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Thursday, June 19, 2014

Birth plan...birth preferences

pilling happens fast when you have only so many shirts...

I sat down the other day to type out a birth plan seeing as I'm 35 weeks along (as of the day this gets posted) and came away with a whole six grand bullet points. Straight from Ye Olde Google Docs, I bring you this spectacularly detailed list that I planned to go over with my midwife at my appointment (which I'm going to share here, because it's the Internet, and I may have heat stroke since it's 91 degrees and it's nearly 9PM as I type this...):

Birth Plan Preferences 
  • Intermittent monitoring
  • Freedom to move around the room if possible
  • No routine episiotomy 
  • Access to unlimited popsicles
  • Skin-to-skin contact with baby immediately after birth
  • No visitors for at least an hour after the birth 
I was 99% sure that some of these were their standard practices anyway, in which case I could strike them, but since I transferred to the midwife center relatively late in my pregnancy (I'm signed up for a tour Sunday that most people take before they hit 18 weeks -- oops) I'm still learning little new things about them and their practice.  Things I knew already: They've got a really low C-section rate, they have tubs, they make you sign a little "I understand epidurals aren't our routine" statements (I may come to regret this, but I like their practice as a whole, so I'm, uh, biting the bullet on that one) and their literature states that they "strongly urge" women to use a doula, so I'm doing that too (I was able to find someone really nice and in my price-range by using DoulaMatch after someone from my cohort of Internet moms suggested it).

After I talked with my midwife directly, she confirmed that immediate skin-to-skin contact is their routine practice (so, I can strike that) when there aren't extenuating circumstances.  And that they do not use fetal monitors 24/7 (strike).  And that while I may want an IV (I don't *want* one but I also realistically know that I have a fast metabolism and I have freaked.friends.the.fuck.out. by suddenly blacking out because I went too long without fuel of some sort, so an IV sounds like a reasonable thing for me to end up with) they won't force me to stay in bed with it if I don't mind waddling around with said IV (strike).  They don't do routine episiotomies (strike).  They strongly urge the couple+baby to be alone for a while after the birth.  So, that leaves popsicles.
  • Intermittent monitoring
  • Freedom to move around the room if possible
  • No routine episiotomy 
  • Access to unlimited popsicles
  • Skin-to-skin contact with baby immediately after birth
  • No visitors for at least an hour after the birth 
I like lists that are whittled down to the Most Important Things, at least!  I haven't asked about their popsicle stash, but I was talking to Patrick and mentioned I would loooove to get my own stash of King of Pops popsicles to take with us to the hospital.  "That'd probably be pretty easy with the tiny cooler," he pointed out.  We'll see how *that* actually works out (the best-laid plans...) but I'm pretty sure they'll have popsicles since I swear the birth class lady mentioned them.  For now, the popsicles stay as the lone birth plan survivors.

My lingering fear is that I'll end up with this tiny little easygoing birth plan and then somehow I'll end up at some OTHER hospital, and be totally screwed into the hospital birth I *don't* want.  We don't have any travel plans so I'm not sure how that could happen, but I suppose it COULD, like if I have some work emergency or something (I work 45 minutes away from home/the hospital).  So I should probably keep a basic one and a midwife one, right?  That's not overkill, right?  I'm only taking 6-8 weeks off (still not sure yet...but it definitely won't be more than that since I'm new at my job as it is and I'm not eligible for FMLA) so I'm worried sick about any possibility of a c-section, just for recovery reasons.

For anyone here who's created a birth plan -- or didn't -- what are your thoughts?  It seems like so many people say they're a waste of time, while others say they're empowering, and at this point, I'm pretty neutral.  I feel like there are so many variables, care provider routines being just one.  To a certain extent, I feel like after having gone through IVF in a Czech clinic where I don't speak Czech other than Prosím (Prosím (pro-seem) = Possibly the most useful word in Czech. It means: 1) Please, 2) Here you are, 3) You’re welcome, 4) What did you say?, 5) I’ll have … and can generally be used in times of doubt), and making that work, writing out a birth plan has been kind of...meh.  Like, not not-empowering, but just kind of A Thing, Shrug.  I don't see it as planning how my birth will go, because I figure things will go how they go.  I like their routine practices.  If things deviate, I trust it won't be because nobody there thinks skin-to-skin is important, etc.  But there's always that possibility that things don't go as planned in ways I don't foresee at all, so I keep thinking about that backup non-midwife plan I should have under my belt, too.  In which case, should I get even MORE nitty-gritty?!  6 bullet points, 6 pages...

Poot.

Next on the terrifying to-do list: Figure out who will take care of the dogs once I go to the hospital, and making that labor iPod playlist (Ke$ha and Iron & Wine are a good mix, right?).  And getting that diaper pail for the nursery.  And finishing at least one infant care book.  And harpooning a Rockaroo for not a million bazillion dollars*...so I'll be here, sailing the high Craigslist seas, harpoon ready to strike...even though I feel like the whale in the equation (see below):


*Ok, it's not THAT much, but still!  

