My Birth Plan Last Time (And How It Differed From Reality)
Recently, I've been thinking a lot about birth plans.
During my last pregnancy, I avoided thinking about them for as long as I could - birth was such a huge unknown, I didn't know where to begin planning for it or what my chances were of things going the way I had hoped.
This time around, I'm excited - I know that birth can be a positive experience and I'm fired up about making sure that happens.
But this post isn't about my new birth plan; this is about the one I wrote for my first labour and how things played out on the [two] day[s].
Recently, I read The Positive Birth Book by Milli Hill. There are a lot of things I like about the book - it's full of information, large chunks of which are impartial; and it advocates for women taking control of their own birth experience, understanding that every single thing which happens to them and their baby should be their choice, and standing up for the aspects which matter to them most. Brilliant.
On the other hand, Milli disapproves of women taking a "see what happens on the day" approach. Which is what I did. She wants us all to stop making what she sees as passive statements and to, instead, write extremely detailed birth plans which cover all eventualities.
And I think that's fine if it's your second or your third or your fourth labour.
But, for me, I suspect that I felt a lot more in control first time around because I hadn't tried to plan for eventualities which I didn't fully understand. I could handle asking myself whether or not I would regret an epidural; I couldn't handle thinking about seeding the baby's microbiome (yes, exactly: what?!). Too many details and too much information would have been overwhelming, so I focused on what was important to me and trusted the rest to the midwives.
If you're keen to have a positive birth (and, I mean, who isn't keen for a positive birth?! But: if you're actively seeking one out rather than watching One Born Every Minute and assuming it's a ridiculous, sparkly daydream), you're often advised to focus solely on positive birth stories and to picture the best possible outcome. In fact, I found it really helpful to hear about the ways in which friends' labours had derailed; this gave me just enough information about induction, ventouse and caesarean to know that I could get through them and love my baby at the end. I felt confident in saying, "Yes, I will do that, if it seems necessary," and in leaving it at that.
And I'm sure, if my pregnancy had turned complicated later on and I had ended up needing a planned section or induction, I would have read up on them and made more informed choices about the details.
But, for a first labour which showed no signs of complications, I didn't need to be overwhelmed with information. I would have found the barrage of possibilities stressful - and stress was the one thing I knew, beyond a shadow of a doubt, that I wanted to avoid.
So, two years and three months on, what did that first birth plan look like and how did things work out on the day?
I wanted: To give birth in the midwife led unit (MLU).
Why? This was a bit of a no brainer for me. I didn't feel confident enough for a home birth but I didn't want the medical environment of the labour ward; I had had an uncomplicated pregnancy; and the MLU and labour ward in Aberdeen are literally right next door to each other so, if things went wrong on the day, a transfer would take all of a minute.
How did it work out? I was in the MLU for most of my labour. It was a pleasant enough place to be - we could dim the lights and theoretically play our own music (I liked this idea but couldn't even begin to imagine what I would want to listen to; I do remember something comically significant coming on the radio mid-labour and thinking "I'll always laugh when I hear this" but, by the following evening, I couldn't have told you what it was). When it became clear that my baby was stuck, I was transferred to the labour ward (which did indeed take roughly a minute); it was a bit too bright and cluttered with machines but, by that point, my surroundings weren't a huge concern.
I wanted: Steve with me.
Why? He's the dad and I knew he'd be supportive.
How did it work out? I felt like we were a team throughout.
I wanted: To try to labour on just gas and air, but I didn't rule out drugs.
Why? To know if I could, really. Plus, a lifetime of medication allergies makes me wary of taking anything unless it's absolutely necessary.
How did it work out? I had one shot of morphine in the middle of the night, largely because the midwives thought it might help me get some sleep (I did manage a bunch of 40 second naps as a result); in the middle of transition, I wondered why nobody was forcibly administering any more (that passed very quickly); and I ended up being given an epidural as part of the forceps delivery. I do believe that, if she hadn't been stuck, the labour would have been quicker and there would have been no need for anything but gas and air, but I have no regrets about taking the drugs!
