Posts Tagged ‘birth plan’

Managing Birth Expectations

Monday, July 25th, 2016

DSCN1032The birth plan … I took a twelve (twelve!!) week class on natural childbirth (and infant care) before the birth of my first son. Part of the class was, after educating everyone on different options (including passing around an epidural needle set to terrify everybody by the sheer size of the thing), crafting the birth plan, using a multi-page checklist as the starter point.

My birth plan was pretty laid back, and mine included no epidural, but still, the head nurse checking me in snickered and told me that I should get an epidural right then at check-in, as there was no guarantee the anesthesiologist could ever get back in time again (assuming that I would inevitably ask for one).

After all of this, guess what? Nothing really went according to plan. And even though I thought I was super laid back about my expectations (you know, the old, “I want a natural birth if possible, but as long as my baby is healthy it’s good”), I was massively disappointed in how my birth story played out. I ended up with an emergency c-section, the only non-natural birth from our class.

Moral of the Story: I think it’s very important to be educated on the birth process and the different options out there, and to know beforehand what you personally are comfortable with. It’s also important to remember that while there are many options out there concerning birth, they will not all necessarily be an option for you. You may want an epidural, but your labor may progress so quickly it’s not possible. You may want a home birth, but likewise your individual circumstances may not allow it.

If you are concerned about your birth plan, hiring a doula is a good way to make sure that your voice is heard in the delivery room and that you are supported the whole way by an educated and experienced third party.

Finally, moms and dads, we need to stop judging the birth plans of everybody else. Using scare tactics against pain relief methods, snickering at patients’ pain relief plans, and bashing each other all on choices made during pregnancy and labor/delivery over the Internet–this helps none of us. No matter the events leading up to the birth, ultimately, that’s a healthy baby is the goal, and everyone of us that has been blessed with a healthy birth should be able to celebrate that, without a cloud of guilt or disappointment over our heads.

Meaghan Howard is a stay-at-home mom to two little boys, both born healthy, despite how their birth plans turned out. 

My Pregnancy: Week 33

Thursday, March 31st, 2016

Week 33Birth plans often conjure up images of doulas and skin-to-skin contact and other simple hopes of families-to-be. After a C-section, birth plans often point to VBACs with undertones of hoping to be redeemed from the original cesarean never wanted. I have nothing against VBACs and all the beautiful ways a baby can be birthed. I am here to include in that list of beauty the planned cesarean. For all first-time moms to be, I always encourage learning about a C-section and planning what one wants from that experience. My first birth cesarean experience was less ideal than my second, and I attribute partly to the hospital and also not being prepared for the possibility of a C-section with my first.

A cesarean often seems defined as something to come back from as opposed to something that simply is. My first was an emergency, and the remaining two are medically necessary. Many C-section moms feel need to give reason for another “medical birth,” as if they need to justify the wonderful entrance of their children into the world. Some mamas still feel the wounds related to what brought about that first cesarean. I hope that in thinking about a birth plan for a planned C-section mothers and families can feel joy, excitement, and peace with having a voice in the details of their child’s arrival.

I see terms like “family-centered” or “gentle” birth in reference to C-section births. Some hospitals and doctors do a better job than others. First, simply speak with your doctor (and possibly hospital) about what a cesarean birth can look like. In all honesty, most of mine isn’t written but communicated with my doctor in the weeks leading up to birth and in discussion with the nurses in the couple hours before I enter the operating room. In case of an emergency hospital staff likely aren’t reading paperwork, but having thought through these things allows my husband and me to advocate for our family.

Before birth and during surgery

Spell out your preference for drugs that won’t hinder breastfeeding (if you plan to nurse). For me this included explicitly saying I did not want a sedative as they gave me during the first birth. I was very drowsy and hazy in many memories after the birth of babe. I spoke with my doctor and anesthesiologist beforehand to let them know I wanted conversation about what they were doing. Some moms may prefer staying in the dark about all that “medical” stuff, but I found comfort in having that open line of communication during the procedure. You may want silence so baby only hears you and hubby, as far as possible. The ambiance of the room may include lighting and music, so let your preferences be known in your birth plan and with the medical staff beforehand. My hands were restrained for my first birth but I requested them not for my second.

You may even want to research types of stitching and other details of your cesarean related to your health and safety. The placement of your IV (hand or arm, left or right) might be of concern to you as you plan to nurse and hold your babe in the coming day(s). For this third and final birth, my plan also includes plans on tubal ligation and circumstances in which I would not want that to occur.

Baby-focused

Many of these things may be the same as a vaginal birth, like keeping the cord attached for a longer period, no K or Hep related medicines administered, delayed bath, and more. Skin-to-skin allowances will vary by hospital, but consider if it can occur immediately with you, with daddy, in the operating room or as soon as in recovery. Make note for dad to cut cord if interested. For me, the biggest hope in my plan (aside from the “healthy birth” we all hope for) is to see my baby in all its gooey glory. First babe was taken immediately to the NICU and second came out a concerning shade of blue so I didn’t see him for several minutes.

