Birth Plans don't work - what I've learned about creating plans and navigating the power of birth

  (Trigger warning: I briefly describe my first birth experience, which wasn't peaceful or desirable. If you are pregnant and avoiding such stories, skip to the second birth experience.)

 

   "You're going to want that epidural!"

   "Don't be a hero!"

   Raised eyebrows, eye rolls, condescending chuckles...

   Negative Nancies are the worst when you are planning to give birth without medication. Whether it is your mother or an actual stranger named Nancy- I get it! Just like someone touching your belly without your permission, unwanted advice and negativity feels draining and annoying.

   So as a doula, how do I break it to someone that they may not have the experience they've worked so hard for? That something, even something small, might and probably will go "wrong"?

   I am a huge believer in positive thinking and the power of the mind. I'm all for thinking of labor as being hard work vs "painful". But I also know the soul-crushing disappointment of realizing at the end of a long road that very little went according to plan, and how difficult that can be to process when you are hopped up on hormones and lack of sleep.

   As a doula I have seen the unexpected sneak up on us pretty quickly, and sometimes simply unfold in a series of unplanned moments. But for now, I will pull from material closer to home- my own birth experiences. What went right, what went wrong, and what have I learned about making a plan?

   Birth #1

   It is no secret that my first birth was a difficult one. Young and uneducated, much of what goes on in a birth room (or a birthing person's body for that matter) was an absolute mystery to me. My plan was to "wing it". Women had been giving birth since the dawn of time after all... right? My only request was that I give birth without an epidural. Giant needles scared me, and I knew my mom had given birth twice without medication. I've seen her pain tolerance. Let's just say that I figured if she could it then anyone could.

   A combination of stress and dehydration kick-started my labor at just 7 months into the pregnancy. Medication stopped my labor temporarily (and made me horribly sick), and I would spend two weeks in bed with little to no food, peeing in a bed pan and awaiting the inevitable. After two weeks labor started again, but this time it was initiated by pitocin after complications arose. I still had no idea what to expect, so as the nurses explained to me that they would be trying pitocin but preparing me for a cesarean, I simply nodded and signed all of the paperwork that was handed to me. My contractions became extremely intense very quickly, and I was overcome with the sensations in my body. Lying on my side I cried and gripped the bed rail and at one point I thought to myself that I just might die from the pain. I didn't care about needle size anymore- I wanted that epidural! It was offered to me from the nurses like a gift from the gods, and I begged for one, but was told that it would be impossible as the only anesthesiologist was currently unavailable. Thankfully it was all over quickly. My baby girl was born just under 30 minutes after we started the pitocin drip, and even though she stayed in the NICU for two weeks, everyone was healthy.

   So how did I feel about the birth? Looking back I am relieved that I didn't have a set "plan" for my birth. Every single thing in a typical birth plan for a parent trying to have an unmedicated birth would have quickly gone out the window and been replaced by fast decisions and emergency circumstances. We all did the best that we could do in the moment and I didn't feel bad about anything that was done in the hospital room during the birth of my baby. However, I do wish that someone had prepared me! Prepared me for the sensations that accompany birth, the birth process that would unfold in my body, and most especially for the most obvious thing- the postpartum period. Absolutely everything was a mystery to me and I had no way of processing my experience. I was clueless about breastfeeding, basic newborn care, my own body and its healing process... the list goes on. And I believe that this lack of support and education about the fourth trimester is a large part of the reason I settled into a deep postpartum depression that lasted for over a year.

Birth experience #2

   I planned every detail of my second daughter's arrival to the planet. I didn't want to give birth in the summertime, so we even chose which months we would try to conceive! During my pregnancy I read books, watched documentaries, talked to every birth professional I came into contact with, and even became attuned to reiki~ all in an effort to have a more calm and empowering birth experience. I was determined to heal the part of myself that had felt so out of control and frightened during my first birth. I had a midwife and would be giving birth at a birth center, in a pool, with candles and a doula. I was absolutely determined to chant and reiki my baby into the world and I was very prepared to do so.

   When I actually went into labor it was just after I had put my toddler to bed and my husband wasn't home yet. Having never gone into labor naturally before, everything was new to me, and I felt a bit in denial that perhaps labor was really starting. I tentatively called my doula and alerted her that I was experiencing some signs of labor, but I told everyone to hold off because I wasn't really sure. A few hours later I was happily moaning and swaying in the shower, not wanting to move from that spot with contractions rolling in every 2 to 3 minutes. My husband finally forced me into the car and as we pulled into the parking lot of the birth center I knew I would be pushing soon.

   My doula came running into the birthing room just after I laid on my side (the only comfortable position I wanted to be in) and I pushed out Isabelle less than 15 minutes later.

   Sounds pretty perfect, right? But how did I feel about this birth experience?

