Tuesday, April 15, 2014
A birth plan, third time around
After the birth of my first child, where nothing went to plan, I dismissed the wisdom of writing a 'birth plan' in the future. It seemed like a cruel promise of false hope in a situation where anything could happen. The natural birth, without intervention, that I had planned and dreamed about was not to be. No one even looked at my birth plan. Cohen was not fully engaged, his spine was on my spine, my labour stopped and started over 36 hours. After 24 hours I was too exhausted to refuse an epidural, which lead to further interventions, ending with a forceps delivery and a bruised and battered baby and Mama. Far from empowering and beautiful, my beautiful boys birth was traumatic, and in the aftermath I felt overcome by failure.
Before becoming a Mother I believed that the decisions that the Doctors and Midwives would make on my behalf would be what was best for me and the baby. But sometimes being short staffed, inexperienced, for the sake of convenience, or having different personal beliefs, means that what they thought was best for me or my baby, was not what I thought was best for me or my baby. I didn't have the confidence to ask why, to have decisions explained, to ask for other options. I'd always been told that as long as you left the hospital with a healthy baby, how you birthed it was not important. Oh, how wrong that sentiment is, and how women continue to suffer because of it. Of course the way you birth your baby is important. It can affect you for the rest of your life. It took me a long time to overcome the sense of failure, and to recognise that with the right support Cohen's birth could have been very different.
With my approaching second birth, I came to the conclusion that it would be wiser to go with the flow of the birth rather than outline a birth plan. When I was advised that Emerson's birth would be safer by elective cesarean, for reason of my Graves disease, her size and the third degree tear I'd suffered from the first birth, I thought any control or decision making had been taken out of my hands. And despite a satisfying and calm cesarean birth, I still question whether or not is was actually necessary.
How different things are this third time around. My Graves disease has not been an issue this pregnancy. My thyroid has been closely monitored and is behaving itself; following the predicted course (for once.) At my first antenatal appointment at the hospital I was reassured that neither the previous third degree tear, nor the cesarean, were any reason for me not to pursue and be supported in a VBAC (vaginal birth after a cesarean). I have entrusted a beautiful third year midwife student and Mother, Elissa, as part of my support team. She has accompanied me to my antenatal visits, interpreted Doctor jargon and answered my questions. And I have read and researched and come to realise the real importance of writing a birth plan.
This time my birth plan is more than just hoping for a natural birth without intervention. It's not about being in control. It's about expressing my informed, personal decisions about the choices that will need to be made during the birth, after the birth and during the hospital stay. It's a document that covers numerous outcomes, and the details that are important for me.
Without writing out my entire birth plan here, knowing every woman's would be so different depending on what is important to her, some of the things my birth plan includes - requesting that the lights be dimmed and the door shut during the labor and birth, expressing my wish not to have constant fetal monitoring so that I can have an active birth, asking not to be offered drugs, requesting cord clamping be delayed and making known that I would like to be the one to cut the cord (Dave having done the honors the last two times), advising that this baby will be exclusively breastfed and that formula should not be offered, informing the staff that baby will take it's first bath at home, expressing my wishes concerning a cesarean should it become absolutely necessary.
These are all the wonderful, small and important details that after two births, I know I don't want to leave up to strangers. This time I know things don't have to go exactly 'to plan.' There are several plans, where different paths may be taken depending on the circumstances. But in the aftermath I want to have felt that my wishes were respected, my decisions acknowledged and whatever the means of the birth, I want to be left without feelings of regret or failure, knowing I have done everything I could.