I was sure that I wouldn’t need a birth plan this time around; didn’t things happen the way they wanted to anyhow? The checklists made me laugh in the first few months postpartum, but I found myself searching for them anyhow in the last couple of days. Birth is unpredictable, and my birth plans might not get read, but I need to at least think about these things in order to ease my mind. So, with 12 weeks left (give or take) until the arrival of Baby 2, here’s what I’m thinking:

I’d like to labour at home again; it was relaxing to be in my own space, though my water bill from the hot shower was pretty high that month. I’d like to bring my music to the hospital again, but will leave basically everything else at home. The hospital gown was practical, so I don’t care about wearing my own clothes. I’m comfortable with family coming in to visit, and I’ll stay in the hospital as long as they’ll keep me (home isn’t as relaxing with a toddler underfoot). My plan is to not really have a plan, and see how things go.

Did you have a birth plan? Were you surprised by how it played out?

One thought on “Birth Plans: Then and Now

  1. I had a birth plan with my first that was very similar to yours, but it was thrown out the window when I had to be induced with Pitocin. Pitocin contractions hurt like the devil and I ended up asking for an epidural after about 10 hours of labor confined to a hospital bed. After about 14 hours of labor, my son’s heart rate started to drop, so I ended up with an emergency c-section.

    My OB said that if I get pregnant again, she won’t do a VBAC, so if I stay with her, I’m stuck with another c-section. I waver between giving into that, or trying to find another OB who would be willing to try a VBAC. I’m not pregnant yet, so while I think about it often, it’s something that I’ll think about more once we know another little one is on the way.

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