So, you’re officially knocked up. And by official, I mean that not only do you have the black and white alien sonogram pic of your baby as your current Facebook status, but you are a card-carrying stalker of Babies “R” Us, you enjoy regular wet dreams about nursery décor, you know how to skillfully puke in a trash can, the inordinate amount of time you spend on BabyCenter.com is rivaled only by time spent shopping for extra large underwear, and your marital arguments now revolve around the significant differences between eggshell yellow and lemon meringue paint colors and why your unborn baby needs a more expensive bedroom set than you do.
And even though you have just discovered the meaning of hemorrhoids and acid indigestion, and despite the fact that your rear end seems to have tripled in size, and admitting that you are unable to complete any activity without two or three potty breaks, you are still high on life. Because when you reach down, you have this amazing bump where your perfect flat belly used to be. And this bump is moving and dancing. And rolling and twirling. This bump is your beautiful baby and everything is dreamy in your world.
Now is the time to write your birth plan. Because you are still in that marvelous idealistic state where you can envision birth positions, breathing exercises, proper posture, perineum massage, meditation, hypnosis, acupuncture, water, yoga, Ouija boards, shapeshifting, feng shui, and other super and supernatural labor techniques as actually helping you without having already experienced the real-life pain of your vagina being shredded like taco meat or pushing valiantly through 39 hours of labor only to be rushed into an emergency C-section in hour 40.
I’m going to be honest with you. Birth is unpredictable. Birth is the first lesson in the school of motherhood. At the moment in our lives when we most want to grab the steering wheel, we are forced to realize that something or someone greater than us is in the driver’s seat. However, at the same time, this does not mean we shouldn’t be informed of our birth options and consider what is most important to us.
But before we get started writing your birth plan, let me give you a couple hints about what a birth plan is not:
1. A birth plan is not a grocery list. You can’t expect to write, “I want to induce labor with nipple stimulation, manage my pain with hypnosis, labor on a birthing ball, give birth while doing the splits, and have Brad Pitt cut the umbilical cord,” and expect to have all your dreams come true.
2. A birth plan is not an entrance exam to motherhood. This is not the GMAT, LSAT, or the MCAT of motherhood. No one is judging you based on whether you did enough vagina exercises to push that baby out in six minutes or less. And you are not getting points taken away for pooping on the table or cursing loudly at your husband. How closely you adhere to your birth plan will have little to no relationship to how awesome and fantastic a mom you are going to be in the long run.
3. A birth plan is not a Ms. Organic Universe Pageant. Your child’s birth is not the time to prove to the world how natural and earthy you are. You may eat a wholesome all-vegan diet of roots and twigs every day, drive a hybrid car, and run a grassroots recycling program in your spare time—but that doesn’t mean that you are going to love pushing a watermelon through your hoohah with no pain relief other than a rice sock and some deep breathing. Be honest with yourself and plan for a birth that sounds truly achievable and appealing. Even if you give up on “birthing from within” during the first stage of labor after throwing a pile of meditation beads at your husband and demanding a double epidural and a Stadol cocktail on the rocks—you are not a failure. Accept your birth experience for what it is and be proud of your amazing ability to bring life into this world.
Okay, now that we have that out of the way, let’s talk about what a birth plan is. A birth plan is a chance to learn about the different techniques for coping with labor and to consider which of these options appeal to you.
Below I have listed some of the most common and popular birthing techniques being used today. While I encourage you to read through the list and think about what you envision for yourself and your baby, I also encourage you to be as detached as possible from your intended birth plan. The last thing you want is to find yourself disappointed with your birth simply because it didn’t go according to plan. What we are talking about is bringing a healthy baby into this world, not whether you were able to give birth in a shiny hot tub following a five-alarm orgasm, right?
