Failing to Plan

McSweeney’s: Jamie and Jeff’s Birth Plan

Mom Stories: I’m Still Mad About My Birth Story. You?

Thankful for a Cesarean Delivery

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One of the hardest things for me as the end of this pregnancy journey nears is how it’s all going to end. With twins, a lot of birthing options go right out the window. Multiple births are always considered high-risk, even for me, with a super easy go of it so far.

I know that all-natural, midwife-assisted home birth is all the rage, and many women get upset at the very idea of hospital birthing with Evil C-Section Doctors. Both of those are too extreme for my taste. BUT–I still support women to do whatever makes them happy. I don’t want to judge anyone on their birth choices–CHOICES, LADIES.  It seems like a lot of People on the Internet get very judge-y about one choice being the “right” choice and the other one is “wrong” and detrimental. In fact, it seems like that’s the case with everything about childbirth and childrearing. I want everyone to do whatever they want and works best for them, while realizing that it’s just that–what’s best *for them* and not necessarily for anyone else. And I hope things go well for each woman, no matter what.

Here’s a fascinating look at the development of obstetrics as a practice over the last two centures. It’s long but worth the read: http://www.newyorker.com/archive/2006/10/09/061009fa_fact  The big piece to remember about birth is that for thousands of years, it’s been a very commonplace event, but also a very dangerous one. It’s still dangerous, even now, in hospitals! One of the strangest things to me about this whole experience is realizing just how much no one knows about it. The process of growing a new person is still mostly a mystery, even to the medical establishment. Shit goes wrong in an instant, no one knows why, and it seems like a lot of times there was no warning and/or no treatment other than to monitor and see what happens.

Anyway, all this to say that if I were only having one regular baby, I would still want to be in a hospital with a doctor. Just my personal preference. Although I would probably want to try for a water birth, as I hear those are a lot more comfortable, and more hospitals are offering it.

As it stands, with twins, I have to give birth in an operating room, no matter what kind of birth we try for. If something goes wrong with one or the other, they are quickly prepared to get them out as quickly as possible–something that sounds scary but also reassuring. But there are also so many other factors at play–the positions of both babies is a big one, as is my first-time status. But also the condition of all my systems, their conditions and weights, the placental locations, etc etc. In general, the type of birth we have is a big old who-the-heck-knows. Which means that it’s kind of out of my hands.

I don’t usually consider myself a control freak (I wonder if that makes anyone laugh), but this situation is making me reconsider. Something about not knowing how or when they’ll arrive has really done a number on me. We took the childbirth prep class and learned about labor and breathing and all that jazz…and I don’t know if I need to be preparing for that. We learned about C-sections, and I don’t know if I need to be ready for that. I don’t know how I’ll deal with pain, or how I’ll know which options are right for me. Mainly it seems like I can’t really consider *any* options, because it’s all still such a crapshoot. I just don’t know what will happen.

Earlier in the year, I figured I should be aware that they could arrive any time after 30 weeks. (Hence my big relief every week that things continue to go well and they continue to cook.) I feel totally at a loss, because I basically have no say in the birth timing or experience. And that’s really made me emotional. A few weeks ago I asked the doctor about the birth–what, if anything, I could plan for or think about–and I started crying! I’m not even sure exactly why. I guess because I don’t/can’t know *anything* for sure, and that has me feeling so helpless and uncertain.

Now that we’re getting down to the wire, things are suddenly getting a lot more real. Like, those are real babies in there, and there will be an actual birth happening in the next two weeks or so. One doctor said that she pretty much guarantees I won’t make it to 38 weeks, because of a few small conditions popping up (low platelets, possible pre-pre-eclampsia). I’m skittish about scheduling a C-section; I would much rather wait and see if my body starts the labor process so I know the babies are as ready as they can be. BUT, I also understand that may not be an option, if my body is starting to get unhealthy and becoming an unsupportive environment. I’m willing to put babies’ health above my personal preferences or wishes.

It seems like for now we’re probably looking at a C-section, and I can already feel my future self coming up with defensive statements about why it was necessary and important. Especially here in Portland I’m not looking forward to potential judgey moms who think that no matter what I should avoid a C-section. My OB, and the practice really, is not about unnecessary interventions at all–all along she’s said it depends on the babies. And so now that B is the bigger of the two, and hasn’t moved from breech in over a month, and she doesn’t want to take the risk for a natural delivery, I can accept that. She knows best.

So why this title and links at the top? Two of the big pregnancy-process words: birth plan.

Just the words make me roll my eyes. First of all, can we just mention the PRIVILEGE that a ‘birth plan’ implies? So much entitlement! To me it smacks of Special Snowflake syndrome. ‘Here’s what I want to happen to me and everyone better read it and know it.’ This isn’t a picnic event that you’re planning in the park, people, this is a very serious medical event–no matter if you’re in your own home or in a hospital. Things go wrong, things have to change at a moment’s notice, for the health and safety of mama and baby(ies). It’s now such a thing to ’empower’ pregnant women to plan everything that it seems a lot of them end up really disappointed, sad, frustrated, and even angry–for years afterward!

