Amateur Hour

So, they say that the thing to do these days is write a birth “plan.” Its really just a list of preferences, because there is no planning these things. But, being a dutiful patient, I wrote mine. To be honest, it isn’t even a list of my preferences, let alone a plan. Because I’m attempting a VBAC, which is somewhat riskier than a typical, uncomplicated birth, there are all these rules about what I can and can’t do. So, its really a list of the things I think I can get away with, along with a few things I know they won’t let me get away with. Its probably too much information for some, so if childbirth grosses you out (I know I find most things about it positively horrifying), you may want to skip the gory details.

Labor:

• I would like to be free to walk around as much as possible during labor. (This is wishful thinking. They aren’t going to let me off the EFM, so I’ll be tied to at least one machine the entire time. I will probably be able to walk around the bed, but not anywhere else.)
• I would like to be able to move around and change positions throughout labor.
• I would prefer to keep the number of vaginal exams to a minimum.
• I would prefer a hep lock to an IV, unless I am unable to stay hydrated by drinking water/clear liquids for some reason.

Monitoring:

• I understand the importance of external fetal monitoring. I would like the opportunity to be removed from the EFM for short periods of time. I will be happy to carry a Doppler to monitor the baby’s heart rate while I am away from the monitor. (They already told me that I will only be allowed off the monitor to go to the bathroom, and that’s only because the wires won’t reach to the bathroom.)
• I would like to avoid internal fetal monitoring if at all possible.

Labor Induction and Augmentation:

• If I am overdue, or my labor stalls out, I will consider non-pharmacological and natural methods of labor induction and augmentation (e.g. walking, foley bulb, breast pump, etc.)
• I would like to avoid pitocin and prostaglandins.

Pain Medication:

• I will ask for pain medication when I feel that it is necessary – there is no need to offer. Unless you’re making margaritas in the break room – in that case, feel free to offer anytime. I like mine on the rocks, with salt.

Episiotomy:

• I would like to avoid an episiotomy. If one is necessary, please inform me, and numb the area before cutting.

Birth:

• I would like to choose the position in which I give birth.
• Once I am fully dilated, I would like to try and wait until I feel the urge to push before beginning that phase.
• If possible, I would like compresses and perineal support to allow tissues to stretch and minimize tearing. (See what I mean? Horrifying.)
• I would like to hold my baby immediately after birth.

After Birth:

• I would like time to allow the cord to stop pulsing before clamping and cutting.
• I would like local anesthetic before repairing any damage from episiotomy and/or tears. (You would think that this should go without saying, but just in case, I’m saying it.)
• I would like the baby to stay with me at all times, including during any necessary examinations.
• I would like to be seen by a lactation consultant as soon as possible.

Cesarean:

• I would like to avoid a Cesarean unless absolutely necessary.
• I would like the incision in my uterus to be double-stitched closed.
• I would like my labor support (particularly my husband) to stay with me at all times.
• I would prefer that my arms not be tied down during the surgery. (This is wishful thinking as well - I know they’re going to tie my arms down, I just want them to know that I don’t like it.)
• I would like the baby to stay with me at all times after the birth unless he is in distress and needs medical care.

If I really had control over this baby’s birth, my birth plan would read as follows:

• I would like my baby delivered via FedEx same-day delivery.
• Please be sure to pack the baby properly so as to avoid even the slightest damage.
• Please note that this package must be carefully handled and stored only in a temperature-controlled environment.
• I would like the package insured, and I would like a tracking number, so that I can monitor his progress along the delivery route.
• If you can phone ahead with an approximate delivery time, that would be much appreciated - a 4-hour window is fine. That way, I will be sure to be home to sign for the package.
• Please note that only my husband or myself are authorized to accept this package. Do not just leave the baby on the porch, or attempt to leave him at a neighbor’s house. Thank you.