Our Birth Plan

I'm gonna go ahead and get a little personal on ya today. Mainly because people like to jump to conclusions about a lot of things when they hear terms like "midwife" and "birth plan". Not that I need to explain myself or that it's anyone else's business, but I don't like misconceptions - I find them highly irritating, particularly when people cling to them - and I'm hoping that talking about it will clear up a few things.

First things first... the issue of the midwife. I'm sure that at one point in time midwives were only used in crunchy-granola birthing-pool all-natural home-birth situations, but let me assure you that this is no longer the case. When a woman says that she's using a midwife, don't jump to the conclusion that she's giving birth in a tree in her backyard. I mean, she might be, but midwife does not automatically equal home birth or even "birthing center" birth. We're using midwives, and we're delivering at a community hospital. My entire pregnancy (with the exception of the kidney follow-up sonograms which were all done in the maternal-fetal medicine department at Johns Hopkins Hospital) has been managed by the team of midwives at my OB/GYN's office. In fact, I've never actually been seen by an OB/GYN in my life - all of my annual check-up visits have also been with the midwives at my practice. There will be doctors available on the L&D floor when I deliver, but barring any major issues, our baby will be delivered by the midwife on-call from our practice that day.

And for the record, guess what else "midwife" doesn't equal? "No Drugs". I have every intention of getting an epidural when it becomes necessary, thank you very much!

Moving on to the issue of the birth plan itself. This is where many older moms (or, for some reason, people who have never even given birth before) will laugh. "Wait til you get there! That "birth plan" will fly right out the window!" Yes, yes, I know... I'm fully aware that as a first-time mom I'm simply not allowed to have an opinion on anything baby- or birthing-related, since I'm completely clueless and have no basis for formulating such an opinion (I hope you detect a hint of sarcasm here). Don't even get me started down that path - I can't tell you how sick and tired I am of being told that I don't know anything, and that every opinion or feeling I've ever had is going to be flushed down the toilet as soon as my baby enters the world...

ANYWAY, birthing "plans" are exactly that - plans - and are written on paper as opposed to being carved in stone for good reason. Maybe some women are psycho about their birth plans but I, for one, am fully aware of the tentative nature of such things. I've never claimed to have an infallible birth plan, and I'm fine with some things changing if they need to. But is it really so wrong to think ahead and consider what I'd like to have happen in an ideal situation? Is it really so wrong to want think through the possible scenarios and outcomes so that I have considered how I'd like to handle things if x, y or z should occur, and to have a written plan in place so that my caregivers can proceed according to my wishes if I'm otherwise unable to communicate them? Call me crazy, but I call that being thoughtful and responsible about my own care and the care of my child.

Maybe you're not familiar with the types of issues that might be addressed in a birth plan. I adapted a birth plan worksheet that I found on BabyCenter.com, because I wasn't sure what all to include either. There were some things that I deleted altogether and some things that I added to make it reflect the issues that I feel are most important to me.

One of my biggest concerns, for example, is that my labor will be stalled or go on too long after my water has broken and I'll be forced into a c-section. With that in mind, I focused on interventions that I might want to have or avoid in order to help avoid that scenario. For example, I'd like to labor for as long as possible without an epidural so that I can remain mobile to help labor progress if need be, with the understanding that I do intend to get an epidural when it becomes necessary (and I don't want to miss that window of opportunity before pushing, either!).

Even more important to me is that my baby be placed on my chest immediately after birth, barring any complications, and that we be allowed to try to breastfeed as soon after birth as possible and before he is taken from the room (again, barring any complications). Also, since we plan to breastfeed exclusively, I specified that we do not want him to have any formula or be offered a pacifier, to avoid any confusion. That's one of those things that might inadvertently happen in the nursery if I hadn't taken the time to put something in writing in my chart. And it wouldn't be the end of the world if he did get a pacifier or something, but if it matters to me and I can do something to try to avoid it happening, then why not?

These are the types of things that I think are important to thoughtfully consider beforehand. If you don't feel strongly one way or another on most of these issues, then maybe a birth plan isn't a high priority for you. But if there are even one or two issues that you feel strongly about, particularly ones that may end up out of your control (like they're happening in an emergency scenario, or while the baby is in the nursery), then it's probably worth at least discussing them with your caregiver ahead of time, and maybe even putting it in writing. For me, since I don't know which midwife we'll be working with, putting it in writing is imperative. I don't know that the person I discuss it with in the office will be the person delivering the baby.

For me, having a birth plan isn't about having it "all figured out" - I'm not that delusional. It's just me doing what I can to ensure that if there are any questions about my preferences when I'm unable to communicate them, there's a resource for my caregivers to refer to.