Lowering the screen just before delivery is what I’ve most strongly discussed with my doctor. Remember to know what is allowed in terms of photography and ask if anyone is the room is able to assist with taking photos of baby and family immediately after birth.

Recovery

We wanted baby with me or hubby at all times and wanted left alone as much as possible in those first few hours after birth for nursing and bonding without family, friends, or unnecessary medical interruption. Others may want to have a mother, sister, friend, or other significant person visit during this recovery time as only one person is usually allowed in surgery. I immediately wanted warm blankets as I uncomfortably shivered with both recoveries. After the immediate recovery and into the first full day, I also consider keeping the catheter in for the first night a big convenience and safety reassurance (we had evening births), but then I wanted to move forward in recovery to have it removed early so I could begin getting up and around in the light with assistance. Your plans for feeding, from formula to nursing on demand, can be outlined as well.

Consider scenarios that could occur, like baby in NICU for a short or extended stay, and how you will respond to meet your plan. For example, immediate access to pumping might help should baby be moved to the NICU. If baby is separated, consider outlining your stance on the use of pacifiers, other people holding baby, and other preferences you may have.

Annie is a mom of two boys, ages two and four. She enjoys the finer things in life, like compression socks and a full night’s rest.

My Pregnancy: Week 25

Thursday, February 4th, 2016

My Pregnancy: Week 25It’s time to get practical. I’ve been feeling my way through all these weeks up until now. The most practical thing I’ve accomplished is sifting through old bins of baby clothes. Let’s get real, though. This pregnancy ain’t getting any longer and things need to get done. Month 8 will likely involve getting the house ready for baby, but there are things I can tackle now. If you’re preggo too, let’s see what we can check off our lists together!

Update or make a will. If you’re like me, with not much to your name, a simple online search for a template and your state’s requirements might suffice. If you have more to your name or just feel more confident with outside help, seeking out legal assistance is useful. Ask friends and family for resources, check with your or hubby’s work to see if benefits include access to a lawyer, or just pull out the old phone book. We have a template that we will complete, notarize, and file with our county clerk. We will then supply copies to our executor and the people we have chosen to take guardianship of our children in the case that anything should happen to us.

Pick out baby’s pediatrician. This time around is quite simple for us. We already have a doctor for our two children, and he will welcome this baby into his care as soon as we do. For those who don’t have kiddos yet, choosing your pediatrician now will save you stress in those first couple of days in the hospital. It’s helpful to nail this down as both the hospital and your insurance may need this information before baby can be discharged. Again, ask friends and family for resources. Check your local hospital to see if they hold an open house at any point in the year. You may be able to meet your doctor before baby’s birth. You can look online at reviews, though I usually take them with a grain of salt. Impassioned people leave reviews far more often than happy, busy people. I also suggest calling an office to see how long in advance you have to book an appointment. We finally changed pediatricians after repeatedly needing to book 1-2 months in advance due to the doctor’s full schedule.

Think about packing that hospital bag. If you’re having a no-complications pregnancy, you may not need to actually pack this bag yet. I haven’t. I do have an idea of what I will put in the bag though. With our first two pregnancies I overpacked. This time around I know a few changes of soft, stretchy clothes, a deck of cards, a light book, nursing pillow, comfy nursing bra, and two outfits for baby are all I really need. Hubby can grab anything else I need as he makes trips home each day. Things outside the bag include toiletries, camera, USB cord for my computer, my computer, and wallet. Ask your friends and what they found helpful to have in their bag and begin your list for when you eventually pack that bag.

Complete necessary testing. This may include a gestational diabetes screening, blood work to see if you’ll need a Rhogam shot, or further diabetes testing. Know these things will happen in the next few weeks and your appointments may take more time than usual or you may have to schedule an additional appointment.

Consider your birth plan and prep. Delivery is not moving further away. If you have interest in taking birthing classes, ask what your hospital or doctor or midwife’s office offers. If you have a particular birthing method you have researched and want to follow, like The Bradley Method, set up those classes now if you have not done so already. Also consider breastfeeding classes. I suggest reading about alternative experiences of birth. I planned on a natural birth. I am now planning on my third c-section. I think knowing the good and the bad about various types of birth can increase anxiety now, but may help you feel more at ease now and if you find yourself in labor needing to deviate from your plan. I recognize the difficult experiences many people have with epidurals, Pitocin, c-sections, and other hot-button issues. I encourage you to also seek out people who have had success with those interventions. I appreciate my first c-section as it likely saved my life and baby’s after 19 hours of labor when complications emerged. I will write about my birth plan with c-section in the coming weeks.

