What Birth Plan? Comments/Questions

After my last pregnancy post, my Aunt left a very detailed comment and I really appreciated her point of view and thought I would touch on some of the issues she mentioned that I did not. You can read her whole comment on my last post here. I also heard from a few people via text, e-mail, in person etc. So I thought I would write about those as well.

My [aunt’s] plans consisted of no drugs unless [she] request[ed] it. “No pain meds needed at all because I’ll work WITH my body and not against it. Thankfully epidurals were not routine, they were for C-sections. They are not healthy for the baby and can create needless medical interventions (C-sections, induction, forceps…). Just remember, any meds that are for you are based on YOUR weight, not the baby’s and so baby will receive a lot of medication. Not all meds given are completely blocked by the placental blood barrier. When a low risk labouring mother is given an epidural she is now confined to bed usually flat on her back (thereby eliminating assisting the process with walking, kneeling, squatting, walking (it really does help), and other issues). Yeah, I’m on the “why on earth would you actually WANT an epidural?” team. I maintain that if you work WITH your body then you will reduce the need for medical intervention and decrease the potential for pain.”

I completely agree. I find it very comforting going into this that I am low risk and my body should be able to figure this stuff out. However, I am definitely not opposed to getting an epidural either. This goes back to I don’t really have a plan because I think it is something that I need to be ok playing by ear. Ideally, things will progress so fast there simply won’t be time for one. However if there is time I will ask for one. I have 2 major reasons for wanting an epidural and honestly neither of them have to do with pain management. Sometimes you can have a wonderful pregnancy and then the baby just doesn’t want to cooperate with the birth. If something happens and I suddenly require an emergency C-section (chord wrapped around the neck etc.) If I already have an epidural they simply up the dosage and prep you for C-section. If you do not have one, you are likely to be “knocked out” cause there simply isn’t enough time to deal with the process of an epidural. I feel like having the epidural in is a safety net that will allow me to stay awake through an unforeseen emergency C-section and thus will allow me to be conscious to hear his first cry and actually be one of the first people to see my son rather than spending hours trying to wake up and understand what happened and who this baby is. My other main reason for wanting an epidural if time/situation allows is because there is a chance that I have a succenturiate placental lobe. Essentially what this means is that a small portion of my placenta may not be attached to the main part of the placenta. 1 ultrasound said I for sure had one, another ultrasound said maybe- maybe not, depends on the angle. If I do have a succenturiate placental lobe there is a chance that the unattached portion may stay inside when the rest of the placenta is delivered. if I have an epidural the Dr can simply go in and get it, if not it makes the process much more difficult. It is vital that if a piece is left behind we get it out though because if it stays in there I could go home and then start hemorrhaging blood at a call a damn ambulance now type pace. Obviously Dr knows about the lobe as do husband and I and it is included in my chart that I have in my possession to bring to the hospital so we will ensure everything is out before I leave the hospital but if is separate, or becomes fully unattached during delivery if it isn’t already, having an epidural will make things a lot easier on my body to get it out.

 

“A word of caution…be aware that if junior wants to come before your wonder doctor gets there, you will be at the mercy of residents and THEIR current beliefs on L&D…so letting them know what you want will reduce the likelihood of a routine birth being hijacked. Including the possibility of needing a C-Section is wise, but you want to avoid it as much as possible, you need to understand the reasoning for the recommendation (& Dr. having a dinner date is a very bad reason), What conditions need to be met before induction or augmenting are to be considered?”

There are so many what-ifs that handing the residents a list of demands won’t change anything because I can’t possibly hit them all. If they believe that a C-section is the right way to go and miracle Dr. isn’t there (she is in fact going on holidays for the next 5 days so if baby doesn’t come today hopefully he will hold tight till she gets back Monday) then husband and I will talk it over with those medical professionals and make the call that is right for that situation. Unfortunately there just is no black and white. Same with induction and augmenting. One of the most common criticism seems to be that the hospitals rush to use Pitocin to speed up labour if it is not progressing fast enough for their liking. Pitocin then increases the likelihood of further medical interventions such as C-section. But again this depends on the circumstances. If I have been in labour for more than 24 hours or getting close to it then yes please lets speed up the process. For one I will be grumpy and annoyed but the baby has an increased risk of infection if it stays in there much longer than that after the water has broken. Especially because when having a hospital birth there are many things constantly going up your lady parts and while sterile gloves and equipment are used, they are still potentially introducing bacteria. However, I consider that a safe risk because home births freak me out. Again, a perfectly normal birth can turn topsy-turvy on a moments notice and only the hospital is equipped to handle the worst case sinareo. I would rather have the chance of bacteria being introduced and then needing Pitocin or a C-section and know that I am in good hands then wait it out and potentially harm myself or my baby,

“How about pain relief well before the transition stage (it is basically useless after that stage)?”

