{Guest post} Planning a Birth Plan, or Not

*This is a guest post written for The Procrastinating Mum by Smelly Socks and Garden Peas

When it comes to giving birth, planning is futile.

Well, deeply detailed planning that ends up being an idealised story, at least, is beyond futile and even foolish. Indeed, that’s exactly what we did with our first, and the consequences were upsetting.

Before giving birth, we’re all a first-timer, naïve and uneducated. Being the first first-time parent in a group of friends means you’re even more unaware of what pregnancy, birth and newborn life is like. We were self-conscious enough to realise that we had no idea what we were doing.

So, we enrolled in NCT classes. There was so much we learned from these. They were so valuable, not just to prepare for birth and parenthood but also to create a little social circle. There were six sessions for an hour or two on Wednesday evenings in the home of the local leader, with six couples attending. We learned how the physical process of vaginal birth works, how to change nappies and bathe a newborn, breastfeeding and bottles, and preparation for post-natal mental health struggles. 

Learning About The Options

We also learned about the “options” related to birth: pain relief, positions, needing extra help, and what might go wrong. There are five common types of problem you might encounter during birth:

• Prematurity
• Induction
• Assisted Delivery
• Episiotomy
• C section

We learned about the different pain relief choices and their consequences. The message was clear, pethidine or epidurals are bad; you’ll either have a sleepy baby or you won’t be able to feel what you’re doing, so you’ll end up with assisted delivery or an episiotomy – see that “bad” list above. Gas and air is better, but the “best” pain relief choice was a water birth.

We came away from that session convinced that the “right” and a “good” birth would be to go into labour naturally after 37 weeks, stay at home as long as possible, have a calm water birth with gas and air as a last resort, and be home the next day.

So that’s what we wrote in our birth plan. I’m sure the NCT leader told us to plan for nature taking a different course. But, we were unconsciously so convinced that our thus-far perfect conception (in the second month of trying) and pregnancy (no morning sickness, everything easy) would lead to a perfect birth that we didn’t think beyond the extreme of a total disaster. 

Not Going To Plan

Of course, our extreme naivety bit us in the ass big time. My parents were visiting on a lovely December morning, and I was so pleased to start experiencing Braxton Hick’s contractions while on a walk. I was 36+2, and this felt like a good thing; maybe the baby would come just as I finished work 12 days later?

After a fabulous family day and a roast chicken dinner, I flopped onto the sofa at 6 pm and pop! My waters broke spectacularly. Not a dribble, a proper deluge. I ran for the bathroom and called through for my husband to bring the house phone. Labour ward told us to come straight in.

As we drove the 12 miles or so, I was having contractions every 5 minutes or so. We were anxious and excited but not panicking. It was earlier than planned, but my body was doing what it was supposed to, right? Anyway, remember that list of “bad things”? Strike 1 for pre-term labour.

Yeah, not so much. We spent the night in a labour room, experiencing what I would later learn were mild and irregular contractions but not sleeping. In the morning, my progress was checked, and we were sent to the open plan antenatal ward as nothing was happening. We spent two days wandering the halls of the hospital bouncing with an enormous maternity pad attached, trying to get labour to kick start properly.

After 48 hours (Tuesday evening) since my water broke, the midwives and doctors decided to intervene. No waters have a high infection risk (a tale for another time, but seven years later became brutally aware of that), so it was time for an induction. First pessaries and then sometime on the Wednesday, the full horrors of syntocinon. Bad things strike 2 for induction.

Realisation

This was when I realised that my beautiful novel of a birth plan was totally unrealistic. It had flown out of the window the moment I plonked down on the sofa, and my waters popped. I had a huge meltdown, a full-on tantrum, discovered that I really hate cannulas in the back of my hands and screamed: “just give me a C section now!” (not totally unreasonable, I am my mum’s image, and she had to have sections because her pelvis is so narrow). 

My husband talked me down, and the doctors dialled in the drugs, and proper contractions got going. I coped for a while with a TENS machine (totally ace), and then gas and air was readily supplied. At last, part of my plan was following the agenda. The gas and air disagreed with the TENS, which I threw at my husband by all accounts. The gas also made me feel sick, and I was high as a kite. I had to be informed that I was hallucinating extra contractions and convinced of this with the evidence of the traces from the abdominal monitors. 

By the early hours of Thursday morning (yes, we’d been awake for four days by this point), we were pushing, or rather I was, but to no avail. Inspection revealed that baby’s head was facing slightly forwards and wasn’t at the right angle. So off to theatre for attempted forceps (strike 3) and, when baby became distressed, an emergency C section (strike 4).

He was fine and healthy, spot-on average weight, and peed on the paediatrician at the first opportunity (this was to become a theme). He also peed on the Dr at his six-week check and on every available post-natal midwife and health visitor until he was six months old). Being premature and having been in utero for four days with no waters, he had IV antibiotics for a couple of days as a precaution. By the time that was done with, he’d developed jaundice. When his jaundice improved, I developed an infection. Then, with that under control, jaundice returned. All in all, he was six days old by the time we got home.

It sounds like a bit of a nightmare, right? Well, it was certainly stressful at the time, not least because I felt so out of control. Nothing had “gone to plan” from the moment my waters broke. Rather, nothing had gone according to my plan. 

It took me quite a while to come to terms with that. The thing with a plan is that it gives you the illusion of control, the comforting feeling that you know what’s going to happen. That’s good and reassuring when life serendipitously follows along with your plan. When it doesn’t, though, the experience brings with it anxiety and extra stress. The very act of planning out how you want things to go sets you up for disappointment at best. At worst, you’re going to feel totally out of your depth and overwhelmed by your inability to connect what’s happening to what you wanted to happen. Honestly, it’s pretty traumatic.

Planning A New Birth Plan

When our second son came along, we knew quite early on that a C section would be likely – at first because his placenta was low lying. Later, we planned for a VBAC (vaginal birth after caesarean), but after three weeks of slow labour, I was very glad when our backup planned scheduled C section date arrived at 40 weeks. This time, I wrote a short bullet list birth plan, saying:

• VBAC if possible
• At 40 weeks natural section
•  If all is well –
  • Leave cord until blood flow stops
  • Dad to cut cord
  • Immediate skin to skin
  • Breast Feed as soon as possible

Those vague, general plans were much easier to achieve than a detailed specification. Our second son was born by natural C section, an absolute lump of a baby. The surgeon reassured us that a section would have been the result of a VBAC attempt, too – my pelvis is as small as I’d always suspected, and monster second baby was never coming out the natural route.

So here’s the thing that I learned from my first son’s birth and the couple of years that followed before we decided to add his brother to our family: better not to plan. It’s better to let nature and, above all, the medical experts lead you through the process of giving birth. Don’t let yourself be fooled into believing in a detailed plan. It almost definitely won’t happen, and when childbirth takes a different path, it’s much more painful if you have to deal with the grief of losing your idealised plan as well as coping with whatever else is going on.

Conclusion

My message is this: try to trust in your body and nature and the medical experts. Let your body and nature lead the way, and if they go off course, let the doctors and midwives guide you. Don’t be driven by your idea of the perfect birth.  Let go of your need to control and try to freely welcome whatever is in store for you.

Of course, that’s easier said than done. Try to take my word for it and save yourself the stress we went through when our carefully laid plans didn’t work out.

Remember, detailed planning is futile.

A massive thank you to the lovely Smell at Smelly Socks and Garden Peas.

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Featured Image by Suhyeon Choi on Unsplash