13 comments:

  1. I made a birth plan, but as long as I went to the hospital with my wants in my head, it didn't matter because the nurses/docs asked me throughout the process. They never did anything without my consent first, so as long as you know beforehand, then wee! "Enjoy!" The key is just to remember is that things happen. I went into the hospital during a shift change, which meant that although I was dilated enough for an epidural, I had to wait about half an hour to get it because one nurse had to give another nurse a recap before handing me over. And hey, that could've been worse, but it was excruciating at the time. ;)

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    1. Yeah, I'd rather just go with a general idea, rather than get too attached to an "ideal", you know? (And that does sound awful. UGH shift changes!)

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  2. I had a birth plan but had to be induced a couple of weeks early for medical reasons so all that went out the window. I will say that even though I didn't get the birth I started out wanting, I'm pleased with what transpired. I was allowed to labor as long as I wanted, and my doctors discussed everything with me like a human being with agency in my own birth process and not a test subject.

    Also! We picked up a cheap trash can with a lid and use Planet Wise pail liners (we found them at Franklin Goose) for our diaper pail and it's worked wonderfully.

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    1. Yeah, we have one of the Planet Wise bag sets, so it's really a matter of finding a pail *without* all the bells and whistles of disposable pails! A regular trash can might just be the thing.

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  3. I have zero short-term memory, so a birth plan was important for me. It meant that Dan and I actually sat down and talked about all our preferences beforehand and go them down on paper, so that those important discussions wouldn't happen in not-level-headed screaming fits during the actual birth. Then Dan was in charge of speaking up if we happened to get to a point in the birth where one of these decisions were important. This is particularly nice for those "if, then" things, like "if X happens, do you want us to do Y or Z?" Having that figured out ahead of time makes you less panicky when the midwife comes to you with Big Questions and you haven't slept in 24 hours. All of this being said, you can't write a super detailed birth plan and expect people to follow it to the letter, unless you're rich or a queen or something. It's like the pirate code. More like guidelines than rules.

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    1. Hah! The pirate code. I like that. And yeah, I'm happy I'm going to have Patrick around since he's on board with stuff. The "if X then Y" approach may be what I end up doing on paper with those bullet points...

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  4. I never made a formal, written birth plan. I knew what I wanted (and didn't want) and discussed this with Greg. He agreed to speak up for me if I ever felt uncomfortable speaking for myself (if I was too exhausted, in pain, etc.) Knowing we were on the same page and he would be my voice if I didn't have the energy was really comforting.

    I was very reluctant to write anything down because I didn't want to get too invested in the plan if things suddenly went a different direction. There were a few things that didn't go as I had hoped for (having to be induced, episiotomy thanks to an 8.5 lb baby, etc) but all I really cared about was keeping us both safe and mentally "present." I have a history of blocking things out when I'm in pain!

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    1. Yep, ditto on the not getting too invested business. It seems like a recipe for disappointment in the end, and truthfully, I trust my care providers, and I want my baby and me to be safe in the end.

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    2. Holler back on the 8.5 lb. baby! I had a tactless nurse the other day repeatedly tell me over and over to cut out sweets because Natalie's in the 5 lb. range at the moment when she shouldn't be. Weeee! So maybe she'll be a 9'er.

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  5. I like your birth plan, yay popsicles! But I would suggest that you make one for a c-section just in case. I know that mine was basically unexplained and unavoidable because my kid was just NOT COMING OUT, THANKS. If I had spent ANY thought about a c-section before it had happened, I might have been better prepared for it. Sure, it's a ton out of your control if it comes to that, but at least this time I've spelled out my requests for things like skin to skin as soon as possible and delayed eye drops and not to be knocked out. (I may have just passed out from exhaustion, but who knows?) But the standard post c-section IS eye drops right away at my hospital, thus the written request. You know?

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    1. Hmm, yeah I'll need to ask them what their standard is. I ended up being given a birth plan template from the midwife that day, so I ended up going back and redoing some parts (it's kind of a fill-in-the-blank thing, which I had to retype for my own sanity since they used Comic Sans, wtf). They just ask what my feelings about eye drops are, but don't really say what their MO is on those. I'll have to ask for some clarification!

      And yeah, it does seem like a good idea to think about what happens if I have a c-section. I'm so, so hoping to avoid it, though at least if I need one, even though I'm with a midwife clinic, the clinic is located inside a hospital, so there's that for a little less nervousness. But yep...I should do that. Thanks!

      Sending you lots of good thoughts!

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  6. I just came across your blog via gomi I'm following along since my finace and are currently going through this whole TTC business and are in the process of hormonal treatment before we give IVF a shot.

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    1. Hi! Best of luck to you both, and if you have any questions about my IVF experience feel free to ask!

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