Thursday, January 27, 2011

To plan or not to plan?

Planning is a funny thing.  It's considered irresponsible not to, yet we're cautioned not to hold too tightly, that flexibility is key.  There are all the sayings:  Hope for the best, plan for the worst; If you want to make God laugh, tell Him your plans; He who fails to plan, plans to fail, and tons of others.


January is pretty much over.  Given that April 1st is my zero-hour deadline to have things done and in place, that means I've got 60 days left in this pregnancy.  60 days until we shut it down and wait.  And breathe, and get our games faces on.  The last thing I want is to be running around last minute feeling frantic that loose ends aren't tied up, that we have no more time and there isn't anything that can be done about it.  That's where it's good to have a plan.


Yet, Agent S is running this show and she'll show up whenever she sees fit.  I'll be 38 weeks on April 1st but 36 weeks is considered term and they don't stop you if you go into labor anytime after 36 weeks.  So while I've got April 1st in my mind, she very well could say "How do you feel about March?"  And we'll have to just fall in line and I can throw my plan out the window.


I've stopped teaching yoga and I'm heartbroken about it but between the no sleep and peeing 50 times a night, getting up at 4:50 in the morning was too much.  But one of the last mornings I was teaching, I was browsing Yoga Journal to get ideas for class and came across this article.  It's an interesting read, but what stood out to me the most was the following quote: 
 "A woman brings everything from her whole life to this moment," Crawford explains. "You can not go into a birth planning what you are going to do. You have to go in empty, so that life guides you."
"With my very first contraction, it became clear to me that nothing anyone had ever said about labor had prepared me for this," says Camille Mulchi, who studied prenatal yoga with Crawford. "But my prenatal practice reminded me to simply be fully present in each moment and to allow my baby's birth to follow its path."
That really resonated with me - the idea of letting go, of being empty, of taking this first step of a new life completely open and with no baggage.  Well, as little baggage as possible.


And again, I'm applying this to pregnancy but this idea can be applied to any new situation.  Particularly, new relationships or new marriages.  If you release your notions of how things should go or how you've always seen it in your head and instead allow life to follow an organic path, where would you end up?  How many times have you just let go and ended up saying 'it was better than anything I could have dreamed?'


With that in mind, how beneficial would it be for me to have a birth plan?  A part of me demands that a plan be in place since there are other players in this, namely the hospital staff and since we will be meeting for the first time on the day of the birth, we should have an understanding in place.  Yet, I've read so many birth stories of women that felt like failures because their birth didn't go according to their plan, whether it was circumstance, the doctor/midwife didn't honor their wishes or it was just the general unpredictable-ness of birth.


I don't want to feel like a failure.  I don't want to be so rigid that any deviation from my 50-point birth plan is cause for a meltdown.  Yet, I don't feel completely comfortable 'going with the flow' because I *am* going to deliver in a hospital and through no fault of their own, they will have an agenda that may not necessarily mesh with mine.  And if I don't speak up about my preferences, chances are they won't be honored.


I've studied pregnancy and birth for over two years now.  I've read the books, seen the movies, talked to the people, read the birth stories and I'm very confident about the process.  Not too much about this is going to surprise me.  I'm not even going to be surprised if the pain ends up surprising me; I'm ready for that too.  Knowledge is power, knowledge conquers the fear of the unknown.


But you can't know everything - I can't have a practice birth.  This is a one-shot deal, there are no do-overs.  There will be no dress rehearsal, not for me, not for Drew, not for anyone involved.  So it just doesn't seem responsible not to have a plan.


Furthermore, I'm not immune to normal feelings.  I had my first experience with doubt a couple of nights ago.  I had a moment of reality and I found myself questioning if I was really going to be able to do this - am I really going to stretch enough to accommodate a tiny human?  What if I'm not a good pusher and they have to cut me open anyway?  I can't practice this stuff!  Same with breastfeeding - what if I don't even produce milk?  Then all the videos I've watched about a good latch vs. a bad one, proper positioning and my meetings with La Leche League (oh yeah, I've been and it's a trip!) will be for naught!


I love the idea of being open, of simply letting my baby lead me on this journey, of allowing her to enter this world how she sees fit without me imposing my ideas on the process.  But I'm kind of an integral part to all of this, you know?  And as much as I would love to stay at home and have a birth like this one (so worth watching - I've seen it dozens of times) that's not in the cards for me.  So I feel like I have to plan,  I have to put something on paper - but what?  


