Beyond the Birth Plan

Birth Plan.  Two words that most expectant parents hear at some point during their pregnancy.  In fact, all expectant parents are encouraged to create a birth plan these days, but it is a staple of an un-medicated birth.  A birth plan is exactly what it sounds like – a plan for your birthing time.  This can include information on the people you would like in the birthing room, requests about music and lighting, phrases and words that care providers should use, services you would like to accept or decline for mom and/or baby, a description of the pain management techniques being used, etc.  Some birth plans are long and others are quite brief.  There is no right or wrong way to write a birth plan and no specific template that must be followed.  Regardless of how it is written, it helps the expectant parents to really spend time thinking about what they want to occur before, during, and after birth.  It also encourages conversation with care providers before the big event.  By sharing the birth plan early and often with care providers, it becomes much easier to work as a team with your care provider during the birth.  The birth plan is an excellent tool for setting and communicating clear expectations.

Many births go exactly as “planned”.  We were fortunate enough to have one of those birth experiences.  Everything went according to our plan.  In our Hypnobabies birth preparation we envisioned our birth occurring a certain way.  The only thing that didn’t go according to that visualization was the fact that our birthing time began at 3AM instead of 3PM.  That change to our birth plan and visualization wasn’t a problem, although I felt bad waking up our doula at 3AM!

**Hypnobabies students please use your bubble of peace.**

The tricky thing is that birth plans are still just a plan.  Plans don’t always get carried out just the way you envision.  This can be very unsettling, upsetting, and even traumatic for expectant parents.  One of my clients had a beautiful birth plan laid out.  She took the LEAN Expectations class early in pregnancy and then completed the Hypnobabies birthing series with Julie Byers.  She ate a healthy and varied diet, she practiced her birthing relaxation techniques, and prepared for the birth of her second baby.  Her first birth had been medicated and she walked away from that birth experience with a beautiful, healthy baby but it was not the birth experience she was hoping for.  In a quest to bring her second baby into this world peacefully and calmly, she was doing everything to make sure this birth experience not only concluded with a beautiful, healthy baby but with a feeling of closure, peace, and serenity.

This planned pregnancy was going to be different. It was going to be perfect. I decided to do Hypnobabies with this birth because I have heard so many wonderful success stories and wanted to experience that myself. I am a hard-headed person, and believe me when I say I didn’t think it was working. I had the hardest time just letting go and relaxing, but I kept at it. I was going to have the perfect home water birth. When my husband said he was on board with a home water birth, I was the most excited woman in the world. I found a midwife we both connected with, and the fun began. I loved the special one on one attention in my home. I loved how everything was relaxed and not the “pressure” of a doctor’s office.

Unfortunately, her birth plan began to shift almost as soon as she and her husband created it.  I have never seen a birth plan or pregnancy plan that included gestational diabetes.  This client certainly didn’t have that on her “to do” list.  Gestational diabetes can be a game changer for an un-medicated birth plan.  All too often moms with GD are induced for fear of the baby being big or blood sugar levels not being stable enough.  This diagnosis was the first deviation from her birth plan.

Things were coming along with plans for my birth until I hit 28 weeks. I was diagnosed with Gestational Diabetes. This automatically risked me out of my home water birth by state laws, but I could still have my natural water birth if I maintained my sugar with proper diet and exercise. This took a few days to mourn, but I was determined to beat the GD. I learned as much as I could and I was able to learn how to keep my eating options open with diabetes and not get bored.

We worked together to find meals that were satisfying, but fell within the guidelines of a balanced GD diet.  The birth plan was modified to accommodate a midwife attended hospital water birth.  My client continued to practice her Hypnobabies techniques and focus on growing a healthy baby.  As time passed and her guess date drew closer she was relaxed and at peace with the change in her plan.  She embraced the change and looked forward to her planned water birth with the local hospital midwifery group.

