Birth Plan

One thing I've mentioned but haven't fully discussed is our birth plan, or our decisions on how we'd like to approach birth in general. I've been warned many times - a birth plan is more of a "wish list" than a "plan"!

I'm also going to refer to most of this in first person, because while Caleb has been an equal partner, very supportive and willing to talk through all of our decisions, most of this is centered around my goals. Caleb takes a more holistic (and probably healthier) approach of the end goals being: healthy mom, healthy baby. While those are also my ultimate goals, of course I want to control much more leading up to that. ;)

In general, I am shooting for what most call a "natural" birth. I prefer to call it "unmedicated" or "non-interventionist," because who's to say what's "natural"? My hope is to give birth vaginally without the use of an epidural, pitocin, or any other drugs that dull pain or speed or induce labor. I also state this goal with the caveat that I am fully aware that I have no idea what I am getting into, so I honestly don't know if I will get to a point and decide that maybe I do want some pain relief, and that's ok. I also have no idea what will happen as far as complications, and I am thankful for modern medicine that can help me if any issues arise. So I mostly want to try to explain my goals without judgment towards anyone who has different goals or who has had a different birthing experience, because I think we can all agree on the most important end goals: healthy mom, healthy baby!

So if you're asking yourself, "Why? Why is she choosing the 'hardest' way to give birth?"... I do have reasons.

• My #1 reason is based on all the reading and research I've done that show the beneficial outcomes of giving birth vaginally and without medications and interventions. Vaginal birth is easier on the mother's body than the surgery of a cesarean section, and babies also benefit. Of the many I've read about, two baby benefits I can recall now are: moving through the birth canal pushes liquid out of their lungs to help with breathing, and while in the birth canal, they pick up important bacteria/antibodies/etc. that help them fight off infections and build immunity (they are actually starting to do vaginal swabs for C-section babies, where vaginal fluids are spread on the baby after surgery to give them the same fluids as if they went through the birth canal).
• So in addition to the vaginal part (vs. C-section), the unmedicated/non-interventionist part is also important to me because from what I've read, the more interventions used during labor and birth, the higher your chances become that you may end up needing a C-section. Two simple examples are that pitocin (used to increase the frequency and intensity of contractions in order to speed labor) often creates such powerful contractions (more intense than your body naturally produces), that you end up wanting/needing an epidural for pain relief. An epidural removes many of the sensations and control you have over the lower half of your body, which can disrupt the natural process of labor and is more likely to lead to a C-section if labor does not continue to progress. I personally want to experience what my body wants to do naturally during labor, and view the pain as a "productive" or "necessary" pain.
• Again with the caveat that I have no idea what I'm getting into, so I could easily change my tune once I get there! I also know that sometimes these drugs and interventions are necessary and can be beneficial. My doula shared a couple of experiences where she encouraged the mother to consider certain interventions, such as an epidural or an episiotomy (where they cut your perineum to make more room for the baby to pass through), because it would help her get through labor. So interventions and medications are certainly not bad and I am thankful they are there in case I need them, and I respect any woman's choice to use them.
• Another part of the reasoning behind my birth plan has to do with optimal bonding and breastfeeding outcomes. The plan has more parts than just labor and birth - it also includes who is allowed in the room (only Caleb and our doula, in addition to the medical staff), what happens to baby right after birth, etc. After the birth, I want the baby placed directly on me for skin to skin contact, which helps with bonding. Most procedures will be delayed (such as weighing, shots, bath) until after we have accomplished our first feeding, which should take place in the first hour or two. They call the first hour after birth the "golden hour," when if you are able to have skin to skin contact and a feeding, breastfeeding success down the road increases, as well as lower chances of postpartum depression.
• I can't deny that there is a part of me that wants to pursue an unmedicated birth because I view it as something to accomplish. I am naturally driven and seek challenges, and my mindset is not completely unlike my drive to run a marathon a few years ago. I don't necessarily think that this is healthy, in fact in many ways I've been fighting this tendency, because along with my drive to succeed, I also struggle with feelings of defeat if I don't succeed or if things don't go my way. Ultimately focusing on healthy mom/healthy baby is the best way to approach this all, but we can't all fight our nature, I guess!

I have made many preparations to pursue my birth goals. The biggest being the decision to work with midwives and a doula. I love working with the midwives because while they are supportive of a birth plan like mine, they are also in a hospital setting and work closely with OBs. So if any complication were to arise, we are in good hands to use some necessary interventions to ensure a good outcome. I chose to hire a doula after talking with friends who had had great experiences using one for their births, and also the research I had done that showed that having a doula helped with important factors when you're pursuing an unmedicated birth - pain/stress/anxiety management. She is there to assist Caleb as a birth partner to help me deal with the pain and stress of labor, which will ultimately help me stick to my plan, if my willpower/pain tolerance/anxiety/etc. are the things getting in my own way. She is also there as a source of support if things don't go exactly my way. Another thing I like about our doula is that we should do most of our laboring at home, only going to the hospital when it gets closer to pushing time. Without a doula to help us know what is happening, I think we'd go to the hospital a lot sooner during labor. I personally would like to be home as long as possible.

Some other things I've/we've been doing to prepare have been:

• Lots of reading and studying (mostly the books I listed in a previous post)
• Birth class with a doula and at the hospital
• Exercises to help strengthen my core muscles for pushing and learn control (and how to relax) my pelvic floor (kegel) muscles
• Exercises for general health and endurance. Some have been helping me feel good during pregnancy, like water aerobics and prenatal yoga, and some are more targeting for birth such as squats, core and hip exercises that keep my pelvic area in good shape for the monumental workout it will be going through.
• Spinning Babies exercises - We've been shown some techniques to do at home that helps your baby get and stay in the optimal position for birth (mostly head down, facing your spine). Caleb has to help me with them. I think we'll try to start doing them regularly a little later on.
• Perineal massage/stretching - So yes, this sounds terrible, but generally stretching out your perineum. Caleb also gets to help with this - lucky guy! We haven't tried this yet but it's another thing we might start later on (like 6 weeks out).
• Stress/anxiety management and relaxation techniques - I've been doing yoga, which is such a great relaxer/stress-reliever, and I need to start listening to my pregnancy-focused guided imagery/meditations I bought early in pregnancy. Relaxation is one of the most important factors during labor and birth, and probably one of the hardest things to achieve!

So, if you were curious (or if you weren't), that's my general plan. If you're curious about more of the details, I'd be happy to share them with you. There was a lot more to think about than I had ever considered before we created our plan with our doula!

I once again have to reiterate that this post is meant to share my plan with you all, not to pass any judgment or declare a "right" or "wrong" way to give birth. I personally don't know how it will all go down or how I'll respond to it all, and I also think that everyone find their own way and does what is best for them and their baby. So we'll all just keep our eyes on the ultimate prize... say it with me again.... healthy mom, healthy baby!