Preparing for Birth {Part 1}

Thursday, October 8, 2015

Edit: After a number of great emails and questions I've started a series where we break down and talk about each portion of the birth plan, and what the options mean. You can find the first three posts in the series:

{End of Pregnancy} Birth Plan
{Labor} Birth Plan
{Birth} Birth Plan

Now that I'm into the third trimester, were talking more about plans and preparation for birth.

Birth Plan 

I don't have a written birth plan. There are important points that we identified early on as what we want and don't want as a part of our birth experience. We used those to help us find the right care provider and birth place for us.

Those topics that are important to us, helped us to find a care provider that has the same values as we do and protocols which we are comfortable with. Additionally, asking those same questions to the birth place where they deliver, confirmed for us that we are indeed in the right place.

It's important to remember that birth plans don't override hospital policy. So doing your research and asking these questions is good practice so you are informed on what your options are in different situations.

"If I don't know my options, I don't have any" -Diana Korte

If you have a birth doula, the different options for birth can be great to discuss with her! Doula's have seen numerous birth plans and worked at many different birth places with various care providers. She can help you identify which things are and aren't important to you, comfortable and clear ways to ask those questions to your care provider, and what options you would like to have available.

A good example of these "possible options" is if you go overdue there are actually a number of different way's to start induction (stripping membranes, cervadil, misoprostal, balloon catheter, artificial rupturing of membranes, pitocin, natural methods) . You don't have to go directly to pitocin and some care providers don't.
Not all care providers or birth places offer all of those options though, so this can be a good question to ask. Especially since many first time moms do go overdue.

Below are some of the topics commonly covered in birth plans. All of these may not be important to you. Cross off anything not important to you and work with the topics that are. Add additional items as you identify them.

End of Pregnancy
Time limit to go overdue
Induction options should I go the full time overdue
Internal Exams
Membrane stripping
Strep B procedures
Water breaking before arriving at birth place procedure
Options for breech presentation

During Labor

Internal exams
Mobility during labor
Eating/Drinking during duration of labor
Fetal monitoring
Water birth option
Shower option
Routine IV
Anesthesia/Other pain medication options

Mom directed pushing/Coached pushing
Waterbirth option
Push/Deliver in any position
Partner receive baby

Immediate skin to skin
Cord cutting
Routine pitocin
Save placenta
Routine tests and vaccinations
Feeding baby

Identifying things that are important to us and asking questions ahead of time has helped us feel comfortable going in without a written plan. We had a written plan for Aria's birth and honestly it didn't matter when it came time for labor. Not in a way that anyone deliberately disregarded our preferences.
Rather, during labor, the birth team (care provider and birth place) fulfill their positions with respect to the values of their practice, thier experiences, and the necessary protocols, while keeping mom and baby safe.

This time we know that we don't need to walk in and hand out a birth plan because our plan is their normal practice.

And should an emergent situation arise, I feel comfortable knowing that our midwives and doula will help us to identify our options in the moment, so that we can make the best decision for us. 

Some of our "important things" we realized from our last birth experience. Some are from research before our last birth that carry on to this one. Some are from new research we've done. And some are from my experience as a birth doula.

If there's something that's important to you or there's something you'd like to learn more about, don't be afraid to ask. A good care provider will be there for you and open to answering your questions. They will want your birth experience to be a positive one for you.


Planning for Differences {Getting Personal}

This time around for us, there are a few small things that we would like to be different from our last birth. These may not be right for everyone, nor should they be. Each woman is different and each birth is different. These are the changes that are meaningful to us.

1. We decided that we want to give birth at a Birth Center. Aria's birth was a hospital birth. While it was an okay experience, looking back it just wasn't what I envisioned during labor or postpartum. Looking back, had I not had a very fast labor, I see where there could have been a number of unwanted interventions.

2. We also decided to go with a much smaller group of midwives. During my pregnancy with Aria our care provider was a group of midwives and OBGYN's. The group was rather large and although they try to have you meet with each one during my pregnancy, I still felt like they didn't really know me or what kind of birth I wanted. Every appointment I was reintroducing myself. Then when I went into labor, someone I had never met was on call. I didn't realize how important it was to me to have someone familiar deliver our baby. It wasn't the comfortable, intimate experience we hoped for. She didn't even know my name.

It made me feel really isolated. I was scared, experiencing an unusually fast labor and no one understood what I was going through (because no one can see inside your body or feel what you are feeling), and not only did I not know my doctor, but I also didn't know the nurses. I was in a room full of strangers, aside from PJ. When PJ had to leave to go pee, I was totally alone... During transition...
Not a good time to feel anything but supported and safe.

This pregnancy we went with a much smaller group of 2 midwives. I've meet with each one many many times throughout my pregnancy and they know me (PJ and Aria) well. I know that when I go into labor it will be one of the two of them delivering our baby. When I call them, they call me back within minutes and I know it'll be a familiar voice who really knows me. It feels much more like the experience we want.

3. We want to be able to go home quickly. After a natural, unmedicated birth the first time, I was ready to leave the hospital within hours. I was feeling good and it just felt unnecessary to stay overnight for 2 nights. At the birth center we can leave within 12 hours of birth, and we're really looking forward to that.

4. Option for a water birth, with PJ receiving the baby. I know that birth unfolds like it is meant to and even though I'd love to have a water birth, when it comes time, I may not even want to get in the water. But...I do want the option. If all of the stars align, I'll be in the tub (which is amazing for helping manage contractions, btw), giving birth in the water.

4. Mom directed pushing. I'd really prefer not to be laying on a table with 4 people yelling at me to push, again. I've been to a number of births where the care provider waits for mom to feel the urge, and let her push instinctively. It's such a different experience.

5. Save placenta. Yes, I want my placenta. As a placenta encapsulator, I'm sure you can imagine what I'm going to do with it.

6. No pain medication available. At the Birth Center there isn't any pain medication available, and I love that. Knowing it was available at Aria's birth, was a lot for my will power to handle. I'd like to think that since I've had an unmedicated birth, that this time around I won't even consider it...but it just makes me feel better knowing it's not even an option.

7. We have a doula this time. Having a doula has been such a great experience so far. She is a neutral, supportive and compassionate ear, with an unbelievable wealth of information.

Birth is a life changing experience. Don't be afraid to seek out what you want and to voice your needs. It is your birth and your baby! And the way you envision it is important. You'll remember this expereince for your whole life.


Edit: After a number of great emails and questions I've started a series where we break down and talk about each portion of the birth plan, and what the options mean. You can find the first three posts in the series:

{End of Pregnancy} Birth Plan
{Labor} Birth Plan
{Birth} Birth Plan

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