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Do I really need a birth plan?

Do I really need a birth plan?

Jackie Vinyard, M.S. Health Sciences | December 5, 2019 | Resources

Our very own Jackie pictured above with her sons.

A personal story on labor and delivery experience and where to find a plan that really works.

I thought I had the birth of my first child covered: I read one book about a midwife in Tennessee and women having beautiful births, plus I took a birthing class. I was also of the mindset that I had a doctor in a hospital who would do what is best for me and that birth is such a natural phenomenon, my body would know what to do. Boom! I was ready for birthing day…boy was I wrong. 


Previous Birth Experience

I had never heard of an “irritated uterus” or “false labor.” I didn’t know I would be left alone for hours at a time, and I didn’t realize that the cold, sterile environment would shut my body down. I had 3 days of on-and-off-again contractions, and was admitted to the hospital and sent home twice. The third time I went to the hospital, I believed I was simply fat, there was no baby in there, and this was all a big mistake. I remember lying there listening to the hospital’s little celebratory song every time a mom and baby go from the delivery ward to the recovery ward, over and over again. I wondered if I would ever hear that song for myself. I think I heard that song 12 times before it was my turn to even start pushing. 

When I was finally in “real” labor, I asked to use the bathtub to manage the pain. The nurse made me a bath with lukewarm water. It was terrible, but I was denied when I asked for warmer water. I got out of the tub and my now ex-husband, exhausted from working a long shift, laid down on the couch. The nurse left the room, I felt entirely alone, and I didn’t know what to do with myself in the small, sterile room. When the nurse came back in to check on me a couple of hours later, I was only 3 centimeters dilated (the goal is 10). I was completely deflated. I accepted the epidural when it was offered to me, and after 72 hours of torture from my “irritable uterus,” the moment it started to work was honestly one of the best moments of my life. 

Seven hours after receiving the epidural, I did the math in my head and thought that if there was any chance that I was dilating according to the dilation charts I had seen  online, it would be time to push soon. I rang for the nurse, who checked me and then promptly yelled for the doctor to hurry; apparently my son was already on his way out. I felt nothing and he arrived quickly. Recovery was also quick, but I didn’t know what to make of the entire experience other than it wasn’t what I had hoped for, and it certainly wasn’t one of the beautiful birth stories I had read. 

With my second child, I went to a midwife clinic for a more personal experience, re-read the same book, and skipped the classes. After all, I had done this before. Unfortunately, while I wanted a different experience, I didn’t know exactly what I wanted to be different. I certainly did not have the resources to advocate clearly for what I wanted. Most of all, I was afraid to advocate for myself. In the middle of my labor, I was unexpectedly asked if I would be comfortable with a male nurse. I wasn’t prepared for the question, but said”OK.” However, it really wasn’t okay.  I also didn’t feel comfortable with one particular midwife in the clinic (I found out months later she was fired for malpractice), and I had specifically asked NOT to have her present for my delivery, but she showed up to “shadow” the other midwife. In general , it’s hard to advocate for yourself when you’re in the middle of giving birth and don’t know what is right or wrong. 

This time around, I got my warm bath and handled the labor better than the first time, but my dilation stalled at 8 cm. They broke my water, and the contractions got stronger but further apart. I had been in labor for more than 12 hours and soon everyone fell asleep except me. After 4 more hours with no progression and painful contractions, I had had enough. At that point I received an epidural, but this time I was not happy about it. I felt like a failure. It took rolling me on each side like a walrus (since I couldn’t move my self) side to side and another 4 hours to dilate those last 2 centimeters. Fortunately, I bonded very quickly with my little guy and was able to put the experience behind me. 

What I am doing differently this time 

Ten years later, I am pregnant again. This time, I’m nearly 40 years of age, more comfortable in my own skin, and married to a man who is excited to be the birthing partner I need him to be. I realize now that it is up to me to educate myself on what I want for my labor and  delivery and how to advocate for myself. Since this is an extraordinarily special day (or two) for me and my husband, I desire to have both a healthy delivery and a positive experience. To accomplish this goal, it’s not enough to just fill out a blank birth plan template with little education. I need to understand my options, including the risks and benefits, and my partner needs to understand them as well. 

You may have heard that birth plans are pointless. Which is what I had been told, but that is 100% B.S. From preferences on male and female staff, cord clamping, freedom of movement, and more, you have the right to the birth preferences you desire. Of course birth is unpredictable: one may end up needing an emergency c-section, the cord may need to be cut immediately, or the birth may go so fast there isn’t time for an epidural.

If educated properly, however, women (and their partners) who create a birth plan (or birth preference list) will understand the unpredictability of birth. What is important is to understand the options that they have when things come up and to communicate with each other what is desired. For example, if a C-Section ends up being necessary, who will stay with the baby and who will stay with the new mom? 

How to make a helpful birth plan (birth preference list) 

How do you know what your options are and how do you make a plan that is healthy for you and the baby? I follow midwives and doulas on Instagram and see their comments on placentas, cord clamping, and natural pushing. All I can think is “Wait! What does that mean? Is there one place to learn all this?”

Where to go to learn

  • Learn about your hospital's birth center and policy (for example, do they have a birthing tub, do they have a squat bar, do they already perform delayed cord clamping)
  • Read online resources
  • Consider hiring a doula for additional birth education and labor support 
  • Download a free template and learn about the options 
  • Talk to friends/family about what they wished they had learned more about prior to birth: for example, medications given to baby right after delivery (you have a say in what you want your baby to receive, but how do you know what you prefer if you don't know the risks/benefits)
  • Take a birthing class 

I have a full-time job, 2 kids, and a new house to manage; I do not have time to become a birth expert. As I learned, having given birth before doesn’t mean the next time will be better, but I also don’t want to fill out a cookie-cutter template on a piece of paper that is totally useless. Luckily for me, Kindara has partnered with Motherboard. This platform rocks. Motherboard took me step by step through each of my options, with pros and cons listed, including education and risks and benefits (see example below). 

motherboard dashboard

 

I had to reflect inwardly to really know what I want in terms of who I want to be there and come to my own understanding of why I felt pressured not to have an epidural, whether I wanted one or not.  As for all the other things, Motherboard and taking a birthing class with my husband, helped me feel empowered and ready — whether or not I have a natural birth, C-section, or epidural — which is how every mother deserves to feel. Now if only finding affordable, reliable childcare was as easy! Oh, and getting back into shape...