Birth Plan? What Birth Plan?

This is exactly how I felt as I meandered through labor and delivery. First of all, I’ve always hated the term “Birth Plan” because it has a tone of finality to it as if that is the way things WILL go. As I have discovered many a time, the best laid plans…never go according to plan. Personally, I prefer the term “birth preference” rather than plan, because in reality it’s your preferences for birth and no matter how much you want them to come true, life will throw a curve ball at you.

My birth preferences were to have a water birth, in the natural birthing center at my hospital. I wanted to do everything natural, no drugs. I wanted to labor by walking or doing Tai Chi Chih or being in the water, depending how far into it I was. I wanted to go into labor naturally, with no inducements. I wanted to start nursing my child as soon as possible. Here’s what actually happened:

Weeks before my due date my doctor told me that our baby was running large and that water birth would not be recommended because if there were any complications with getting the big baby out it would be virtually impossible in the birthing tub. So bye bye waterbirth. OK, I can handle that. At least I’ll still be allowed to deliver in the natural birthing center (where the nice rooms are.)

At about 2:30 in the morning I noticed some spotting and since I was new to all of this I woke up my husband and had him call the midwife on-call. As he was on the phone with her, I stood up to go to the bathroom, and my water broke. I continued on to the bathroom while his conversation with the midwife took a new tone. I went into the bathroom and changed my pants. I came back and called my sister to tell her to be on the next flight out (she being the nearest family member to be able to come and help us, especially with making sure our pets didn’t revolt while we were at the hospital.) I once again got up to use the restroom and it flet like my water broke AGAIN. Here’s what Hollywood and no one else tells you about labor and delivery: One, only 12-15% of women have their water break as a first sign of labor (oh yay, I’m special like on the tee-vee) and two, your water doesn’t just “break” and it’s all over with. It can continue to flow multiple times. I changed my pants three times before I tried to quell the flood with pads I’d bought for after delivery. For several hours of my labor I leaked like a sieve. There is nothing dignified about labor and delivery, and eventually, I just got used to feeling like I was wetting myself every so often.

Next the midwife comes in and says that my fluid has meconim in it and because of this, I won’t be allowed to use the natural birthing center rooms. In addition, if my labor lasts more than 18 hours from when my water broke, we’ll have to stay longer after delivery to rule out complications. Also the NICU will have to check out my baby upon delivery. Well, there goes that preference out the window. At least my labor is going OK and it’s not too hard on me, so I should be able to do this with out any other complications.

The nurses and midwives at my hospital are on 12 hour shifts, so they switch out and I get a new nurse at 7AM and a new midwife at 8:30. I do not like this new midwife, she’s kinda…gruff. Anyway, I grin & bear it. She checks me out and says that I’m 3cm dialated, 90% effaced and at +1. I’m sent out to walk to try to get my cervix to dilate more. After walking around the hospital multiple times over a few hours, the midwife rechecks and there’s been no real change. I’m told that if I haven’t doubled in dilation by 3 PM, I’ll have to get Pitocin to speed things up. In addition, the heart monitor is not getting the best readings, so I’ll need to have an internal monitor for the baby’s heartbeat. Yes, an electrode will be clamped to my baby’s head. They want to do a second internal monitor for the contractions, but I’m not dilated enough to insert it.

Three O’Clock rolls around and I’m still not dilated enough. Here comes the IV and Pitocin. There goes my preference to not be induced in any way. An interesting side effect of Pitocin, at least for me, was that my contractions became much more intense. Oh, and now there were no breaks in between them. And my labor moved to my back. After an hour of back labor, I moved to my hands & knees to try to ease the pain. After nearly 5 hours of being on my hands and knees, with contractions coming continuously and with intensity off the charts (literally, my husband thought that I needed to know the pain spikes were off the chart because it’s not like I was feeling them or anything.) Here’s the thing about back labor: it hurts, a lot. Mine was concentrated on the one area of my body where pain will cause me to cry because I have a previous injury from a car accident in that area. I liken it to Prometheus having his liver removed every day while chained to a rock, only mine was my spine being ripped out every minute or so for hours on end. In addition, the Pitocin wasn’t working as effectively as the midwife had hoped, so they kept turning it up. Every time they turned it up, contractions seemed to get more intense. After nearly 7 total hours of back labor, I threw in the towel. I asked for an epidural. There goes my no painkillers preference.

