Planning for the Unplannable

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I’ve had two friends generously regale me with their birth stories in the past few months, and of course have been reading countless others on the internet. The recurring theme is “Keep an open mind. Nothing went according to our plan.” No doubt, great advice, but flexibility has never really been my strong suit.

The only birth course we’ve taken is RPA’s Natural Birth Intensive which was fantastic but focused only on what they call “normal births”. I guess I’m getting distressed by how few people I know who seem to have normal births, to the point where it almost seems like an unattainable dream.

So far I’ve got no reason to worry. I’ve had no pre-eclampsia, diabetes, not even any swelling. At today’s midwife appointment I learned my fundal growth has tapered off, the baby’s head is face down and already 3/5 engaged! (At 0/5 she’s ready to go!)

Pretty textbook. Or is it only a matter of time before something goes awry?

It’s a hard line to balance between wanting to psych myself up but also keeping realistic about the potential for complications.

I tried to find that balance in writing out my birth plan, and thought I’d share it here in case anyone wants to know what they might include in theirs (or if anyone has thoughts on scenarios I might have left out).

Mama Shaz’s Birth Plan:

Starting labour
I do not want to be medically induced unless we have gone past 41 weeks or an emergency situation requires it.

Birth companions

My husband, Jim will be my primary birth partner. We do not want any other friends or family present for labour and birth.

Positions for labour and birth
I’d like the freedom to move around and be active, use a yoga ball, use the shower, and not be restricted to a bed. I’d prefer no IVs, drips, hep locks, catheters or any other interventions that will keep me bound to a bed.

Pain relief
I’m hoping to avoid any medical pain relief as much as possible. Please do not offer me drugs (even gas) or especially not an epidural unless Jim authorises it. (We’ve made an agreement that he will try to coach me through the pain even if I am asking for relief, up to a certain point.)

Water birth
We would love to be able to deliver our baby via a water birth if possible and/or use the tub for pain relief. We understand that using it too soon could slow down labour, so would like to be mindful of that.

Monitoring baby’s heart rate 

We’d like fetal monitoring to be as minimal and non-invasive as possible.

Pushing
I would like to follow my body’s instincts on when to push, and not be too directed in my breathing. I do not want an episiotomy. We have been practicing perineal massage and if I cannot birth in water, would prefer a warm compress on my perineum to keep tearing minimal.

Assisted delivery

Ideally we will not need forceps or vacuum for delivery. But if necessary, vacuum is preferable over forceps.

Umbilical cord
We would prefer to let the cord finish pulsating before cutting it. Jim does not desire to cut the umbilical cord and this can be done by a midwife. We do not plan to bank the cord blood.

Delivery of the placenta
I’d prefer to let delivery of the placenta to happen naturally, without the use of drugs. We are planning to save my placenta for encapsulation, so please advise if any arrangements need to be made to take the organ home.

Feeding the baby

I plan to breastfeed and would like skin-to-skin contact with the baby and a chance to try feeding as soon as possible after birth. In the event that I am unable to breastfeed we will provide soy formula. Our baby is never to be given formula derived from cow’s milk.

Post-natal care
We would prefer the baby to be with one of us at all times, and for any procedures to take place in our presence. We are fine with the baby receiving a routine injection of Vitamin K and immunisation for Hepatitis B at birth.

Emergency situations
A c-section is our absolute last resort, to be done only in an emergency. As I am very anxious about the idea of surgery, I would prefer a sedative and want Jim to be by my side for as much of the process as possible, and for the baby to stay with him until I am able to be with her. If our baby ends up in neo-natal care, we want to be allowed to care for her as much as possible ourselves.

Discharge
We would like to be discharged as soon as possible following birth, but reserve the right to change our minds in the event of complications.

***

I hope we’ve done a decent job of making our preferences known, but allowing for other possibilities.

I also thought I’d link to another resource I recently discovered for pregnant Aussies: MyBirth.com.au is a great site which tells you what your rights are, medically speaking throughout pregnancy and labour and also gives you stats on the various intervention rates at hospitals all over Australia. The only bummer is they don’t distinguish between birth centres and labour wards so the stats are an average.

They also give you the WHO guidelines on intervention rates and you can see clearly that most of these places are well over the recommended rates. All the more reason we feel so principled about having a low-intervention birth. But ultimately we’ll still choose whatever is safest for Pickle.

4 thoughts on “Planning for the Unplannable

  1. I had a very similar birth plan, although I forgot to give it to Clem. She decided to flip into breech position during labour. Basically all my plans went down the drain and we had an emergency c-section. So I will agree with those who say to be open minded. Realistically, a safe and healthy baby is the ultimate goal.

    1. Yeah, I read your birth story. Is that common, for babies to flip during labour? You sound like you handled it far better than I would. I guess when it comes down to it, and the baby’s well-being is all that matters, you get through it. But my anxiety around surgery is so high I think I’d just fall apart.

      I’ve tried watching c-section videos, reading about them, talking to people who’ve had them, hoping it would alleviate the anxiety but I think it’s made it worse.

      (And just so I’m clear it’s totally anxiety around the idea of being cut open and literally putting the inner workings of my body in someone else’s hands. I don’t feel like it’s a second-rate birth experience or something like that. If anything it takes more bravery!)

  2. I was terrified of the idea of a c-section. It never really crossed my mind as a possibility because my whole pregnancy was pretty textbook. As soon as they said they had to get her out ASAP the actual surgery part took a back seat in my brain and I basically zoned out just waiting to hear her cry. The worst part was waiting in recovery by myself for 2 hours dying to see her.
    Don’t watch the videos! Even the water birth ones had me super anxious.
    Your body just kind of takes over, like instinct. It’s pretty cool really.

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