I am now 37 weeks. My son spoiled me and arrived at 37 weeks, so I was hoping for an early arrival…but 37 weeks came and went. Now began the waiting period. I’ve never been pregnant this long, what do I do? I tried to stay busy, and my VERY active toddler knows just how to do that. Walks and fun activities every day kept me distracted. Weekly Midwife appointments kept me trucking along with my fantastic sugar levels, very low weight gain, and excess energy level…we just kept waiting for the arrival of our little surprise. I listened to my (Hypnobabies) scripts every single night, sometimes 2-3 times a night depending on my insomnia. I was determined to stay positive no matter what, because this was MY birth, and I just knew that my birth story would one day be able to help that mom who needs to know there are options for her.

Every chance we had we talked about how her experience was going to help someone else along the way.  Her experiences would bolster another expectant mom who was transitioning to a GD diet or a hospital birth from a different plan.  She remained positive and I have to admit I was so excited for her birth.  Would she have a boy or girl?  When would he or she arrive?  What would she think of the water birth?  What Hypnobabies technique would be most helpful during her birthing time?  This baby was being eagerly anticipated by everyone surrounding this mama and excited daddy-to-be.

38+weeks, I woke up and I could have sworn that it felt like my baby was sideways. I felt 2 hard lumps, but my midwife appointment was that afternoon, so I sat back and waited. My midwife said baby felt head down, but would check with a portable ultrasound just to be safe. She verified I was 39w 2 days along…then called in another midwife…and said…”I’m sorry you are right, this baby is transverse (sideways)”. I knew right away what this meant and burst into tears for another loss in my birth plan. I had to hold myself together as my little toddler who was running around the office got scared and just stopped and said “mamma?” and rubbed my leg. I had to be strong for him. I called my husband to come meet me since he was working in the area and we both cried. He called off work the next day because we were running out of time; we needed to act FAST. I didn’t want to post my troubles for the world to see, so only shared with a handful of close friends for support. I was referred to a local high risk doctor the next day for birth options and an ultrasound to verify baby’s exact position. That night, we jumped onto and did it all. Transverse and Breech baby positions all night long. I probably did about 4-5 15minute inversion stands off the couch and chest to knee.

I laughed as I said, for weeks I’ve been telling baby to come on out, but now I’m saying baby STAY IN! I downloaded the most relaxing script ever, “turn baby” from Hypnobabies and I swear listened to that maybe 5 times a day. The following morning a dearest friend let me come over and use her pool in the low 70 degree weather. Yes, I jumped in and did some relaxing laps and a few handstands and my husband held up my feet. We sifted and repeated. That afternoon, the doctor verified the baby is now breech and I had limited options as how far along I was. The best option was to do an external cephalic version (ECV) where they turn the baby on the outside. She scheduled this for me first thing Monday morning. We now had 3 days to keep at it and get this baby to turn. After a relaxing belly massage and more knee-to-chest positions on Friday and Saturday…we thought the baby turned. We called the midwife and she was so excited she called us into the office on a Saturday to check….the anxiety, the rush of adrenalin to verify what we knew…but no…baby turned back to breech…or never turned at all, we don’t know.

My husband and I didn’t say a word the whole drive home. We just cried together and decided to watch a movie. I couldn’t eat I was so depressed…but now something was happening. I was cramping and it was 4pm. I knew these cramps were baby trying and I begged and talked to my baby to please give mommy more time. I don’t even remember the movie, I was on the birth ball, I was balancing off the couch, I was in knee chest and just kept crying begging my baby not to come…the clock turned to 7:30 and I was cramping…I knew it. I called my midwife and said this baby is coming today or tomorrow, the version for Monday will be too late. She told me to take a warm relaxing shower, drink some tea get some rest and call her first thing Sunday Morning to come to the hospital for the ECV. I boiled some water in my kettle and steeped some tea. I decided to let it steep extra long while I took a warm shower.  At about 8, while in the shower, I let out a LOUD moan and squatted in the shower….my first real pressure wave. My husband ran in to see if I was ok…I couldn’t stand I needed my birthing ball. I left the shower and ran to sit on my ball…that was the best place to be to get through a pressure wave. Then BAM another one right away. These were nothing like before, these were real. I decided to download an app and see how long they were because they felt long (I still have this saved). Yup, they were real…they were 3 ½-4min apart lasting 50-70seconds…this is active labor.