This just seems counter-intuitive. And sad.

Which is why I really appreciated what the childbirth prep educator shared about the whole birth plan thing: instead of listing all the things you don’t want (epidural, pitocin, c-section, whatever), make a general list of what you *do* want (or really, “hope”) to happen, and keep it vague, on purpose. She said that her first birth had a lot of complications and interventions, but she absolutely loved it, because the big things were still there–like that her partner was with her the whole time.

Turning the birth plan on its head like this made me feel so much better. Mostly because, as I’ve now said like eight times, I basically can’t plan for my birth and it’s not really up to me. (Which, I also understand, is not a common situation; most mamas-to-be do have a lot of say in their choices.) I’m happy to let the medical experts be the experts and make the call for what’s best for my health and babies’ health. I do have a few big ideas that I would like, that are pretty generic, and that could be feasible no matter what (barring unforeseen circumstances, of course):

–If I end up in labor, I am open to pain medication, since I have no idea how I’ll deal with that kind of pain.

–I want my husband there, and I want him up with me, not at the business end.

–I would really like to hold the babies as soon as possible. I’ve heard two different people say that the hospitals here are really good about fairly immediate skin-to-skin, even in C-sections. I’m not sure how that works, if I’m all numbed up for another 30-45 minutes. But if I can’t hold them, then at least Andy will be there to hold them.

–If I have a C-section, I’m afraid of being left alone and cold after the babies come out. I’ve read a couple birth stories where that happened, and it sounds kind of upsetting. So I will have to ask what happens after the birth. It’s kind of tough, if they get taken away to get cleaned up, or to the NICU–do I want Andy to stay with them, or stay with me? Can they give me lots of blankets or turn the heat up in the room?

–This is silly, but I’d love to find out the possibility of music, even just iphone on speakerphone, in the OR. Since I listen to music all the time, I think it would be neat to have some good music on when the babies come out and then for me to listen if I’m getting stitched up.

And really, the biggest part is the health of everyone at the end of this event. I think it’s important to understand that unlike teaching, there is definitely such a thing as too much planning. In fact, it seems like it might be most helpful to do as little planning as possible. I want everything to go as smoothly as possible so that all of us are ready to start our new life as a family.

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8 thoughts on “Failing to Plan

  1. I had no birth plan. I wanted to avoid a c-section if possible (who doesn’t) and get an epidural. My water broke at 38 weeks, and I had to be induced (which judgey moms might not like but it was medically necessary). The epidural sped up my labor (and made me a lot less crazy), and I only had to push for an hour. My water broke at 6 am, I had no contractions until I was induced, and my son was born by 6:30 that night. It may not have been a birth judges moms liked, but I was happy and had a healthy son.

    Judgey-moms are doing that because of something missing in their life. If anyone doesn’t completely understand that in a twin birth you don’t have as many options, that’s their problem not yours. Your only issue is bringing home two healthy babies, however they come. Best of luck to you.

  2. Though not a mom myself (an auntie) I deal with mom’s all the time at a daycare. EAch story is different. My sis went to the very end of her pregnancy, labor only a few hours. My sis-in-law had a pre-scheduled C-section for medical reasons. A cousin had a sudden disorder requiring an induction 6 weeks early and still took all day in labor. I know friends whom did home water births, home births with dulas and midwifes, others in hospitals just like you’re considering. I’m glad there are multiple choices for birth options. Rather have I heard a mom regret anything and don’t pay attention to judgey parents. Healthy babies and you is what you’ll remember I’m sure.

    • Yes, that’s the weird thing, isn’t it? That there are so many different types of birth, and yet there are still some that insist there’s a “best” way to do it. Argh. And yes, no one should regret anything about their birth.

  3. We didn’t have a birth plan either – I had to be induced due to high blood pressure and possibility of pre-eclampsia. I think its important just to relax as much as possible, go with the flow, and really rely on your partner to be your advocate. Everything will turn out great, because in the end you have the prize of two wee ones! Sending positive labor and delivery thoughts your way, Julie. You’ll do great. xo

  4. I remember when I first read about birth plans and how I thought maybe it was a bit ridiculous. How can you plan something that you cannot predict… That you don’t even know when it will happen!! As the birth got closer and my due date passed, I began thinking what I wanted wouldn’t be what I would end up with. So I decided to record those things that I would ideally want to happen in case it all went another way. I think it’s good to at least put something out there without getting too tied to anything because it is quite out of our control. Best of luck here at the end of your pregnancy and in the birth (if it comes before i get to wish you luck again 😉

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