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My First Pregnancy Part 3: The Birth Plan

Posted Dec 02 2008 1:50am

The reflection on my first pregnancy/birth continues... Below is the birth plan I prepared for the birth of my first child.  Reading over this, many years later, I am struck by a few things.  It is rather obvious that I was trying too hard to control the process.  I wanted to give birth in the tub and if this wasn't possible, a supported squat.  What about standing up or side-lying or on all fours (to name a few other options)?  It is impossible to predict where/how you will give birth.  I "wanted" to give birth to Nettie in our bed since we were moving and at least I could take the bed with me, but I gave birth to her in the bathroom.  In birth you have to be open, literally and figuratively.

I am also surprised by some of the language which definitely indicates that I bought in to the "doctor knows best" mentality.  By writing that I would "prefer" to do the care for the baby after it is born, it sounds as if my wishes are secondary.  I would like to remove the sentence "We would prefer to do all of the care for the baby unless I am overly exhausted after a difficult labor in which case Matt will work with the staff to care for the baby."  I am strong! Why did I think I wouldn't have been strong enough to take care of my baby ?  Haven't women been birthing on their own, in the fields, for thousands of years?  I've never doubted any other undertaking, why did I doubt my ability to take care of my own child?  Again, evidence that I had bought into the medical model.  Though I wasn't aware of it at the time, throughout my prenatal care in a hospital, where pregnancy is viewed as a disease, I was slowly losing confidence in my ability to birth.   My sweet Khady, I want you to know that drugged up as I was (I couldn't lift my legs for hours after the cesarean) you were cuddled near my breast for much of the time, happily nursing.  And of COURSE you stayed in our room.

And my last comment, thank GOODNESS our first child was a girl!  If we had had a boy, he would have been circumcised.  I remember that when I was pregnant with my second (who turned out to be a boy) I told Matt that if he wanted the baby circumcised, he would have to do it himself.  That encouraged Matt to do a lot of research on the matter (because who really wants to take a nursing baby away from his mom and go find someone to circumcise him unless it is really necessary) and what he discovered was that routine circumcision doesn't make sense.  Thankfully sweet Fen is intact.

I did not write birth plans for my second or third births, both of which were at home.  I believed that birth would work and I trusted that if I did transport to the hospital, that those transporting with me would ensure that my care was mother and baby friendly.

Birth Plan Prepared March 30, 2003

Background Information: 
I grew up in the military, moved extensively and lived in Mali, West Africa for three years so I am not afraid to try new things.  I am not very comfortable in hospitals, probably because I have never been seriously ill or experienced major surgery and because in Mali I survived numerous bouts of strange viral infections, dysentery, and schistosomiasis with minimal medical care.  A natural childbirth is extremely important to me but I understand that in an emergency, this might not be possible and I will be grateful for modern medicine and the talented staff at the University of Chicago Hospital.  I would like to thank everyone, especially the team of midwives (Charity, Pat and Sue, who are all awesome!) at U of C, for helping me and my husband prepare for and go through the miracle of childbirth. 
I would like the freedom to move about throughout labor.  I do not want any intravenous fluids.  External and intermittent fetal monitoring is fine if necessary but I would prefer having the mid-wife listening with an ultrasound or regular stethoscope.  I do not want any pain medications during labor.   I will be using hydrotherapy (shower and birthing tub) and patterned breathing.
Birth Options:
I would like to give birth in the tub and I would like my husband to be in the tub with me.  If this is not possible, I would like to give birth using a supported squat.  I would like to use spontaneous, rather than directed, bearing down, unless my midwife feels that directed is necessary.  I would rather risk a tear than have an episiotomy.
We would like to have the baby with us as soon as it is born.  We would prefer to do all of the care for the baby unless I am overly exhausted after a difficult labor in which case Matt will work with the staff to care for the baby.  We would like to be informed in advance of all procedures involving the baby.  We would like the baby to stay with us and we would all like to be together overnight (Matt, the baby, and me).  I will be breastfeeding the baby.  If the baby is a boy, we would like him circumcised. 
Unexpected Labor and Delivery:
I would like Matt present with me at all times before the birth.  Both of us should be consulted before procedures are performed.  Matt will make decisions if I am unable to.  We will call our friend Trina to give Matt the time to take a break if the labor is unusually long (more than 24 hours).  If a cesarean is necessary, I would like to remain awake and be able to touch and breastfeed the baby afterwards.  If the baby has to go to the nursery, we would like Matt to accompany the baby.  If the baby is in a special care unit, we would like to be involved in the baby's care where possible and be notified of all problems and procedures.  If the baby is unable to breastfeed immediately, I would like to express colostrum and milk so that it is available when the baby needs it.

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