By now it was around 9-10ish and I was texting my doula and a couple of friends wanting to know what to do.  This is active labor, I cannot talk through these waves, and they keep coming. I’m now in a knee chest position on the floor. I didn’t want to move because this position was so relaxing, but the decision had to be made.  Do we stay home and try to make it stop (haha I can’t believe I even said that) or  do it alone?  I knew what heading to the hospital would mean.

Changing plans during birth can be one of the hardest things a birthing woman will ever do.  At a time when hormones surging  and excitement is heightened, having to make decisions you never dreamed of having to make requires superhuman strength.  Every time I read this client’s birth story I want to shout with joy and amazement at this next sentence.

But hey, this is MY BIRTH right, it will go the way I tell it to…maybe the baby will flip right???

This is a testament to her strength.  Just that – a testament to a birthing woman’s strength in the face of adversity.

Now, I’m in bed trying to rest and it’s about 11 and we call the midwife again and tell her we are heading to the hospital. She had my husband put me on the phone (while I’m in the middle of a pressure wave let me tell you I wanted to curse this lady out like come on woman trying to ride my wave here)…she couldn’t believe how fast I progressed in 2 hours or so…so now we go….but wait my bag isn’t full packed and my papers aren’t together.  Trying to pack and zone out during pressure waves is NOT FUN. I laid in the back seat of the car in a knee chest position the whole way. Our car has an exhaust problem right now and is SUPER loud…ANNOYING. Then all of a sudden I hear this blinking noise..I’m trying to be calm and not take my anger out on my wonderful support husband…but I snapped “WHAT IS THAT BLINKING NOISE!!!!”  It turns out he had turned on the hazard lights, what a silly man. Anyways, we FINALLY get to the hospital (who ever wants to drive to a hospital while in active labor you’re crazy…but anyways).

We get there and I tell my husband to park in L&D and DO NOT drop me off. I wanted him with me. We buzz in which took FOREVER for someone to answer. REALLY PEOPLE active labor here haha. They didn’t see me on the camera so I had to sit up and say pregnant woman back here! As we start walking into the hospital a kind security officer comes out with a wheelchair. “Nope, don’t need it thank you. I am not sick.” I remember those words from my Hypnobabies class and said them very firmly….so my husband and the security officer watch as I have 2 more pressure waves from the parking lot to the front door of the hospital. My husband told me “just take the chair” NO I said, I have to pee. While using the bathroom, I lost my mucous plug. I knew time was a ticking, so somehow made it to the L&D floor (more more more pressure waves).

Despite the changes that had already occurred to her birth plan, she was able to retain some key pieces.  Being able to tell the security guard that she was not sick was huge.  After all, she wasn’t sick!

Ok, now where do we go.  No one was at the desk as it’s about midnight or so and we call triage, 3 times which made me cranky.  I’m having pressure waves, my baby is breech, I don’t want to be here…but trying to also stay happy and sweet so these nurses will be nice to be and let me do my natural thing.

Into triage we go…put on this gown you say?? Nooo I’m not sick, but I need to be comfortable.  Luckily, here comes my doula to my rescue! She was such a help to keep me calm. My midwife was already there and I asked for an ultrasound STAT.  It took 3 people to confirm BUT, it was confirmed – the baby was breech.

I can’t even begin to imagine the pain and sorrow that she felt upon hearing it confirmed that the baby was breech.  This declaration made about 99% of her birth plan officially null and void.  What happens next is simply beyond words, but I can say that you will want to hug these parents.

The pain and remorse and mourning that occurred after that has taken so much time to get past. My husband couldn’t look at me as he was in tears. All I remember is crying like my world was over…why me…as the midwife said the words…you need a c-section…I just let it go. Goodbye Hypnobabies, goodbye everything…I just cried. My doula held me so tight because I couldn’t stop…I didn’t think I could ever stop crying.

