April 18, 2012 posted by Lindsay Ferrier

When Good Birth Plans Go Bad

When Good Birth Plans Go Bad

It’s always good to have a plan, but some birth plans go too far…

My five-year-old son’s birth story began when my husband and I were on a walk, two weeks before my son was due.

As I walked up our neighborhood’s biggest hill, I had the unmistakable feeling that I’d… well… wet my pants a little. It hadn’t happened before, but I knew it was common in the last trimester and since my super-sized fetus (who would weigh in the next day at ten pounds) had been exerting some serious pressure on my bladder, I figured it was simply another indignity in the life of an extremely pregnant woman. I said nothing to my husband (oh, the teasing I’d have had to endure!) and changed when I got home.

As it turned out, I hadn’t wet my pants. My water had broken, but I didn’t realize it until I sat up in bed with a start at one in the morning. I stumbled to the bathroom, blearily aware that something was different, and there I had the classic “OH MY GAAHHHHH MY WATER HAS BROKEN!!!” moment. We hightailed it to the hospital at one in the morning, where I was promptly checked into Labor and Delivery- no triage for me! Once your water has broken, you’re in like Flynn.

When my obstetrician arrived, she immediately wanted details on the exact moment that it had happened.

“Well, technically it was at one in the morning,” I told her.

“Oh good,” she said. “So it hasn’t been long.”

“But,” I continued, “I think it may have actually happened at around seven. But I was out walking and just thought at the time that I had wet my pants a little.”

“Oh don’t tell me that,” she said nervously. “I don’t even want to know that. The longer it’s been since your water has broken, the greater the risk of infection. So we’ll just go with one a-m.”

This is how I learned that once your water breaks, the sooner you have your baby, the better. So I was surprised as I watched TLC’s A Baby Story while on the elliptical yesterday to see a woman laboring unsuccessfully in her apartment, ten hours after her water had broken… and then 15 hours… and then 20…. and then 24. At that point, the midwife told her she needed to go to the hospital, but still, the woman was resistant.

“I didn’t want to go,” the woman tells the camera in a soulful, after-the-fact interview (and her words are a paraphrase, since I couldn’t find the episode online.) “I had planned on a home birth. Having to go to the hospital was one of the worst moments of my life,” she finished, with tears in her eyes.

At that point, I fell off the elliptical.

Well, not really, but I might as well have.

Because… Really, lady? Choosing your baby’s safety (not to mention your own) over a home birth fantasy that clearly wasn’t working for you was one of the worst moments of your life?

Let’s get something straight before we continue. I’m all for home births, hospital births, water births, hypnobirths, natural births, and anything else you can dream up that’s been deemed safe. Every woman who’s having a child, who’s had a child or even who’s dreamed of having a child has an idea of how she wants labor and delivery to go.

But somehow over the years, drawing up a birth plan has become equivalent in women’s minds to planning a wedding. It’s alllllll about the mom, which is fine and dandy… until the mother’s demands potentially endanger the child. I’m seeing more and more women throw absolute fits after their birth plan goes awry, or devote numerous blog posts to their grief over their botched birth plan– despite the fact that they still came out of it with a brand new child who’s healthy and whole.

Forgive me if I’m way out of line, but I just don’t get it.

With Punky, I waited to get an epidural until the last possible moment — I wanted to feel like I had experienced labor (and ohhh, did I ever experience labor!), but I had absolutely no desire to feel the legendary “ring of fire” at the very end. I planned to wait for my epidural with Bruiser as well, but shortly after I checked into the hospital, his heart rate dropped briefly.  Suddenly, doctors and nurses flooded the room and an anesthesiologist was in my face, asking to put in the epidural immediately. If it was in, she said, I’d be able to stay awake if I had to have an emergency c-section and even more importantly, they’d be able to get him out ten minutes sooner.

That was all I needed to know.

“Put it in,” I said. Yes, I was disappointed- and having an epidural for that long of a period was totally not fun. But I didn’t grieve. I didn’t mourn. I didn’t throw a fit.

I hadn’t checked into the hospital for “MY BIG FAT METICULOUSLY PLANNED BIRTH EXPERIENCE.” My main goal was to hold a healthy child in my arms at the end of the process.

I’m not here to criticize anyone. (Except for that woman on TLC. Seriously, woman. I hope that the moment you were told you’d have to have your baby in a hospital instead of your apartment really is the worst experience of your life, because then your life will be very good indeed.)

I’m merely suggesting that perhaps in the future, we counsel the pregnant women in our lives to consider their birth plans as less a set of rules and more a general idea of how they’d like things to go. Here’s the advice I’d offer, based on my experience having kids:

  • First off, you can make this entire process more pleasant by taking time at the very beginning to find an obstetrician who really listens to you. My OB/GYN is one of my favorite people in the world- She treats me like I’m intelligent, she took time to get to know me as a person and not just another pregnant lady, and I feel like I can talk to her about anything.
  • Once you have an OB you trust, make your birth plan a collaborative work. Talk to your OB about what you want. Ask him/her for suggestions. Listen to those suggestions. Remember that you are not the expert and take that into consideration.
  • When you’ve written your birth plan, realize that it’s simply a general idea of how you’d like things to go, that it’s subject to change once you’re in labor, and that much of it will go out the window. I think I had “mood lighting,” “scented candles,” and “soft music” on my first birth plan. Once I was was in labor, though, I didn’t give a flying fudge round about any of those things. I just wanted that baby OUT… and everything else became irrelevant.
  • While you’re in labor, don’t think of yourself as a queen, surrounded by minions. Instead, consider yourself the quarterback- You need all of your teammates’ help and expertise to get that baby delivered. Take the advice of nurses, doctors, and midwives seriously- They may not be suggesting what you had originally planned, but they’ve delivered thousands of babies and know what they’re doing… I’m pretty sure they’re not making recommendations just to mess with you. Having a baby really is a collaborative effort, and the more you think of it that way, the better it is for everyone involved.
  • Know that the end of it all, there’s a good chance that your fantasy will have played out in a completely different manner than you’d planned. Your home birth turned into an emergency c-section. Your natural birth was marred by an epidural and pitocin. Your nurse wasn’t very nice. LET. IT. GO. You have a beautiful, healthy baby. Nothing else matters.

Those are my thoughts. What are yours?


Image via BradleyGee/Flickr