When they come and ask you when your contractions aren’t that bad if you want them to insert the thread for an epidural “just in case” you get one later, dear Goddess, say yes. Sure it will limit your mobility a little (so you don’t dislodge the thread) but trust me, you don’t want to be in back labor, in intense pain, being told to “hold completely still.” After my epidural my back labor was thankfully gone, as was all feeling other than tingly numbness in my legs. Well, especially in one leg. I tried to sleep all night, but it was difficult because as I could feel myself able to move my right leg, I had no such luck with my left leg. It was like it was paralyzed. They should tell you that it’s normal to be able to have more sensation in one leg than the other so you don’t freak out all night like I did. Also impeding sleep were the nurses coming in every 20 minutes or so to help me shift from one side to the other. It was during this time that they also put in the second monitor. So now I have 3 wires taped to my thigh (2 monitors and the catheter tube because of the epidural) and I’m being shifted every 20 minutes like a beached whale. Like I said, labor and delivery isn’t dignified at all.

So I didn’t have the “plan” I wanted. Pretty much everything I wanted was thrown out the window by halfway through my labor.  I could never have anticipated that my water would break first and contain meconium, that my cervix wouldn’t keep up with the rest of my body in terms of labor, or that I’d suffer the evil that is back labor and actually ask for an epidural. I don’t take painkillers for anything, so why would this be any different. Though at first I was really disappointed in myself for getting the epidural, I am glad I did. And I spent almost 7 hours in back labor before I got the epidural, so at least I gave it the old college try. Things will happen the way they are supposed to happen. The epidural allowed me to relax and get some rest during my active labor phase that I would not have gotten otherwise. I firmly believe this gave me the energy to push later. Also, the epidural did something unexpected and wonderful-it helped the Pitocin work because my body was more relaxed, so it actually shortened my labor, which is counter to what people think epidurals do.

By 7AM I was at 9cm and the midwife was really please with my overnight progress, but I still wasn’t there. It looked like I was going to meet a fourth midwife and nurse combo at shift change. I found out that the midwife coming on at 8:30 was my midwife, my actual midwife who I’d been seeing the entirety of my pregnancy. I’d already planned on her not being at my delivery, so this was a nice surprise. I also secretly felt the baby waited for her to come on duty. My midwife wanted to wait a bit for that last bit of dilation, but by 10 AM the urge to push was so intense we got on with it. Pushing is the best part of delivery. It’s a relief to actively do something in the process. Pushing, for me, was like being in a Vegas casino-I had no clue how long I was doing it because I was in the zone. Pushing lasted 2.5 hours for me, but seriously, it felt like 10 minutes.

There is a moment when you feel an amazing burning (not unpleasant per-se, but certainly not comfortable) and then a huge release. Because I am who I am and I was fairly cognizant throughout, the first thought I had when I felt that release was of the nature shows I’d watched & seeing cows give birth. Don’t ask, I just had that thought. Also I thought of the word “splort.” I briefly saw my midwife spin around and then I heard all the activity of the NICU staff who were on hand to check the baby out because of the long delivery. At this point, I still had no clue if I’d had a boy or a girl. Moreover, the time between that release and when I heard that first cry seemed like an eternity. Finally, I asked my husband if it was a boy or a girl. He didn’t know either. He went over to look-it’s a boy! Then he got to cut the cord. Finally, I got to hold our son. The first thing I did was unswaddle him and attempt to nurse. He took to it like a champ. So, even though almost nothing I had planned on occurred, in the long run the one thing I had planned on-a healthy baby-was the only thing that mattered.

All that matters in the birth plan is here.

Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: