When we had Arddun, I came to the hospital without a written birth plan. Partly because Arddun was early (she came in week 38), but mostly because I wanted to go with the flow as much as possible. It was my very first time, I had chosen not to educate myself on other birth stories for fear of setting up unrealistic expectations personally, and I’d rather scoffed at the idea of planning a birth. As if something as mysterious and miraculous as that could be wholly micro-managed. Pfft.
I’m rethinking my stance now with Boy Blob.
It’s not about micro-managing Boy Blob’s entrance to the world, and nor am I trying to tell my obstetrician and midwives how to do their jobs. But I do want to capitalise on the lessons learnt from Arddun’s birth. At the very least, articulating on paper how I’d like to try new things and what I found disempowering will help crystalise what is important to me and my family.
So here’s what I’ll be trying to cobble together in the next 24 hours as the clock ticks over to Week 39.
Document length: short and sharp
If I am to whip this out and wave it in front of staff in a tremendous hurry, I need it to be scannable and easy to digest. Enter Web Writing 101 – good headlines, chunk content, use dot points to break down large sentences or concepts. Preferably kept to one page length.
The introduction: a disclaimer
I read the following introductory paragraph in a birth plan, and like it enough to want to adapt it for my own. It sets the context for the document, assures everyone that I’m not a control-freak (or try not to be), and that I understand things can get fluid.
Mine might go something like this:
We’re hoping for a natural childbirth without unnecessary intervention or the use of drugs, although we are open to changing our minds on pain relief medication down the track if needed. We appreciate your support with our birth preferences.
This plan represents our preferences. However, we recognise that in the event of unforeseen difficulties it may need to be re-negotiated. In this eventuality, please discuss all procedure options with us. When possible, we also kindly ask for some privacy to discuss our decision(s) between ourselves before agreeing to any new procedures.
Backgrounder: How did the last birth go?
Chances are, my midwife will be someone I’ve never met before. Which means she is going to assume that my body will labour at a similar pace to other women’s. Except I know what party tricks my body whipped out the last time, and that knowledge will ultimately benefit her judgement, too. Things like
- the fact that Arddun’s birth was mostly drug-free (does paracetamol count?)
- how Arddun’s birth was augmented and I was on syntocinon
- how, after contracting every 1 to 2 minutes for about 2½ hours, I had dilated a mere 2cm
- how, after being told I probably had another 12 hours to go, promptly dilated 7cm in 30 minutes so my obstetrician had to abandon his lunch and run back
- how my total length of active birth was 4 hours
- how I used vocalisation as my primary pain management tool, especially when hooked up to a cocktail of drugs and confined to the bed. Read: if you are going to constrict my movements, be prepared to hear me bellow for 4 hours like a dying animal. And oh, I have a pretty fit, choir-trained diaphragm. I can project.
What I’d like to try out
Because my last birth was an augmentation and I had a monstrosity of tubes and such sticking out my right arm, I ended up delivering Arddun while flat on my back. I’m not saying the same won’t happen, but if I could, I’d like help to move around the room more, get into easier birthing positions, and get into that bath so I can pummel warm water down my back for pain relief. Assuming, of course, that baby isn’t in distress and nothing crazy is about to happen.
What I’d like to avoid
I also want to stress my right to speedy pain relief if I decide that’s what I need. I think I’m going to try and do it without drugs again because part of me wonders if Arddun’s birth had been quick because of that. But if this birth turns out to be the opposite of Arddun’s (i.e.: slow, start-stop) and I feel that I need to conserve energy for the final push later, I just might opt for an epidural. I am older now. I am also less fit than how I was when I had Arddun, and I’m getting less quality sleep every night. I understand my limitations, but I want the assurance that others will trust my instincts, too.
Also, the idea of forceps and episiotomies scare the living crap out of me — even more than a C-section. I’ll brave them if I have to, but I’d really rather not.
I’m open to hearing other birth preference ideas, if you have any. Even if this turns out a purely academic exercise and I don’t actually whip out a plan on the day.
25 November 2014 at 10:54 am
Do you want a copy of my birth plan? Doula vetted. I have been thinking about doing mine too. It may need to be revised significantly… Contemplating a home birth.
25 November 2014 at 9:23 pm
Don’t mind if I do! Wouldn’t hurt. :-)
25 November 2014 at 1:34 pm
Well I just clicked back to your previous link and see that I commented the first time around on my thoughts on this heehee ;) Yes, I still very much beleive in educating yourself and thinking through your birth **preferences** – not something to be set in stone but something that communicates your ‘preferences’ for along the way. Just the process of thinking those things through can help you and hubby so much – whether you whip the bit of paper out or not! And as you said, not about not being open to the changing nature of birth or telling staff what to do, but often options can change depending on them knowing what YOU acutally want. so good on you for considering it this time around and I pray it is helpful towards a good birth with of course a great outcome (baby!). my two main ideas for birth preferences apart from what you have already listed (good stuff!) is to mention something like ‘if i want pain relief, i will ask for it, please dont offer it to me’ – bc when you are battling through contractions, being offered pain relief can tend to undermine you – though of course you know u can ask for it if you want! also u may want to think about and add something about your hopes for after birth (pending smooth delivery and both parties healthy) eg do you want immediate skin to skin, delayed clamping, delay weighing and washing etc? clearly i cant stop my rambling lol!! but all the best w ith (and pending birth!!)… thinking through these things can only help you, as you know as well as most that we can never fully predict what will unfold but we can be forearmed :) xx
25 November 2014 at 9:29 pm
I found Calvary hospital quite automagic about immediate skin to skin, delayed weighing etc. They were great, actually. Gave us a lot of privacy after the birth, fed us, quite sensitive and this, despite having half their staff in a conference in Africa then!
Because I had mentioned wanting to try a drug-free birth, the midwife we had sure took her time when I finally thought I needed it – hence my own plan above mentioning that I’d like SPEEDY pain relief if I choose to go that way. :-)
More than anything, I just want to give everyone caring for us a head’s up on how the first time went, and that I’d really appreciate more support in seeking alternative pain relief apart from bellowing on my back with tubes sticking out of me.
Agree about modern mothers perhaps being more informed than ever, but I’m also of the school of thought that Dr Google can be very misleading, and that I ultimately trust my healthcare professionals.