   I was so empowered! So happy! But so bummed... yes, bummed. There was no laboring in a tub, and everything went so quickly that it really felt as if there was no "labor" at all! I missed out on the candles, the doula support, the reiki, and all of the things I'd prepared with. (And a non-refundable deposit on that birthing tub went down the drain as well). I was disappointed to have missed out on "my plan", but I tried to keep those feelings mostly to myself. With this new empowering and peaceful birth experience under my mom belt, I felt as if I could do it all- and I tried! I wore my newborn in a wrap while jumping right back into every task on my list without missing a beat. It is a much-told story in my family about how I showed up to the superbowl party at my mom's house to eat tacos just a few hours after I gave birth. There was not a hint of postpartum depression this time (something I was so pleased about!) but there was still something... I knew I was missing something. I was exhausted. I was stretched too thin and I knew it. Suddenly, a couple of months after giving birth I regretted that I hadn't cared for myself better in the weeks immediately postpartum. My body responded to my do-it-all lifestyle with headaches, mastitis and severe mental fog.

Birth experience #3

   Soon after giving birth to Isabelle I already wanted to do it all over again! I wanted my perfect water birth dammit! But my husband and I agreed that we were done adding to the family, so I set my sights on surrogacy. It would take a couple of years before I found myself pregnant again, and when I did I was determined to have an even better experience than what I'd had before. I ran into a problem for my perfect water birth though.. it turns out that most people do not trust the safety of having a baby in a tub, and the majority of surrogates are required to give birth in a hospital with a NICU. I shrugged it off and changed the plan- I would have the most empowered and natural experience possible in the hospital.

   I had the ultimate birth bag packed and ready to go. I knew how to advocate for myself, I knew the hospital and much of its staff and I had my doula. I was ready! But if you have read my birth story (you can here) you know that this birth didn't go according to plan at all. Like... at all. In fact, it was so fast that I actually felt terrified of the loss of control in my body and didn't enjoy the experience the way I might have imagined. I was so relieved to have it all be over, and even though it was over quickly, the intensity lingered in my physical body and emotional body for some time.

   So how did I feel about this birth?? I was told by many people that they wish they had had my birth experience and I would laugh, but on the inside I would cringe. I didn't feel empowered... in fact, I developed a bit of postpartum anxiety and struggled mentally to let go of the fear that this birth had instilled in me. But I did do something right. I took care of myself postpartum. I stayed in bed for close to a week, and then didn't go far from there for the next few weeks after. I read books, ate nourishing foods, gave myself daily self-massage and wrapped my belly in a bengkung belly bind. I felt strong, invigorated and perhaps the best I have ever felt in my life after my "laying in period".

 

What have I learned from these 3 very different births?

That nothing ever goes according to plan. Even when you have a wonderful birth experience like I did with Isabelle, you may still have missed out on parts of your plan! Does this mean we should throw our plans out of the window? Does it mean we should expect the worst and prepare accordingly? No, of course not. But we need to give ourselves permission to be led by these unseen forces. We need to allow ourselves to bend, sway, open and surrender to whatever lessons are being taught to us during this mysterious process. Be educated, yes. Advocate for yourself, yes. But be open. And know that birth is not always going to look like quiet seductive moaning in a candlelit room. (or whatever your vision of birth happens to be!) Sometimes birth is bloody and smeared with shit. And when we can accept that part of it too, we can step into the full power and do what it takes to bring a life earthside. If we can be open to whatever this experience throws at us, we won't be surprised when sensations are bigger than we imagined or interventions are needed when we didn't anticipate any. I've discovered that it is our rigidity and the way we cling so tightly to "the plan" that most often leads to feelings of resentment, disappointment and anger once our baby is here.

I was reading the book Awakening Shakti by Sally Kempton recently, and in the chapter about the goddess Kali, I was struck with how much I resonated with the following paragraph:

"Violence is a part of the creative process. (The big bang, after all, was an explosion.) The energy that pushes a baby out of the womb, in a process that is bloody and full of the threat of death, is full of creative violence. Like anything to do with Kali, once the birth process begins, it is inexorable. Of course, in our time we employ drugs and surgical knives to "civilize" the process, to make it more convenient and often to save the lives of children and mothers. But in the essential truth of the body, the process of birthing belongs to Kali, and for many women it offers the first great recognition that here is a place where the human ego has to get out of the way."

   Indeed, when it comes right down to it, though we may be gripping our visual and organized birth plans, we have to step out of the way and let the power of birth take us over. There is no way to truly prepare for that or for the lessons waiting there for you. And in a time when I see more and more parents creating beautifully laid out birth plans, presented as if it were a contract between them and the Universe, I sometimes feel a little twinge of sympathy - because I know that this little piece of paper will be useless in the face of what is to come.

   As a doula I don't want to be one more person heaping negativity onto a birthing person's desire for the birth they are envisioning. So maybe instead I can inspire them to give into the unknown. Embrace the power of birth and all that comes with it. To show them that nothing actually goes "wrong" when you are having a baby- things simply unfold in a way that is as chaotic and beautiful and messy and unpredictable as nature always has been.

 

(these opinions that I've shared in this blog post are just that ~ my own opinion. Take from it what resonates with you and leave the rest! You are a powerful force and you deserve to have the experience you envision. I believe in you and your abilities, and I believe in your power to accept whatever may arise on the way to your destination.)