Bionic Mamas

you're not losing a vagina, you're gaining a son

Birth Planning For The Twice Shy

19 Comments

Well, it’s happened: as of yesterday morning, I have crossed over into the terra incognita of The Most Pregnant I Have Ever Been. So far it is an achy and moody territory.

I asked my main OB, early on, whether the Bean’s arrival at 38 weeks, 0 days, predicted anything about the likely timing of this one. Short answer: no, unless that was a placental abruption, in which case you are at increased risk for another one, which would make an early delivery more likely. Um. Yikes. (Incidentally, this same doctor, who is also Jess’s gyn, insisted to Jess last time around that the whole “first babies come late” thing was not true. Not only was it not true in my case, but I’ve done some reading recently that says that whole idea is based on one tiny study; the site I was looking at said the average (median? Don’t remember.) arrival time for first babies in their own, decently large cohort was 39 weeks, 5 days. For second babies, it was…39 weeks, 5 days. Their sample excluded inductions, which I logic out to mean it is a little on the early side.)

On Thursday night and Friday morning, I was half-convinced (read: panicked) that labor was starting, ready or not. But it turns out sometimes a vicious backache and bouts of intestinal distress are just a vicious backache and intestinal distress. Today, I am feeling better and more energetic, so naturally I am afraid this is that nesting energy thing. Meanwhile, every time I groan, poor Sugar about hits the ceiling from the tension. I groan kind of a lot, apparently.

We are at least sort of more prepared than last time, at least with regard to practical things. We have a slightly loose but I hope workable childcare plan in place for the Bean — this is the most nerve-wracking part, besides the whole actually giving birth bit. We have a suitcase half-packed — I don’t have enough clothes to pack anything away prematurely — which is half more than last time. And I wrote a birth plan, this time before actually going into labor. Which is good, because I intend to take the advice of the OB I saw most recently (not Dr. Smarm) and high-tail it to the hospital as soon as possible this time. I would so much rather be sent to pace the atrium than have a cab ride like that horror of three years ago, I can’t even tell you. This OB — let’s call her Dr. Ready, which makes her easy to identify if you want to look up the practice, NYC folks, but not actually googleable — says there is no good reason I can’t get an epidural in early labor this time, so why wait at home? (I like her: everything about my labor was faster with the epidural than without, so I am just ignoring the part of the birth books that say not to do this. Seriously, I was at 4 cm for at least 3.5 hours last time; after the epidural, I dilated at more than a cm per hour.)

When I was putting this together, I had trouble finding useful examples for the post-traumatic birther. The birth plans I found as examples online were either completely open-ended (rare) or far more fiercely ideologically “natural” than I am comfortable with. (Pause to consider again how I really need to write that essay about how much I loathe that word.) To the extent that these plans address the emotional issues of birth, they mainly do so by means of seeking to control the medical aspects only. That’s not my main concern — I do have some medical likes and dislikes, but really, I am way less worried about any particular intervention than I am about being made to feel lazy, worthless, and generally bad again.

So, in an effort to be a little servicey, I am going to post here what I’ve written, not as an example of what things a person ought to want or not want in the medical line but rather as an example of trying to balance those desires with some attempts at emotional safety. I’m sure this is obvious, but I am not looking for criticism here, F your I.

Birth Plan

Wife: Sugar
Doula: College Friend
Obstetricians: Downtwn Wmn (google away, gentle readers)
Emergency Contact: (my father, phone numbers)

Please note that I have been diagnosed with PTSD related to the conditions of the delivery of my son in 2011.

It is very important that I am treated with special gentleness and care and that no one yell at me or shame me. Please avoid any suggestion that I am not “trying” or am otherwise laboring wrong.

Please help maintain a calm, supportive atmosphere in the labor room. Please talk to me about any necessary procedures, etc.

My wife, SUGAR, and my doula, COLLEGE FRIEND, should be allowed to stay with me at all times.

I would like an epidural as soon as possible after arriving at the hospital.

