In Bloom Doula Services

I am due in 10 short weeks. I know the past 30 weeks have flown by, and the next 10 will too, so I am wasting no time when it comes to preparing for this little one’s arrival. One thing that has inevitably been on my mind is the birth. This is my second pregnancy and birth, and I hope everything will go as smoothly as my first birth went. I had no complications and had the unmedicated birth (you can read about it here) I had planned on and prepared for, but I know nothing during labor and birth is predictable.You will never know when or how labor will begin, how long it will last, or what could happen. I know weird, sometimes scary, and unexpected things can happen, but I will STILL have a birth plan.

I think birth plans are important for many reasons, even if nurses, strangers, your doctor and the nosey Nancy next store may try to tell you to forget all ideas of a birth plan. I personally think it annoys some people (especially those in L&D) when birth plans are considered. This is probably because I encountered some bossy nurses during my labor with Holden and they weren’t shy about making it well known to me that my specific requests were annoying to them.

The thing is, a birth plan is all about being prepared, and in order to be prepared for the variety of situations or circumstances that may happen, one must be knowledgable about what is happening. How can you make informed decisions if you are ignorant to what is going on? Trust me, once you know what is going on, you will have an opinion about it.

Your birth plan should be discussed with your midwife or doctor prior to your actual birth, so you can all be on the same page and have an understanding of hospital protocol and procedures. Birth plans are not about coming in and bossing around the professionals, it is about empowerment during an event in your life that will forever be a profound, memorable, and life changing experience. It is routine for doctors and nurses, but it isn’t routine for most moms. Being an active participant in the decisions being made for you and your baby is important.

I have talked about women’s feelings surrounding birth before (in my blog post Why I Will Continue to Romanticize Birth), and I know that some women are not interested in a specific type of birth, but some women are, and if they desire a birth plan it should be respected.

When writing your birth plan, there are things you need to consider.

• How do you feel about inductions?
• Will you be having a planned c-section?
• How do you want to labor?
• What medications are you comfortable with using?
• How do you feel about an episiotomy?
• What procedures do you feel comfortable with being done to your infant?

The birth plan covers much more than “I do/do not want an epidural,” and actually requires quite a bit of thought and research to be done, in order to cover the entire birth process. Without a birth plan, or an idea of how to handle many of these situations, a birth can feel stressful, the questions can make you feel pressured to do what your care provider is suggesting, as opposed to what might be the best choice for you and your baby. Not everything is black and white, good or bad. There isn’t a one size fits all birth plan, so why should hospital staff expect every woman to want the same or have the same experience?

When writing my birth plan I even planned for things I hoped would not happen, for example; I wanted to avoid a c-section at all costs, but I knew if I happened to need a c-section I wanted to have a “gentle cesarean.” In a gentle cesarean moms can request a clear or lowered curtain to actually view the birth, and instead of waiting to have skin to skin time and try to breastfeed until in the recovery room, skin to skin can be done immediately as the mom is being sutured together. You can ask that conversations by doctors and nurses be limited to the procedure, and that music is played. Obviously this may not be for everyone, but the whole point of the plan is to ensure that everyone has a choice in what is happening to their body, and your care provider can be aware of your desires and expectations beforehand.

I would have been devastated over the loss of the birth I had been imagining had I needed a c-section. I had a moment at about 38 weeks where a c-section was discussed because we feared Holden was breech. He wasn’t and everything went according to the original plan, but knowing the options available to accommodate me would have made a huge difference to me.

Holden was also “overdue,” so my midwife brought up the idea of an induction. My induction date was scheduled to avoid me missing anymore of my maternity leave without a baby, otherwise I would have held out longer. So, at 41 weeks and 3 days I would have gone in for my medication free induction. If possible, I’d have my membranes swept and a folly bulb inserted to help me dilate and hopefully begin contractions. I would be able to go home and wait for the effects to begin, as opposed to coming into a hospital and being induced with a medication like cytotec, cervidil, or pitocin.

I had learned in my child birth education classes that cytoec is very dangerous, and has been linked to many maternal deaths by hemorrhaging. I also knew that pitocin can be administered too frequently by the nurses through an IV when they are expecting your labor to progress at a specific rate. Since not all labors are the same, and I wanted the most natural birth possible, I knew I didn’t want pitocin, which could make my contractions harder to bear and make labor harder. Thankfully, I went into labor on my own at 41 weeks and 1 day, and never had to follow through with the induction plan.

Once I did go into labor I knew there were certain things I wanted available to me. I wanted certain people in the room. I wanted to eat and drink. I wanted to move about the room as needed, and I wanted to wear my own clothes. Those are basic enough, but when it came down to the hep-lock and intermitted monitoring I had to be more vocal about my plan even though it was cleared with my midwife, which is why I am so thankful for my doula. Without a doula to stand beside me and speak up for me when needed, I may have done what I was told, even if it isn’t what I wanted to do in order to avoid confrontation. More of my birth plan is detailed in my post 12 Weird Things I’m Doing in the Labor and Delivery Room.

Pain Management

Of course you need to discuss pain management. I had my birth team well aware that I did not want to be offered an epidural. My nurse was informed about this and I wasn’t offered one, but that didn’t stop me from asking for one. I had told them to distract me, help me cope with pain in other ways. I was progressing very quickly and honestly had no time for one. But, I know some women who get exhausted by labor and need a break in order to rest, or begin to stall instead of progress and the epidural helps their labor advance. Some women get an epidural and labor stops progressing. Some women have good experiences and some women have bad ones. There isn’t one sure way that it will go. I would say go with your gut. Prepare yourself for every situation and be aware of all side effects, risks, and outcomes.

Postpartum

Once you have delivered your baby there are seemingly endless procedures and different things that will be done to you and your newborn. Research everything! Do you want your placenta? How do you feel about erythromycin, the vitamin K shot, and the hep-B vaccine? Do you want your baby bathed? Do you want to try skin to skin and breastfeeding? If you don’t voice a certain opinion some of these things may or may not happen with or without your direct consent because that is what the nurses are used to doing. It is procedure. You need to speak up and let them know what things you do or do not want because it is your body, and your baby and you have a right to make decisions.

Depending on your birth setting ie. a hospital, birthing center, or your home, your birth plan may be less important because there may be fewer people around who care about rules and regulations, but every birth plans are still important in every circumstance. If you have a birth center or home birth, what is your plan if you need to be transferred? There should always be a plan for how something will be handled, so it will be less stressful if the need is there.

It is also beneficial to have your entire birth team on board with you. This way your doula, mom, husband, sister, or whoever you plan on having by your side can help make sure your voice is heard. When Holden was taken to the side to be weighed and measured I had Nathan watching while I got stitches. I was distracted by all that was happening, and overwhelmed by the birth that had just happened. Nathan could tell the nurses what we did and did not want, and with this baby he will do the same.

Basically, if you care about how your birth goes, with any aspect of the birth, no matter what that plan looks like, you need to have a birth plan. How you want to navigate each aspect of birth is up to you mostly, and having an informed plan beforehand will make the process of you birth so much more relaxed and peaceful. Again, it is not a guarantee that everything will go as you envision it, but it may help you cope with the new plan if you are well aware of each option available to you.

A birth plan isn’t about controlling an uncontrollable situation, but instead empowering yourself in unknown territory. If you are armed with information about each step in the process, you can make decisions, no matter what may arise, that are the best for you and your baby.