I don't need to write down that I want the lights dim in the room.  When I get in there I will turn them down myself and if someone turns them up, I will tell them to turn them back down.  I don't need to tell anyone that I'm going to play music to soothe me - I will just play it.  I don't need to tell anyone that I will vocalize to deal with my pain - I'm just going to do it.


But I feel like I should let someone know that I plan to use mother-directed pushing - no cheerleaders for me, yelling in my ear to hold my breath and pushpushpushpushpush!!!  That will most definitely win someone a punch in the throat and I just feel like they should be warned about that, you know?


I don't plan to ask for permission to use different positions to labor in - I will follow my body's cues and that's that.  I have the power to say no at any time and I plan to exercise that power and I don't need to tell anyone that.


Oh yeah, and the eating and drinking during labor?  Got it covered - we're going to bring "snacks for Drew" and I DARE someone to take a banana or some apple juice out of my hands. I'm not asking permission to eat.  Period.  If I end up throwing it up, oh well.


In short, I feel like I should have a birth plan but aside from 'inside voices only please, no talk about anyone dying and I will come to you if I decide I want drugs, so don't ask' I'm not sure what else I should have on there.  I will not allow anyone to do anything without first thoroughly explaining it to me, but does that really need to be written down? Again, I will just say no if I'm not feeling it.


I'm not giving birth tomorrow, but 60 days is going to come and go awfully quickly and I don't want to get caught with my pants down.  I mean, at some point I'll have to take off my pants, but you know what I mean.


Where is the balance between being open and having a plan?  What needs to be said and what is simply understood?  My doctor and I have an understanding but she's not going to be there the majority of the time.  I know it will be very important to establish a  positive rapport with the nurses so I definitely don't want to come across as paranoid and militant, yet I'm no pushover.  I may freak out over approaching a stranger about paint, but it's a whole new story when you're heading my way with a scalpel or needle in your hand.  


So how 'bout it?  I've studied lots of birth plans and none seem quite right for me.  What would you suggest I write out on my birth plan?  Should I even bother?


I've got 60 days. 

16 comments:

  1. I suggest having at least what you would like out of birth i.e. no drugs, drugs, wait until you can't take it anymore for drugs. How you want things to go etc.

    I ended up having an emergency c-section.. yep, totally against everything in my birth plan.

    And obviously you can only plan so far. BUT, at least you, your husband and your doctor know what you 'hope' to happen, that would be best. Then in case something happens (God forbid), then your doctor will know what you hope for, your husband can take reigns in whatever way necessary. And you and baby can be safe!

    My daughters birth was nothing like I hoped for or could ever plan for. She was 36 weeks, 3 days after trying to shift her out of breech positions while having pre-eclampsia. Aftewards finding out because of the shape of my uterus, they could have ripped my uterus open in the process. Her but was engaged, I was at 5+ centimeters, not even in labor... and she decided it was time to come out. So c-section it was, after I told my boss I would be back at work that afternoon! We weren't ready, we didn't bring the hospital bag or the carseat! My daughter was born 45 minutes after I was told she was being born that day. I was in the 5% who would birth their chidl the same day as the flipping procedure.

    ok.. that was longer than I thought... but always be whatever you can prepared... and go with the flow.

    ReplyDelete
  2. I'd say write down the things that are most important to you. This also includes any information about Drew that might be vital for the nurses to know. (ie: he'll faint if he sees blood... or he has seizures please be advised.)

    Any newborn procedures that you wouldn't want them to do such as eye ointment, or vaccines. Sometimes those things happen fast without someone consulting you first.

    A birth plan is not to literally plan every aspect. I like to call them preferences. If things change, and need to change for a reason, then by all means do not stand rigidly next to this piece of paper with your "Plan" on it and say "but but but!!"

    I had my preferences, but knew that with an induction, some things would change. I talked it over to my doctor prior to it all starting and I marked out some things with him saying "Listen, things have changed... ignore these things." (ie: heplock, intermittent fetal monitoring)
    I actually think that made him soften up a little, realizing I wasn't going to be down his throat annoying about it.

    I also had one resident who (I was told) STUDIED my birth preferences so she could really get where I was coming from. lol After all, I was there for 2-3 days.