I would like to drink clear fluids throughout labor. I would like to be able to change positions.

Unless medically necessary, please do not administer pitocin. If breaking my waters is necessary, please explain why first. (This was softened in a concession to Dr. Smarm. To tell you the truth, I don’t really care all that much, but I do think there was no good reason to have done this last time; that dumb monitor never could tell when I was having contractions, and I repeat, I dilated plenty fast.)

When I am fully dilated, I would like to labor down rather than begin pushing right away. I would like the epidural left on: turning it off in my last labor was a disaster. (I feel so relieved that the doctors in this practice think leaving the epi on is a good idea. Bonus points to Dr. Joy, who said we should learn from how my last labor went. Imagine that, learning something.)

When I begin pushing, I would like to control my breathing without completely holding my breath. Holding my breath makes me feel panicky and tense. If this is not working, I will try holding my breath, but I would like to start with controlled breathing. (Another pseudo concession to Dr. Smarm, but only a pseudo one.)

Any coaching during the pushing stage should be positive encouragement only, no shaming.

When the baby is born, please delay clamping the cord. SUGAR should cut the cord.

Please put the baby on my chest immediately. If medical care for the baby is necessary, SUGAR should be with him/her at all times.

I had a postpartum hemorrhage with my last delivery and was very sick from anemia. Please be alert to excess bleeding. If my hemoglobin is below 8, I would like to discuss transfusion or other treatment options. (And let me tell you, I plan to ask this time.)

If a c-section is necessary, I would like my wife and doula to remain with me as much as possible. If I am in recovery separate from the baby, SUGAR should be allowed to be with the baby.

I intend to breastfeed. Please do not introduce any artificial feeding or pacifiers.

We would like the baby in our postpartum room unless we request otherwise. Please delay tests such as the hearing test until daytime hours. (OMG, waking us up at 3 am for this last time was so deeply unnecessary, I can’t even. What would have happened if he’d gone undiagnosed until, say, 28 hours after birth?)

Please DO NOT circumcise the baby. (No, Gentle Reader, I really don’t care if you circumcised your boy(s), I swear.)

So. That’s it. Some of the things are in there even though I know they are SOP at this hospital (like baby on the chest right away), just because…I don’t know, maybe that will make the nurses feel like we like how they do it? And because you can’t be too careful, I suppose. Also included on the hospital’s birth plan checklist is a spot for the name of anyone who isn’t allowed to come into your room. Guess whose name goes in that spot, hmmm? (Even though, yes, I know there’s no reason she would want to. Can’t be too careful.)

Meanwhile, as long as I’m being a self-important pregnant lady, here is I hope a happier portrait of my current gravidy, taken this weekend, on the occasion of our realizing our most recent family picture was from mid-2012, and none too flattering, at that. (Not pictured: The Bean trying to shove a drumstick up my nose.) I actually didn’t notice that I looked sad in the other one, because I looked more sad in the out takes. I’m trying, y’all, I really am.

Family portrait 38 weeks

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19 thoughts on “Birth Planning For The Twice Shy

  1. Awwww, you are all so lovely in the picture. It’s a wonderful plan, thanks for sharing it.

  2. Thanks for sharing. I’m still shocked that anyone would yell at you in labor. Maybe mine doesn’t really compare to a full-term birth, but the nurses and doctors were nothing but helpful and supportive and kept telling me that I was doing great (although I didn’t feel that way). I so much hope your experience this time round is not only better, but actually a good experience.
    Also, the four of you make an awesome family, that’s clear from this picture already!