Take a deep breath. Really. Do it right now. You got this, mama. Repeat as needed.

Annie is a mom of two boys, ages two and three. She enjoys the finer things in life, like compression socks and a full night’s rest.

When Your Pregnancy Ends in a Complicated Birth

Friday, January 23rd, 2015

When Your pregnancy ends in a complicated birthLooking around, I was terrified. The bright lights of the operating room, my husband in scrubs, so many nurses, and a doctor setting up. I felt a wave of nausea kick in and the nurse held up a bag to me to be sick in. I had not eaten in 18 hours and was so hopped up on medications that my stomach just could not take it. I remember telling my doctor this was the worst moment of my life–that the baby was going to be awesome but this royally sucked.

This was not the birth I had planned or wanted. I dreamed of a peaceful, calm birth filled with joy and happiness. I got a heavily medicated birth to alleviate the eclampsia that was making me sick and harming the baby.

Whether it is exactly as you planned or a complete deviation from the plan, birth is something that cannot be controlled too carefully. There are often bumps and twists in the road, unexpected complications and surprises. The most common childbirth complications are pre-eclampsia, postpartum hemorrhaging, abnormal presentation, failure to progess, umbilical cord prolapse, umbilical cord compression, and embolism. These can happen to anyone, of any health, age or social status regardless of fitness level or prenatal care. Often we prepare for baby and pregnancy and prepare for the care of our newborns but no one really prepared for any of the issues with birth.

When things do go south, many mamas often feel cheated out of what they feel should have been their experience. These feelings of sadness and regret can lead to aiding in postpartum depression, issues bonding with baby and general melancholy about the whole thing. But occasionally interventions are necessary both for mama or baby, and in my case they were life saving.

What I found in dealing with the aftermath of my birth experience this time around was that I needed time to mourn. Mourn that my dream of natural birth was not to be, accept that my body would heal and the pain and swelling would leave me. Talk to the professionals who deal with postpartum periods, with loss, with difficulties and understand that while every hour of this time might feel like an eternity, every day in the NICU or ICU spent worrying about whether baby or you will be ok, every second of pain and confusion is merely a short time in your life. This too shall pass.

Sometimes as mothers we wish we could control everything, but coming to terms with our experiences gives us peace and allows us to focus on what is truly important: a sweet healthy baby, a growing family, and the love that comes with it all.

Pia Watzig is a stay at home mama of three small boys ages five, two and seven weeks. She lives in constant chaos of trains, legos and laundry in Portland, Oregon. 

Pregnancy Week 35: Writing My Birth Plan

Monday, July 21st, 2014

Pregnancy Week 35: Writing My Birth PlanFive weeks to go. Yesterday, I took a tour of my hospital and got to see the rooms where my son will be born. It’s getting real, ladies. With my daughter, I didn’t write a birth plan. I didn’t really have a lot of strong opinions and I was just eager to have her. This time around, I am trying to be more educated and prepared, just in case. A birth plan is basically a written document that guides you through making educated decisions about your labor and delivery, and also tells your medical team your preferences for labor.

Here are some things I am including in my birth plan.

Labor Preferences

Do you want to be able to walk around, move, and be in different positions while laboring? How much, if any, pain medication do you want? How often do you want to be checked during labor? One question I hadn’t even considered is, do I want to see baby as he greets the world for the first time. For me, I am planning on an epidural during my labor. I am definitely going to opt for minimal cervical checks this time, however. Who do you want in the room with you as you labor? We will not have any family or friends at the hospital with us. Many women find relaxing music, dim lights, and even few distractions optimal. Whatever you want your nurses or providers to know about your labor preferences should be included here.

Postpartum Preferences

Do you want to hold baby right away after he or she is born? I do! Do you prefer for baby’s bathing to be delayed? Don’t worry about cleaning him off–just give me my sweet son and let me put his skin against mine. That’s my plan. Many moms bank baby’s cord blood. While this isn’t in my plan, I do think it’s a great idea. It’s a good idea to include your preferences about breastfeeding or formula feeding. I do not want my son to be introduced to any artificial nipples while in the hospital. No pacifiers, no bottles. We are planning for my son to be circumcised in the hospital, so this should also be included in the birth plan. I would like my husband to cut baby’s umbilical cord.

Many websites and hospitals provide birth plan worksheets to make the process of writing the birth plan easier for you. While you are pregnant, there are so many things to do, so don’t stress over a birth plan. Just get your thoughts together, write them down, and discuss them at one of your doctor visits. I plan on doing this in the next few weeks. Five weeks will pass before I know it!

Karyn Meyerhoff is a mom of one and one on the way from Northeast Indiana. She is so excited to meet her little boy in 5 weeks!