    If you feel like you're not getting anywhere pushing, try squatting or sitting on a birth stool.

    Depending on how your hospital bed is, I've seen some that have like a u shape cutout when they lower the foot rest.
    If you have them lower the foot rest so the u shape cutout is there, voila, birth stool.
    My doctors were willing to try that even with my epidural in place, since i could still move my legs.

    ReplyDelete
  3. I have lots to say about the issue of birth plans...will try to share my thoughts when I have the time. Tonight, though, I'm going to soak in the jacuzzi and then go to bed.

    ReplyDelete
  4. I didn't have a birth plan other than I wasn't planning on an epidural with my first. I really wanted to see how far I could go but apparently my tolerance for pain was low, low, low. So, yeah I had the epidural and didn't regret it. I also had it with my second. The difference to me was with my first, I ended up not feeling what was going on with my body so they had to tell me when to push. With my second, the anesthesiologist did an awesome job where the pain was non-existent but I could feel when to push. It was so much better.

    As far as the eating goes, I think they might be okay with apple juice since it's not red. I know in case they have to go to plan b, they don't want you throwing up anything red colored just so they know if it is blood or something else. The food thing, well, there's a reason not to eat. Again, the just in case thing plus you don't want stuff coming out the other end (I heard about women pooping while pushing though it didn't happen to me).

    Anyways it's good to have a plan but keep in mind plans change. Don't think they immediately will cut you down there. I gave birth both times without being cut down there and I had 6-7lb babies. The hospital I gave birth at did not immediately do episiotomies.

    Good luck and enjoy the last couple of months! Rest up!

    ReplyDelete
  5. First - you have 60 days!! CELEBRATION! :) I think I am more excited about your countdown then mine! LOL

    Second - I've never had a kid. I don't know how to write birthing plans. I was there when one of my best friends had her baby and witnessed the whole thing. A couple suggestions for you from what I saw - do NOT let family in the room. It makes it chaotic. Just have you and Drew and the nurse. It's much more special that way. My other piece of advice I think you already know and plan on doing - do things on your schedule. Don't let the doctors or family or anyone convince you to do something that you don't want to do.

    Oh yeah. And enjoy it! You're going to be a mommy! :)

    ReplyDelete
  6. I had a detailed birth plan and it went to hell and at the end of it I got a healthy baby. THAT IS IT. I hadn't put "have healthy baby" on the plan at all, I'd just assumed that was a given...
    So this time it reads #1 have a healthy baby by vbac if possible. #2 have healthy baby by any means necessary. #3 get baby to meet big sister ASAP, and #4 is breastfeed ASAP, and then I have a bunch of things written down that would be nice if they could happen, but I'm pretty easy going about it now.

    ReplyDelete
  7. i agree with the first comment. it's good to have specific list of what you absolutely don't want to happen, but to be open about the rest.

    but other than that, i tried to have a good rapport with the hospital staff and let them know what i wanted. one of my nurses (i was in the hospital for a week before i ended up having a c-section) was a slight heifer during her shift, but for the most part they were really helpful.

    it also helped that one of close relatives is a labor and delivery nurse, so i was able to get her input throughout the process. her biggest piece of advice was to think about what is in the best interest of your baby and be flexible with your birth plan.

    ReplyDelete
  8. This time is gonna fly by although it will seem like forever.

    I say like someone else said, write down the things that are important to you since you do seem like a planner lol. I feel like I could never plan for birth. It never happens the way we want it to and I really just wanted to play it by ear. She came when she wanted to@ 36 weeks and I was ok with that. She was healthy and we were both happy.

    ReplyDelete
  9. Hmmm. In the packet of paperwork from my doctor, there is one paper with huge letters that say: WE DO NOT ACCEPT BIRTH PLANS. They must have had issues with trying to accommodate every woman's specific wants and I can see how that (to me) is way too much to ask from experts who do know what they are doing. I trust (and it sounds like you do too) my doctor and myself to make decisions in my best interest as well as the baby's. But I am also wayyyy less informed than you are! I know I would stress out too much if I read all the information you have read and would worry more than I already do. So...I don't really have an answer. It sounds like your balanced approach, as with most things in life, will be just fine.

    ReplyDelete
  10. Thanks for sharing that quote!!! I absolutely love it and NEED to live by it.