Natural childbirth is laboring without the use of any medication for pain relief. There are many different techniques and methods that can be used to help a woman cope with the challenges and hard work of labor. Breathing, massage, positioning, hypnosis, and visualization are just a few that are widely used. As active participants in their own labors, many women who birth naturally experience a sense of empowerment and accomplishment both during labor and after the baby is born. Of course, there is also the added benefit of not subjecting your unborn child to the side effects of drugs and other potentially harmful interventions.
Being the earthy person I am, I was convinced that I would have natural childbirth. I envisioned myself giving birth to smoking incense while grooving to Enya with images of mother goddesses decorating the birthing center walls. But, unfortunately, I ended up having morphine-hazed C-sections under the bright lights of the sterile operating room.
It’s important to remember that with birth, and motherhood in general, no matter how determined you are to do things a particular way, there is always the X Factor. There is no book or website or DVD that can fully prepare you for these experiences until you have them yourself. And there is no amount of knowledge or endurance that can overcome a baby that will simply not emerge, a cord twisted around a neck, or any other birth complication.
Not to mention, pain is personal. While labor might feel like rushes and waves to some, others might experience a sensation more close to drowning and being crushed by a cement truck.
However, despite my own personal failures, natural childbirth is a beautiful birthing option. And if natural childbirth appeals to you, I have a few pieces of advice for you.
1. Consider using a midwife and/or a doula. The practice of midwifery has been around for millennia. Midwives are extremely skilled in helping women to birth naturally without drugs and interventions. They will help you work with your own body and will encourage you to use gravity, positioning, massage, water, and other natural methods to tolerate and accelerate labor.
The culture of birth with some conventional obstetricians in hospitals can be quite different. Birth is sometimes perceived as a medical procedure as opposed to a natural part of life. Women are sometimes discouraged from trusting their bodies and asked to assume positions for labor and birth that actually work against the body’s natural abilities. For example, birthing in stirrups on one’s back is one of the most difficult and uncomfortable positions to birth in. But it is the most commonly used in American hospitals because it is the easiest position for doctors to “deliver” the baby.
Midwives and doulas put the mother, rather than the doctor, at the center of the birth experience. A doula is a mother’s helper. She is there to mother the mother. Like the midwife, she is also skilled in many natural techniques that will help women through the stages of labor, without the need for drugs or other interventions.
One of my closest friends is a doula and she has helped many women give birth naturally—even within hospital settings where mothers were being encouraged by staff who were unfamiliar with natural childbirth to accept interventions such as epidurals, narcotics, and pitocin, A doula is able to act as a buffer for the mother and remind the staff of the mother’s intended birth plan, so that the woman is not coerced into accepting interventions she did not want while in a weakened mental state.
2. Trust yourself. The journey into motherhood is a journey into the soul. As mothers, we are learning bit by bit to trust our own instincts and to surrender to life as it is given to us.
It is so easy to be swayed by the feelings and expectations of those around us, especially during an experience as momentous as birth. Make sure that you choose a doctor or midwife that honors your feelings and respects your instincts. That way, when you are in labor, you will be less likely to be detoured from your intended path by a practitioner who is more concerned about getting home to watch American Idol than allowing you to dilate naturally.
3. Educate yourself. Because the current culture of birth in this country tends to view birth as a medical emergency as opposed to a natural process of life, we have to make an effort to find depictions of birth that are not alarmist and histrionic.
Popular movies and TV all portray birth as some kind of reality horror show. Women lie on their backs, their feet in stirrups, screaming in terror while doctors and nurses blandly tell them what to do. Women do not birth babies. Doctors deliver babies. The power is all in the hands of the practitioners and not in the hands of those who are doing the real work—mothers.
Natural childbirth returns the mother back to center stage where she belongs. The mother is the one making the choices about how to labor and birth her own baby while using the thoughtful guidance and kind support of skilled caregivers such as midwives, obstetricians, and doulas.
Read as much as you can about natural childbirth and all of the options available to you. You will be amazed at how beautiful and gentle birth can truly be.