I wanted: To avoid intervention, particularly a c-section.
Why? Because I was scared an epidural would damage my hips further; because forceps and ventouse sounded brutal for the baby; because I had had enough of being immobile and didn't want to add on a couple of weeks of recovering from abdominal surgery.
How did it work out? Well, I avoided surgery! I had the epidural and forceps delivery and, actually, I felt amazing about it afterwards - after 36 hours of contractions I was knackered, so a quick, easy, pain-free final delivery was very welcome. I did occasionally feel a little sad about not having felt my baby's ultimate entry into the world but that was only ever a fleeting sorrow (I do realise her health was the most important thing, but I'm not going to deny having contradictory emotions!).
I wanted: Freedom to move around.
Why? Because lying on my back in late pregnancy was agony; because moving around allowed me to find comfortable positions; because we're built to deliver in basically any position but prone.
How did it work out? I did most of the labour leaning over a birthing ball. Lying down for examinations was excrutiating so being able to move around was definitely a good thing. For the forceps delivery I was on my back but I was numb from my chest down so couldn't feel any discomfort.
I wanted: To try the birthing pool.
Why? Curiosity! Also, I had read that it might be gentler on my hips.
How did it work out? I did get to try it (there's only one in Aberdeen so it's pot luck). Early on, I found that being submerged up to my hips was helpful but, overall, it was far too hot for me and, as I could only stand to be in it if I was hanging over the side, I didn't find it very comfortable. I did feel guilty, thinking about other women (possibly) arriving and not getting to use the pool because I was hogging that room!
I wanted: Whatever the injection is which speeds up delivery of the placenta.
Why? Because I felt no strong urge to do it myself and couldn't think of a reason not to have the injection.
How did it work out? I remember nothing about it so: well? I have no regrets, anyway.
I wanted: Steve to tell me the sex and to have the option of cutting the cord.
Why? Because she was our baby and it felt really symbolic that he was the one introducing her to me. The cord cutting I didn't have any strong feelings about, but it was a way for him to have more involvement, if he so chose.
How did it work out? We're both about 99% sure he declined to cut the cord; he doesn't regret it. As for telling me the sex, I still feel damp eyed remembering whoever-it-was-who-pulled-her-out holding the baby out to him and asking, "Can you see?" and then him turning to me and saying, "It's a girl! We've got a girl!" It was the most amazing moment.
I wanted: The baby to have the vitamin K injection.
Why? Because it could potentially protect her from brain damage and there didn't seem to be any downsides.
How did it work out? There have been no downsides.
I wanted: Skin to skin.
Why? Because I wanted ALL THE CUDDLES. Also, there was some leaflet about it being beneficial...
How did it work out? The hospital here is very pro-skin to skin; it's the default option. We had some before she was whisked off to the neonatal unit and an awful lot more over the days which followed.
I remember her birth as being such a positive experience. No, it didn't all go to plan, and, yes, it was loooooooooooooong, but I felt really supported by Steve and by all of the hospital staff; I felt that all of my requests were listened to and everything that happened to me was done with respect and permission; and, other than one screech of "I CAN'T!" in the middle of transition, I didn't feel scared or overwhelmed by what my body was going through.
Big chunks of my birth plan were "go with the flow" and I stand by that. I trusted the midwives to guide me through anything which I didn't understand and, on the day, the detours from the original plan - the morphine; the epidural; the forceps - were easy enough for me to accept and didn't lead to regrets.
But I'm also glad that I had spent a little time thinking about which things were really important to me. There were very few of them and, actually, they're all pretty standard here - freedom of movement; Steve to tell me the sex; skin to skin - but being clear in my mind that those were my priorities helped me to focus on the good.
And as for my birth plan this time...? I'll tell you all about it nearer the time!