Again I am hoping things go really well and I can do the majority of the labor process at home. I would then be using things like a warm shower, heat pack, getting husband to rub my back, trying to sleep etc. as much as possible. If I have to go to the hospital before that then I will be able to get the epidural earlier haha. But no, a woman’s body is built for this. We will manage.

“Episiotomy? Do you want them to automatically do one or only if absolutely needed to avoid ripping you all over hell’s half acre? (If they aren’t skilled at working the perineum to avoid one, let them cut I say).”

These aren’t really common practice anymore, most Doctors say it is better to tear and the healing time is actually better. However I just don’t care. I am fully expecting a baby whale (at 34 weeks the ultrasound guessed him to be 5lbs 7 oz, if he has been gaining at a “normal” pace he should be about 7lbs 7oz now at 38 weeks. Husband was 7lb 11oz and I believe I was 9lbs 14oz). I am very fortunate to have an amazing support network and husband will be taking time off work to be at home with the family after baby arrives. So I’m not afraid of healing times.

 

You also have the right to limit numbers of people in the room. (you don’t have to have all the med/nursing students & residents and their friends in there).

I am actually ok with students in the room and would encourage them to be there. I think the best way for the next generations of medical professionals to learn is by doing and seeing. Throughout this pregnancy I have had brand new student ultrasound technicians and nurses a couple times. The lady that did my gestational diabetes test had never done one prior to me. These students are always highly supported and supervised so that doesn’t bother me at all.

As for my friends/family. I really do believe the birth of a child is something very intimate between a husband and wife and while I am laboring I would prefer to be alone with my husband. Once baby is out and we are all safe and happy then please come visit!

And do you want a birthing room? Or delivery room? Do you have that choice (hopefully yes, and that the default room is a birthing room).

I have heard that the hospital I am going to has the best birthing rooms in the area with some even coming with a full room space so that husband can sleep comfortably in there as well.

Are you wanting to nurse immediately after the birth?

Yes please! I have considered making him a onsie that says, “I am trying to learn how to breast feed, please don’t give me a pacifier or anything else. If I am fussy, please bring me to my Mom” This is one area where I guess you could say I do have a plan because I want to do whatever it takes to establish a good supply and ensure that my son is getting the best nutrition possible.

Cut the cord?

Is more a question for husband but we have discussed and he doesn’t really want to do it. I can’t blame him….it looks really friggen disgusting. The medical pros can go ahead and do that!

Oh, and if there is only thing you demand, make it the warmed blanket immediately after they clean you up! That is non-negotiable, you must have the warm blanket afterwards! It is almost as great as holding your baby for the first time!

Great tip! Thanks! I would not have thought of that!

What are your plans when you get home?
Relax. Take it easy. Focus on establishing a good supply and having time to bond as a new family. I don’t think anything can fully prepare you for what life with be with a newborn however as I said I have an amazing support network. I plan on leaning on them. I have not made freezer dinners because we most likely won’t eat them. We have come up with lots of quick and easy meals including lots of quick and easy crock-pot meals. We have cleaned the house up and it falls to pieces again oh well. The important thing is that we are bonding, a good milk supply is being established and baby and I are recovering from the whole process. I bought some cute comfy (and Black!) pajamas specifically to wear around after he is born (they are like loose lulu lemon pants I could probably wear them in public without anyone batting an eye and they are sooo comfy). I won’t let myself touch them until after he gets here so I am really looking forward to that!

When are you having a baby shower? Are you registered?
We are waiting until after he is here so it is hard to say. Probably mid-late October. Yes, we are registered at Babies-R-Us. We do already own all the big things necessary for his debut (crib, change table, diapers, wipes, car seat, stroller, pack and play etc.) We registered for the things that are a little more “fun” toys, clothes, diaper genie, etc.

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One thought on “What Birth Plan? Comments/Questions

  1. Love your intelligent, thought out, logical and most importantly, realistic birth plan. Yes, even if it isn’t written out, ready to hand to someone, it is a birth plan. The plan is mostly for you and hubbens. Thinking about things ahead of time reduces hasty decisions, or indecision and I think can actually reduce stress because you have plan A, & plan B and C if parts of plan A change. Some mommy websites may make a big detailed deal about them, but that is unnecessary. The biggest need for birthin’ your baby is to be informed about different ways of birthin’ and the logistics of those ways along with the reasoning behind them. The very very most important thing to BE after all this knowledge transferring is to be flexible because you don’t know how it will go down. And it sounds like you are flexible. [I’ve met moms who were so determined to follow their birth plans to the letter that when something went sideways, even a little that required a change of plans they couldn’t cope very well. I’ve also met moms who didn’t prepare themselves in any way, shape or form and hadn’t a clue what to expect or do…those are the ones who are screaming and are out of control & really are annoying when you’re trying to focus on working with your body. I had a screamer next door when I was having J. and I just wanted to go slap her & tell her to pull herself together].

    Your home plan is excellent. The dust bunnies can wait for someone else to deal with them. For the first ten days it is all about you & junior. People can serve you. (There’s research to back that up).

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