On Birth Plans

In a previous post I mentioned that birth plans often get a bad wrap by people who don't know what planning is.

Good plans include contingencies. Your birth plan will basically be a list of contingencies and preferences. For example:

"I would not like to be offered an epidural. If I want one, I will ask for it."

"In the event of an emergency C-section, I would like to remain conscious unless there is a medical reason to put me under."

There is nothing stupid or naive about wanting your partner, doctor/midwife, and others present at the birth to all clearly understand your needs and preferences, especially where they may differ from the norm. Lord knows you won't have the wherewithal to articulate them when you're in labor.

A birth plan should not be a laundry list of demands, like, "I want to be able to move freely" or "I insist on being allowed to eat solid food during labor." Those are the kind of things that are allowed or restricted by hospital/birth center policy, and you should speak at length with your provider about the policies and regulations for the facility in which you plan to give birth. If an act is against hospital rules, having it in your birth plan won't do a damn thing. It's not a legal document and no one is compelled to follow it. If your provider says that the policy is one thing but that they can make an exception for you, get the exception in writing and add it to the labor bag.

The process of writing a birth plan should be an experience of discovery for you. Look up birth plans online and consider all of the various points they touch upon. Do you agree or disagree? Would you want the same thing mentioned in this plan, or something different? Does your facility allow for your personal preference? What if circumstances change, like the baby's heart rate drops or you turn out to have a higher or lower tolerance for labor pain than you're currently predicting? Write it all down. If you did it right, a few weeks later you should end up with about 10 pages of soul searching and know yourself a little bit better than you did before. This is not your birth plan yet.

Now take the main points of those 10 pages and skin it down to a single-page, bullet-pointed list for your health care provider. Take it to your next appointment (or if they schedule a longer appointment for just this purpose like many providers do, take it to that one) and discuss it.

Remember those contingencies. For every "I want" or "I don't want" on your list, try to think of a situation where that would change, and include it in the shortened list. For just about everything you don't want, you can add "unless deemed medically necessary by the attending." For just about everything you do want, you can reword, "I would like the option of..." since you really don't know what you'll want until the time comes. If what you want is already hospital policy or standard procedure, don't bother including it. No nurse is going to read a list of your preferences and take them seriously if they look like what she's trained to do anyway. For the brief plan that you'll share with those at the birth, focus on that are unconventional.

And if you mention your birth plan to someone with 5 kids who says, "HA! Good luck with that... it's so ridiculous to try to map out exactly how your birth is going to happen," just tell them that yes, moron, it would be ridiculous to do that. Good thing that's not what a birth plan is.

Unsolicited Advice for First Time Moms

Read at least as much material on the moments and days immediately after childbirth as you do about preparing for the birth itself. You won't have time to catch up when the time comes.

Don't watch the birth shows on the medical cable channels. They are designed for ratings. That means that of the hundreds of births they film, they will air the most "dramatic" ones, giving you a very distorted view of what a typical birth is like. Instead, watch births (especially home births & natural births) on YouTube. I know it sounds gross, but you'll get a much better idea of the reality of what childbirth is like than the edited-for-maximum-advertising-revenue version.

Try to witness at least one mother breastfeeding successfully before you give birth. Talk to people who are successful at it and ignore those who weren't. Hire a lactation consultant to come visit you in the hospital the day after the birth, even if you're sure you won't need one.

Room in. Keeping your baby with you in the hospital while you recover may seem like extra work that you're not up for, but the confidence it gives you when you're back home is well worth it. You'll want to be there the first time your baby has a coughing fit or screams suddenly or does any number of scary things so that you can get first hand experience handling it in the presence of professionals.

Prepare your partner for the worst, but be your best. Apologize in advance for all the horrible things you will do and say to him (or her), and then do your best to NOT live up to that picture.

Be nice to the nurses, even if they're annoying the shit out of you. To do a job like that every day it's easiest to just turn off your compassion, but it's harder to do that when they actually empathize with you and like you.

At some point during labor, even if you're not drugged up beyond coherence, you will feel like you are. Don't be afraid of that feeling; relish in it. It's what will get you through the next couple of hours and leave you wondering why you were so worried about giving birth.

If possible, have someone there to take pictures, if not during, then immediately after the birth. Later you won't believe how beautiful that slimey, wrinkly little thing was, and wonder if you're remembering it correctly.

If the hospital offers the option of a private recovery room at an extra expense, and it won't break the bank, go for it. Or, ask friends to contribute money toward a private recovery room at your baby shower. (Much more useful than the 20th through 80th pink or blue size NB onesies.)

Have a birth plan. Those who say that the term "birth plan" is an oxymoron don't understand the definition of the word "plan," and probably aren't very good at "planning." Don't you look up directions to a place you've never been before, even though there's a possibility that some of those roads will be closed? More on birth plans in a future post.