So maybe you like the idea of natural childbirth, but you still want to give birth in a setting where you can feel comfortable that all the advantages of modern medicine will be at your immediate disposal. A hospital birth might be the right choice for you. Because I had a C-section for my first birth, I chose a midwife/obstetrician duo for my second pregnancy that practiced in a hospital setting where I knew I would feel safe birthing my baby. For me and my particular situation, this was the perfect combination because I enjoyed all the advantages of midwifery and modern conventional medicine. Both my obstetrician and midwife were wonderful and talented practitioners who respected their patients deeply and honored a mother’s birthing intentions, so long as the mother was experiencing a safe and uncomplicated delivery.
In my case, I did end up having a scheduled C-section once again, but I was lucky enough to have both my midwife and obstetrician attend the birth. The midwife was not involved in the surgery, of course, but she was very supportive emotionally and sat with me for the duration of the operation. My obstetrician was a fantastic surgeon, very nurturing, and took excellent care of me and my newborn for our entire stay in the hospital.
Even if you are not anticipating a C-section, there are certain advantages to birthing in a hospital. The important thing to keep in balance is not succumbing to the idea of birth as a medical procedure as opposed to a natural force of life. As long as your practitioner shares a holistic view of birth with you, you will not feel bullied into accepting interventions during your birth that you didn’t intend to use (i.e. membrane stripping, pitocin, fetal monitoring that requires the mother to labor in bed, epidural, vacuum suction, forceps, etc.)
Of course there are times when certain complications (abnormal presentation such as posterior or breech, umbilical cord prolapse, umbilical cord compression, failure to progress, etc.) might arise during labor that can make birth into an extremely challenging experience and can also make a mother re-evaluate her birth plans. If such complications arise for you, do not feel uncomfortable reorienting your views on birthing with medical interventions. This is the time when we can all feel extremely blessed to have access to all the benefits of modern medicine and educated practitioners who can skillfully deal with such complications and avoid the high childbirth mortality rates of the past.
We are lucky to be born in an age and a part of the world where pain medication exists and is readily available. This is no reason to medicalize birth, treat mothers as sickly patients, or allow practitioners to schedule births around their kids’ soccer games. But it is nice to know that there are options for pain management if we choose to use them.
Labor can be very difficult and painful. No one ever said that birthing a baby was like a Caribbean cruise with round-the-clock gourmet buffets and Chippendale dancers.
There are many reasons why you may choose to accept pain medication during your labor and you do not need to explain or justify your decisions to me, your mom, your yoga instructor, or anyone else. Labor is intense and modern medicine has given us many options for pain management that were not available years ago. It is more important for you to be comfortable and safe during labor than to prove that you are some kind of birthing hero.
If you decide to accept an epidural or other pain medication, don’t be ashamed of your choice. Be proud that you were able to determine your pain threshold and take care of your own needs.
Although no one in their right mind would want to opt for a C-section (except of course for celebrities who schedule their C-section/tummy tuck together for convenience/vanity and the unparalleled fear of their vagina being converted into a black hole), I was surprised to find that recovery from C-section was not actually as bad as I expected.
Due to unforeseen circumstances, I ended up with C-sections for both of my births. Once I got over the deep depression I experienced from not being able to realize my Enya birth and the bone-shaking fear of dying in the operating room while my intestines were strewn all over my armpits, I realized that there are certain advantages to the Big C.
1. You may not win the Earth Mama Natural Childbirth Award but you will be pleased to discover that your ladyparts are still intact and snug as a bug in a rug.
2. The recovery from a C-section can be actually less painful and quicker than 3rd degree vagina rug burn.
3. You look great in post-birth photos thanks to not having sweated through 82 hours of labor beforehand.
So there you have it. Write your birth plan. But do it in pencil. And then let your dog chew on it a little. Just in case the X Factor happens. That way you won’t be disappointed when your little peanut decides to make his entrance onto the stained linoleum of your kitchen floor rather than the dreamy soft 800 thread count sheets of the beautiful and perfect birthing center you spent the past five months of your life meticulously choosing.