(Interestingly, before my recent birthing journey I thought birth plans were a bad idea, because I thought it would make me seem like a bad patient who wanted to fight the system. Now I realize that I'm not in the hospital because I'm sick, so why shouldn't I have some say? I'm the one paying them. Technically, they're working for me. I'll accept their advice the way I would any other professional I hire, but until my labor turns into a life or death situation, why shouldn't I have what I've decided I wanted after taking their advice into consideration?)
Well, that ended up being a long parenthetical statement.
And then I thought birthing plans might be bad, because I read someone saying how women who had their birth plans written and had their hearts set on them but ended up not getting them are more likely to be disappointed later, or have trouble getting over it, or possibly become depressed.
Obviously I don't want to increase my chance for depression.
But as I continued to think about it and continued to read all of these experts recommending them, I came across one author who wrote, essentially, "what's the big deal about being disappointed?" The thought was "is disappointment really so horrible that you should avoid even thinking about what you would like to have?" I didn't think so; I decided that I am strong enough to overcome disappointment.
My encounter with pre-eclampsia with my first pregnancy gave me a strong dose of respect for obstetricians. The only cure for pre-eclampsia is getting the baby out, and my body was not anywhere near going into labor on its own. I am convinced that modern medicine and interventions saved my life at that point. Could I have prevented having pre-eclampsia? Possibly, but I had no way to know I was going to have it, and once I had it, there was no cure (other than having the baby born). So obviously I am very grateful that I am alive and that Jill is alive and subsequently that Danny is alive since I was alive to have him and that soon Alice will be born. Thank you, doctor and medical staff.
That experience has given me the perspective that should another scenario occur, then I am completely fine with throwing my birth plan out the window and allow the doctor and nurses to save my life or my baby's life. In fact, I'm more than fine with it—I'm ecstatic that it's possible. What are the possible scenarios, you may wonder. They are complications like my water breaking at 33 weeks, placenta previa, triplets (wouldn't that be a surprise?!), actively laboring for over 36 hours (or however long) to the point of exhaustion and inability to push, pre-eclampsia again, fetal bradycardia, umbilical cord compression/prolapse, footling or kneeling breech (but not automatically for a frank or complete breech). Bottom line: I recognize that there are possibilities that would decimate the importance of my birth plan. And I can handle that. When true emergencies arise, I will do what I have to do, or rather I will allow to have done to me what needs to be done.
The flip side of that, of course, is that in a low-risk, unmedicated birth, the mother should have lots of options. I've have read many articles, interviewed many doctors, and read (some—obviously not all) ACOG guidelines, and I am now aware that a lot of what I assumed was sacrosanct is actually opinion. One OB in good standing will allow a woman 24 hours to wait for her labor to begin spontaneously after her membranes rupture. Some OBs in good standing immediately begin augmenting her labor with Pitocin. Those are their opinions, their preferences, coming in to play. And since it is my body, and my baby, and I will be the one living with the consequences, I think that my opinions and preferences should come into play as well. That's why I interviewed so many practitioners before I found my ideal providers. I discovered that a lot of the "rules" were actually just preferences and that there are a lot of studies proving and disproving both.
So all of this got me thinking about a birth plan. I think one of my favorite aspects of a birth plan is that Jeff won't have to remember everything, and I won't have to be bothered with decision making. I'll make all of the decisions that I can think of ahead of time, share them with Jeff, and write them down. Then when we're in the moment, Jeff can either remember what my (and, in some cases, our) decision was or he can refer to my birth plan. Sounds pretty nice, doesn't it?
Well, one book introduced me to the idea of a birth fantasy. If a birth plan is pretty nice, then a birth fantasy is like the most awesome ever!!
It is the process of writing down your complete fantasy no matter how far fetched or even impossible it is (like having a relative present who is already deceased or being in a completely different country). Then after going through that process, review what you've written and then determine what those desires really mean and translate as many as possible into realistic possibilities to put in your birth plan.
Creating the birth fantasy is a pretty fun writing and psychological exercise.
So, without further ado, I present my fantasy!
Early labor will last a while, giving me a nice slow warm up and time to realize that birth was going to happen in the near future. I would have certain loved ones with me: Jeff, Jill, Danny, my mom, my sister, my dad, a few other family members and some best girl friends. We'd be in some forested area with hills and very comfortable weather with warm sunshine but not hot enough to be sweaty. I would spend my early labor walking through the gorgeous forest with people I loved. Marveling at waterfalls, admiring rock formations, gasping over beautiful vistas, enjoying a delicious outdoor picnic. It would all be a great distraction from the contractions/surges that are slowly gaining in intensity.
Someplace like this would be perfectly acceptable.
(This is a picture I took during my summer in Maine.)
A place like this would be acceptable, except in my fantasy, there wouldn't be strangers there.
(This is a picture from our Myrtle Beach vacation.)
As I reach transition, I am now in my fabulous birthing center in their fantastic birthing tub. Jeff is in the tub, too, and I am leaning on him in whatever position feels most comfortable (perhaps squatting, dangling, or semi reclining). My doula, nurse, and obstetrician are also present, as well as my mother and sister. Jeff is providing me with the physical support I will desperately need, and the others are providing the verbal support to get me through this—the toughest part of labor. I will remain completely relaxed. A vanilla candle (or flameless scent maker) will fill the room with one of my favorite aromas. My children will be present and excited to be some of the first to see Alice. I will gently breathe my baby out as I allow my muscles to do what they know how to do. I will immediately hold Alice, and Jeff will immediately hold me and Alice as we wait for her umbilical cord to stop pulsating and then cut the final physical tie connecting her to me. I'll climb into my comfortable queen-sized bed with my husband and children around me as Alice and I figure out nursing and eventually my placenta will be delivered.
And then . . . *drum roll please* a unicorn will appear. Along with the unicorn, my in-laws, siblings, and Jeff's siblings will come and see our new baby. My parents or Jeff's parents (or both) will take Jill and Danny away, so Alice and I can rest.
Doesn't that sound fantastic?
So now I get to turn that into a plausible reality.
I will labor at home with my children as long as feasible. I will dance with my children. I will let them help me bake a birthday cake for us to celebrate Alice's actual birth day. I will read to them. I may call my mother-in-law or a friend to come over to talk to me and distract me. (If this begins at night, I will just try to sleep as much as possible. If I can't sleep, I might watch Sense and Sensibility and Hello, Dolly! When it seems like I'm done with early labor, I will meet up with my doula at some point, and she, Jeff, and I will drive up to the birthing center. If it is during the day, then my kids will come, too. If it is during the night, then I'll let them come the next morning when they wake up.
At the birthing center, I'll stay relaxed and try all the techniques they throw at me. I'll utilize the squatting bar, the shower, the birthing balls, walking the halls, counter-pressure, massage, dancing, singing, and eventually the birthing tub. If my children seem happy and fine, then they'll stay. If seeing me like this is freaking them out, then they'll leave. I don't need them there if they aren't enjoying it.
I imagine the actual birth will happen pretty close to how I described it in my fantasy, minus the unicorn and relatives who live too far away to be there. But it will include freshly baked bread!
So there you have it: my fantasy and my loosely outlined plan.
Note: The birth plan I am actually going to use is more detailed in case I end up in the labor & delivery department instead of the birthing center. If you are curious what I deemed important enough to write out, just say so, and I'll eventually e-mail you a copy. It is still a work in progress right now as I research and learn about different options and procedures, and it includes more details on what I want to have happen to Alice after she is born.
So there you have it! My fantasy and plan. Won't it be interesting to see what really happens?