    When I think of birth, all I can think about planwise, is what we'll do at home. Husband grab the pre-prepared bag, etc. and I will meet him at the door while trying to refrain from pushing the baby out on his seat.

    I just kind of think in the spare of the moment, with all the panic and pain, a real PLAN is gonna fly out the window and be replaced with, "LOOK I JUST WANT TO GET THIS KID OUT HEALTH-ily (not a word, but you know."

    ReplyDelete
  11. Linda Worzer talks a lot about communicating birth preferences in her childbirth classes, which I've really enjoyed taking. If you haven't checked her out yet, she's in Richardson and her website is www.naturalbeginningsonline.com.

    It might be worth taking one of her classes, or talking to her about a doula. Because the doulas work in so many different venues, they can often tell you some of the inside dirt about what's typical at a specific hospital (for example, one mentioned in our last class that Dallas Presby doesn't have water available, that you have to ask the nurses for it).

    ReplyDelete
  12. I've chatted with Linda at length but her classes didn't work with Drew's travel schedule so we weren't able to go. I really wish we could have though - she's a great lady!

    ReplyDelete
  13. I suggest having at least what you would like out of birth i.e. no drugs, drugs, wait until you can't take it anymore for drugs. How you want things to go etc.

    I ended up having an emergency c-section.. yep, totally against everything in my birth plan.

    And obviously you can only plan so far. BUT, at least you, your husband and your doctor know what you 'hope' to happen, that would be best. Then in case something happens (God forbid), then your doctor will know what you hope for, your husband can take reigns in whatever way necessary. And you and baby can be safe!

    My daughters birth was nothing like I hoped for or could ever plan for. She was 36 weeks, 3 days after trying to shift her out of breech positions while having pre-eclampsia. Aftewards finding out because of the shape of my uterus, they could have ripped my uterus open in the process. Her but was engaged, I was at 5+ centimeters, not even in labor... and she decided it was time to come out. So c-section it was, after I told my boss I would be back at work that afternoon! We weren't ready, we didn't bring the hospital bag or the carseat! My daughter was born 45 minutes after I was told she was being born that day. I was in the 5% who would birth their chidl the same day as the flipping procedure.

    ok.. that was longer than I thought... but always be whatever you can prepared... and go with the flow.

    ReplyDelete
  14. I had a detailed birth plan and it went to hell and at the end of it I got a healthy baby. THAT IS IT. I hadn't put "have healthy baby" on the plan at all, I'd just assumed that was a given...
    So this time it reads #1 have a healthy baby by vbac if possible. #2 have healthy baby by any means necessary. #3 get baby to meet big sister ASAP, and #4 is breastfeed ASAP, and then I have a bunch of things written down that would be nice if they could happen, but I'm pretty easy going about it now.

    ReplyDelete
  15. I'd say write down the things that are most important to you. This also includes any information about Drew that might be vital for the nurses to know. (ie: he'll faint if he sees blood... or he has seizures please be advised.)

    Any newborn procedures that you wouldn't want them to do such as eye ointment, or vaccines. Sometimes those things happen fast without someone consulting you first.

    A birth plan is not to literally plan every aspect. I like to call them preferences. If things change, and need to change for a reason, then by all means do not stand rigidly next to this piece of paper with your "Plan" on it and say "but but but!!"

    I had my preferences, but knew that with an induction, some things would change. I talked it over to my doctor prior to it all starting and I marked out some things with him saying "Listen, things have changed... ignore these things." (ie: heplock, intermittent fetal monitoring)
    I actually think that made him soften up a little, realizing I wasn't going to be down his throat annoying about it.

    I also had one resident who (I was told) STUDIED my birth preferences so she could really get where I was coming from. lol After all, I was there for 2-3 days.

    If you feel like you're not getting anywhere pushing, try squatting or sitting on a birth stool.

    Depending on how your hospital bed is, I've seen some that have like a u shape cutout when they lower the foot rest.
    If you have them lower the foot rest so the u shape cutout is there, voila, birth stool.
    My doctors were willing to try that even with my epidural in place, since i could still move my legs.

    ReplyDelete
  16. I have lots to say about the issue of birth plans...will try to share my thoughts when I have the time. Tonight, though, I'm going to soak in the jacuzzi and then go to bed.

    ReplyDelete

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