  3. I see you’ve worked hard to write down your birth plan. Hmm. Would you like to tell me anything else about it or are you finished with this work?
    (slightly raised eyebrows and head tilt with slight smile indicate to observers who know me that I am internally jumping up and down, sticking a million stars on your chart about advocating for yourself while being careful not to squelch your intrinsic motivation with my enthusiasm and pride)

  4. Not in labor! It had certainly occurred to me that you might be. I’m sorry the pregnant part is so physically rough, but I’m glad the ‘Lope is hanging in there. Ooof, I am saddened at the things a woman has to state in this day and age (like, don’t take my baby off and circumcise him without asking me, like, don’t take my wife away…) But I think it’s a lovely birth plan! It makes me imagine it all going really smoothly and lovingly, with zero shaming and anemia, and nothing but happiness. You guys look like the kind of family who deserves just that. Even if it’s an effort to look that way.

  5. WHEN did the Bean get so TALL?! I always see pictures of him by himself, and I seriously did a double take to see his long legs spilling down Sugar. You are such a gorgeous family. I am so nervous for you and am hoping so much that things can be better this time around. I wish it with all my heart. Your doctors for the most part sound amazing, and so I am hopeful.

  6. 38 weeks! You rock, mama. I think W might need to crib from your birth plan , it’s awesome. For what it’s worth, when I was pushing I made everyone in the room chant and cheer, a la high school spirt rallies. W was mortified but I loved it – just saying, it’s an option.

  7. Sounds like a plan, a good one!

  8. You’re all set! Now you just need that baby to decide it’s time. 🙂

  9. Love the family photo! What an adorable family.

    I’m kinda mad that any of the stuff in your birth plan even needs to be written down. But I’m glad you’ve done it and I have everything crossed that this birth will be a healing experience for you. Is that a weird thing to say?

  10. Fantastic photo! And it breaks my heart that you have to even write such a birth plan… Such a shame, considering there are places where most of these things are offered in the first place, no one has to ask for the baby to be in the same room or for the people to be nice during labour and delivery. Whatta heck?! Anyway.
    Everyone who has experienced a second birth, including myself, say that it goes faster the second time. Most things that happened during my first birth, happened during the second as well, only faster. No one can tell how it will be for you, but statistically, you can rely on a faster pace.
    Wishing you the best. I hope you get to have a healing birth experience this time. Thinking of you.

  11. I love your birth plan (though it breaks my heart you have to write “no yelling or shaming”). I hope the birth is smooth and emotionally healing for you. I am so excited as your family prepares to expand – I’ll be eagerly awaiting the announcement here or on FB! 🙂

  12. Yay for a happy picture! I’m so excited to welcome this baby – not half as much as you all though 😉

  13. You look gorgeous and radiant and ready to do this (whenever it happens)! I think your plan sounds sane and logical and completely reasonable and that they should be able to follow it. The only thing that was in mine that I would throw out as a minor consideration is a line saying that I wanted anyone entering the room to introduce themselves and explain what they were planning to do, so I could know in advance what their intentions were. I hope this whole thing is healing for you, in many ways.

  14. You look gorgeous and I love the happy family shot. And while you obviously do look quite pregnant, you don’t look like “Oh my gosh how could she hold on another second” pregnant, if you know what I mean. (From the perspective of this one tiny pic, obviously I don’t know how you truly feel!) Good luck with the next few days. Time sure does slow down at the end.

    I am certain your birth plan will be honored and respected as it should be for all birthing women, and I am pleased that you have two good advocates on your side and a practice full of nearly all rational human beings who will respect your wishes. You’re going to do awesome. I am so excited for all of you.

  15. Your family is so gorgeous I could cry. Thank you so much for sharing your beauty and your birth plan. I am sorry that you had to put so many “don’t’s” in it, but am proud of you for doing so.

    Best of luck, dear Bionic!

  16. What a beautiful family photo! I agree with the above commenters that it is sad that A lot of the things in your birth plan need to be written down. The middle of the night tests particularly struck home for me, Bingo’s first bath was at 2am!

  17. You all are SO cute!

    You will be awesome. You will be fine. This time will be different.

    x

  18. Love the photo and the plan. Marking it for revising my own although everything is in flux right now, and I have no idea whether I will be with my midwives or 1 of the 12 OBs I’ve never met.

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