January 11, 2014 – Birth Plans

    As we enter the third trimester the questions about birth plans have begun.  According to the pregnancy bible, What to Expect, I should be writing down my detailed thoughts on all the possible scenarios for delivery and how I would like them to be handled.  I am going to let you all in on a little secret: You don’t really have a say.  I love my control probably more than the next person, but this is one situation in which I have to accept I don’t get to be in control.  I don’t get to say when my water will break or how quickly (or slowly) I labor.  Unless I want to be the ultimate control freak and schedule the event, which I have no desire to do.  I would like to go into labor because it is time for my son to be born.  Even that may be out of my control though, given my high-risk pregnancy.  If my blood pressure doesn’t chill out my doctor may end up recommending early delivery and I will just have to get on board with that. 

    My birth plan is simple, “Get my son safely delivered into this world.”  Notice that it really isn’t about me, but about my son.  Welcome to motherhood!  I may have to be uncomfortable, in pain, scared, and yes even out of control in order to bring my son safely into this world.  I can accept this right now or I can let myself be full of anxiety and eventually resentment when it doesn’t go the way I planned. 

    I am surrounded by doctors who have spent their fair share of time in the delivery room.  They all say the same thing about birth plans, “things never go the way the mom plans”.  The minute a mom comes in with a 27 page (I wish I were kidding) birth plan everyone knows it is going to be the most difficult delivery of the day.  Nothing will go smoothly or as planned.  It is the kiss of death for a safe and healthy delivery.  Psychologically I understand the need for control and the plan’s ability to help moms process the events to come, however I think too often it creates a psychological block that can interfere with the delivery process when mom clings too tightly to her plan.  Stress can change the way your body responds to everything, including delivering a baby.  It also takes the mom longer to process the fast paced changes that can occur in the delivery room and leaves her to wait longer than necessary to finally okay that emergency C-section the doctor recommends.  I don’t know any doctors who want mom to have a C-section.  Most of the doctors, OBs and pediatricians, prefer if mom can deliver the baby the old fashioned way, because it requires less recovery time.  They recommend C-sections because they recognize that mom is unable to deliver safely the old fashioned way or because the baby is in danger.  Did you catch that last part?  Baby is in danger.  This is another one of the moments where it just stops being about you (or should). 

    By focusing on my desire to have a healthy baby delivered safely into the world I can relax about controlling the events on the day and prepare myself instead to place trust in the professionals I have chosen to help me obtain this goal.  I have heard hundreds of scenarios about how things change, evolve, and frankly go wrong during deliveries.  Every delivery is different and unpredictable things happen.  I should prepare myself to be on board with whatever happens, because it is out of my hands. 

    So how does this control freak get her control fix in a situation so out of her control?  I focus on the things I can control.  I learned everything I could about the hospital where I will deliver, obviously I have an advantage knowing so many people who work there (Doc included).  I learned everything I could about all the doctors who deliver there, because you never know who might be delivering.  Although I know my doctor plans to deliver me, crazy things do happen and we may find ourselves in a situation where he can’t be there and I have to be ready to embrace that change too.  I asked a ton of questions about who receives my son and will be doing his initial check.  I have stated my preference to my husband that the baby be checked before being placed on my chest to warm.  I have even asked who will be checking my baby in the nursery, because at our hospital babies are either checked by the hospitalist group or by the pediatricians from the clinic.  My preference is that a pediatrician from my chosen clinic (the hospital clinic) checks the baby.  This is sheer insanity on my part because my husband is a pediatrician from the clinic and he will have already checked the baby, my best friend who is planning to be there will check him and she is a pediatrician, and the majority of our friends are pediatricians either in the hospitalist group or the clinic and I am guessing they will all check him just in case.  After all, the first pediatrician to examine my sweet niece E after she was born was Doc.  My son will probably be examined by 20 pediatricians (including his own pediatrician because he and Doc are good friends) and specialists by the time he leaves the hospital.  Despite knowing this, I asked just to be sure.  I can also control the environment by controlling how many visitors we have and when we have them.  I can do this at the hospital by stating my preference (you actually get a say about this) and I can do this at home.  I am planning to breast feed, so I inquired early about a breast pump and have asked my mom friends how they felt about theirs.  Our insurance carrier has a nurse that calls to answer questions monthly and they encouraged me to get the pump early and learn how it works.  I asked about lactation experts at the hospital (free to use, so do!) and plan to consult them while I learn this new skill.  I have read and watched videos as well as walked through the process with my best friend as she learned how to do it.  Despite all my planning for this I still have formula on hand, just in case this doesn't work out as I planned.  I have also thought through and discussed with those people who will be around my desire to have some privacy while I learn this new skill.  Obviously my husband will be there while I learn, and since he discusses breast feeding with new moms all the time he may be helpful.  I also think it will be a good time for him to learn even more about it and since I understand how that will benefit his patients and their moms I am cool with him being there.  My brother in law is a frequent visitor to our home and will most likely be helping out with our dogs while I am learning to be a mom, so I discussed it with him and we have set up rules for our comfort.  Otherwise it is going to be a private affair. 

     Finally, Doc and I have started formulating our plan for the first few weeks after our son is born.  We have asked the moms we know what they would have done differently or what they loved having happen in those first few weeks.  If we haven’t gotten around to asking you yet please feel free to email or message us with your thoughts.  So far the majority of moms we talk to wish they had planned for more quiet time and asked for fewer visitors in those first few weeks.  Giving birth is a stressful time of adjustment for a family and the family unit needs time to adjust.  Hosting a whirlwind of visitors interferes with that adjustment and makes slipping into a routine difficult.  So Doc and I have decided to not host out of town visitors during those first few weeks.  Instead we would like to plan to host those visitors once we have settled into a routine so that the visitors can fully bond with our son and spend some quality time with him.  We are also asking that they visit one at a time, be vaccinated before they come, not to come if they are sick or were recently exposed to sick people, and to always wash their hands before touching our son.  Our son is so lucky to have 8 grandparents that are dying to meet him, and it is so important to Doc and me that he have time to bond with each of them.  In order to do that we need to set up some guidelines for visits, because if all 8 show up at once during the first crazy days no one will really get a chance to bond with him.  It would be too crazy and hectic for anyone to enjoy it and that is the opposite of what we want.  We want everyone to have special time with him. 

    So, those are the things I can control.  The rest is just out of my hands.  So here is hoping that my birth plan of delivering my son safely into this world goes off without a hitch!