Birth Plans; Expectations & Managing the Outcomes
BY VALERIE ROBINSON
At my most recent OB visit, I received my packet containing a blank template for a birth plan. I filled it out, a little different from the first time, but filled it out nonetheless. When I got home and talked to my husband about different things on it and highlighted what was really important to me, I was comforted by his simple response: “We will figure it out, and it will all work out, just like the first time.”
If you’re a type-A planning control freak like me, you will understand this. It’s overwhelming when things do not go as planned. At 29 weeks with my first pregnancy, things went about as unplanned as I could’ve imagined. I left a toxic job and was paying an arm and a leg for continued coverage through COBRA. There was a lot of uncertainty surrounding the pandemic. Everything was changing…fast. I was going alone to every appointment, hospital policies were changing, and my baby shower was no longer going to be what I had dreamed of. I walked into what was supposed to be a routine, quick visit just to be instructed I needed to go to the hospital. My blood pressure was 150/98. In the grand scheme of things, I thought to myself, “you know, with everything that’s going on, that’s really not all that bad?”.
I ended up staying overnight at the hospital, with the consistently elevated blood pressure but otherwise in good health. However, this was the start of a journey I had not anticipated. Biweekly visits to the OB for regular blood work, ultrasounds, and non-stress tests (NSTs) – all without a support person. As a few weeks went by, my blood pressure continued to climb, and I was diagnosed with gestational hypertension. Since I didn’t exhibit any of the other symptoms of pre-eclampsia, I wasn’t diagnosed as such, but it wasn’t being ruled out. I had already been to the hospital a second time, and so at 34 weeks, I was being introduced to the idea that it was likely I would be scheduled to be induced.
I was insanely crushed. Nothing was going the way I wanted it to. And my hopes for a completely natural birth experience were flying out the window. For months now, women had been shoving their birth experiences down my throat, how tough they were without the epidural worn proud like a badge of honor. How short or long it took and whether or not they got a 4th-degree tear. I had one mom tell me I had to figure out how to get the anesthesia consult (all canceled due to the pandemic) because I just wouldn’t make it without the epidural. It had all been built up in my head, and my strict birth plan had been my way of staying in control and proving myself to all these women. I was going to go into labor naturally, I was going to go unmedicated, and episiotomies and c-sections were for absolute emergencies only.
But at 35 weeks and after a third hospitalization, my doctor told me if something didn’t change, I was at an increased risk of stroke and bleeding out. It was explained to me quite bluntly, as I watched my blood pressure reach 160/115, that the only priority at this point would be to make sure baby and I were alive and healthy. Finally, at 36 weeks, I was scheduled to be induced right at 37 weeks on the dot. I was very closely monitored for any last-minute changes resulting in an emergency. With God’s grace, though, we made it to 37 weeks – Full term. It felt like the one thing I’d manage to do right in the last several weeks.
At this point, I knew I had very little control over what would happen. So I tried to focus on my attitude and my demeanor. I was open to the new plans the doctors had for me. I received a foley ball, which was removed after 12 hours. Also, I received Pitocin and, after a few more hours, requested an epidural. I’d accepted that I waited too long to ask for the epidural and started pushing not even ten minutes later. And after about an hour, I was just overcome with joy at what I had accomplished. My baby boy and I were perfectly healthy. We’d arrived on a Thursday evening and left early Sunday afternoon. I was so proud of myself. My husband was proud of me. And everyone around me just seemed so happy.
Pregnancy will teach you the importance of striking a balance. Nature is in control of this one. I think it’s essential to generally have an idea of what you want and don’t want. Birth plans are good for keeping you focused and organized. But it’s not the end-all-be-all. Draw out all sorts of exceptions and boundaries. If you can keep an open mind and put yourself in the right headspace to accept all kinds of various scenarios, you’ll save yourself from a world of disappointment and anxiety.
My biggest takeaway is this – you don’t have to prove anything to anyone. This isn’t a competition. Don’t let all the birth experiences talk make you feel like you have something to prove. Every birth experience is exceptional in its own way, and no one can take that away from you. The only thing that matters is the good health of you and your baby. Cherish every moment! I wish you all a wonderful labor and delivery; good luck!