A neonatal nurse’s experience with planning for the unpredictable.
“Whatever you do, don’t make a plan. It never goes the way you want it to.”
It’s an unsolicited comment that will grace the ears of most pregnant women from the moment their little secret becomes public knowledge.
As a former neonatal intensive care nurse who desired a spontaneous, unmedicated birth for my first baby, I was terrified to give birth. I had only seen the bad: forceps and vacuum assists, births that required emergent action, and worse, death. Birth is unpredictable. With all these images shrouding my mind, I needed a safety net. I needed something I could control.
I could control how I prepared for my baby’s entrance into the world. And maybe with preparation, I would experience the birth I wanted.
So, I prepared.
I put my fears aside with meditation and positive affirmations. I researched every evidence-based study regarding topics like induction to perineal massage to eating dates. I hired a doula. I exercised. I performed yoga and stretches that would optimize my baby’s position. I did everything the research suggested I do.
I also wrote a plan.
When writing my plan, I informed myself of each choice I could make and what option best suited my needs and preferences, with my baby’s safety being the utmost priority. I learned what reduces cesarean risks and infant mortality and what increases the chance of spontaneous, unmedicated birth.
There were a lot of outside opinions regarding my plan, but that did not matter. I was prepared. I was ready. I wanted to show the naysayers that I could do it. I was speaking my positive birth experience into existence.
Then my baby’s “due date” came.
The stress crept in with the fear that things might not go as I wanted them to. My child was showing no signs of making an entrance anytime soon.
Then 41 weeks came and went.
Alas, my water broke with no signs of contractions starting even 24 hours later. When I went to the hospital to check, I agreed that I needed to be induced to prevent infection. The first line on my birth plan expressing my desire for the start of spontaneous labor in the comfort of my own home was already out of the window.
The induction unfolded, and I followed my birth plan as closely as I could safely and realistically. I desired no pain medication and the freedom to move, eat and drink as needed. I used hypnobirthing techniques, a heating pad, cool cloths, and the constant presence of my husband, mother, and sister to get through labor. I used my plan to guide every decision I made and to collaborate with the medical team as things progressed.
But even so, my baby couldn’t tolerate the Pitocin. His heart rate was dropping. Contractions brought a new, different pain akin to my pelvic bones feeling like they would break in half. And when the Pitocin was turned off, they just stopped altogether.
What was my body, my baby, telling me? I had to listen to my gut. Something wasn’t right.
38 hours later, my cervix was dilated to 9cm but my labor stalled. I consented to what I had wanted to avoid: a cesarean section. We were both so tired. I knew in my heart and gut that it was the safest route for my baby and me. Sure enough, it was. Upon his entrance into this world, we discovered that he was malpositioned, his head tilted sideways and unable to descend and pass through the birth canal.
Some people say not to make a birthing plan, but I beg to differ. As I sat with my baby safe in my arms, new stretch marks angry from the liters of fluid pumped into my body and struggling to move after the surgery, I couldn’t help but be thankful for that plan. That plan was created on the foundation of knowledge and research. That plan helped me decide when an intervention was necessary.
That plan empowered me to be at peace with how my birthing unfolded, even if it wasn’t the way I had pictured it.
I don’t mean to pretend that I was happy about the cesarean. I still had so many complex emotions to sift through, and still do seven months later. I reckon most mothers feel that way about their birthing experiences regardless of the method.
But the one thing I can say with certainty is that my baby was born the way he needed to be. I know that because I listened to my body, my baby, and to that accumulated knowledge that was bundled up in my birth plan. That knowledge helped me accept the inevitable outcome with much more grace.
To every mother and partner reading this, I encourage you to make that birth plan. Use it to teach yourself, to become knowledgeable of birthing options, and to empower yourself. That knowledge will allow you to be flexible and informed. Because at the end of the day, healing after birth is more than physical, and the mind and heart need to be at peace with each decision and scar.