After that it’s a blur, so many people were in and out.  Sign this, sign that, IV in here…it was sooo much I couldn’t see straight through my swollen eyes. A kind, WONDERFUL nurse when alone with us asked if I could have an ECV.  “But I’m in active labor” I said…she goes, “it can’t hurt to ask, but I can’t tell you to ask”. As soon as my midwife walked in I begged her to please find someone who will attempt this before the c-section…and she did. This sweet young doctor I will never forget. She said this was a last attempt and if it failed, it would be an automatic c-section. I understood and chose to take the epidural right then and there…if she succeeded I don’t care about a water birth anymore, induce me if you must, just PLEASE do not cut me open. This doctor attempted to turn my precious baby for 45minutes. I held my birth necklace in my left and while I held my husband’s hand the whole time. I started to sing the Itsy Bitsy Spider…my son’s favorite song, to try and cheer me up. I reminded everyone in the room to PLEASE not reveal the gender on the ultrasound because we don’t want to find out this way. They turned my silly baby left and right but nope, baby would not fully turn….so it was time.

As they rolled me into the bright room with these HUGE lights above my head, it was cold. I was shivering and couldn’t find my husband. I clenched my birthing necklace that my friends gave me in my hand soo tight and cried some more. All of a sudden I felt this huge warmness take over my lower body…I peed all over myself. I was so embarrassed, but super confused. I asked the nurse why was I peeing so much and all over when I have a catheter in…was it in right I asked?  My water had broken; it broke 3 times. So now they started to move quickly just in case a foot popped out. They finally let my husband in and he held my hand. I tried so hard to use my scripts to stay calm, and it helped a little…but I still felt pressure and paid. I felt everything while they were inside me…but I did feel them pulling my baby out…I knew it was time and this would all not matter anymore once this precious baby arrived. They held the baby up and I heard it’s cries. They let my husband reveal the gender to me…it was my last wish because from day one, Mario was to tell me the gender.

He started to tear up and cry and in a small shaky crying voice, he said we have a girl. We have a daughter. I couldn’t believe it, I couldn’t believe everything we had been through, we had a girl. She cried so much and they let Mario hold her and bring her over to me so I could touch her and she could smell me…I wasn’t allowed to hold her. But she knew daddy and was super calm and quiet with daddy. They took me out to recover and daddy put her on me to nurse. My baby girl nursed like a champ. My beautiful girl knew just what to do. What a blessing not to have to fight to nurse like all of the work with my son.

Birth plans are amazing tools, but it is important to remember that it is ok for plans to change and it is ok to mourn those lost or changed plans.  The grieving process can be a bumpy road in which support and time are key to healing.  When offering support remember that the grieving person is entitled to their feelings and emotions.  I have heard too many parents say that they mourn the loss of their planned birth, but find that onlookers (usually family and friends) offer the platitude “but you have a healthy and happy baby and that is all that matters” when they try to seek support.  As a woman who has given birth I agree that the ultimate goal is to give birth to a happy and healthy baby but does not have to be the only goal.  We are allowed to have hopes, feelings, emotions, and goals that go beyond the simple “have a healthy and happy baby” goal.

I can’t tell you how much I admire the grace with which this client birthed her beautiful baby girl.  She never gave up.  She was strong and dedicated to bringing her child into this world in a way that would be safe and peaceful for them both.  She worked with her baby, her body, her husband, and her care providers from beginning to end.  I am in awe of every woman who gives birth, but especially of the women who have to change their plans.

This story still is painful as I’m crying typing it up, but it’s time. It’s been 3 months and I still mourn my birth, but it is getting easier. I’m not sure how to share it in a positive way, except to say I fought. I fought for my sugar levels, I fought to turn her…but in the end she came out a wonderful happy healthy girl. I won the battle of GD and learned a lot about me. I had the help of AMAZING friends to prepare for the birth and recover after. It most truly does take a village to birth and raise a child.