Tuesday, November 29, 2011

birth plans

I went to the water birth workshop at my hospital's birthing centre yesterday. It was - to employ local parlance - absolutely brillant!!! So informative - and whereas before I thought I would only want to labor in the pool but not give birth in it - now I 100% want to give birth in water. I think it will be especially helpful for me to be in the water to take weight off my poor dysfunctioning pelvis, I just need to be careful about getting in and out of the pool. It also is no problem that I have GBS and will need to have intravenous antibiotics every four hours throughout labor - they just put a rubber glove over the hand that has the cannula... still not sure how that keeps the water out, but if I have to just keep one hand out of the water I think I can deal with that. They also addressed all my other worries about water births. They have telemetric fetal monitoring which is waterproof and thus can be used to continuously monitor baby's heart-beat if need be. (Although I would prefer that, if everything is going normally, that they only monitor baby's heart-beat every 15 minutes. Intermittent monitoring is just as effective and results in fewer false alarms of fetal distress.) Some more embarrassing aspects of giving birth were also addressed. (Er, you know, contact me if you want to know more.) You don't have to get out of the pool at all. They examine you with a flashlight and a mirror while you're in the pool. You can also use gas & air while in the pool, and there is a shower head for some water massage! All in all it sounds just exactly how I want to go through this powerful, painful, wonderful, empowering, life-changing, life-giving experience.

I am so lucky to be giving birth in the UK where birthing centers and water births are integral, accepted and encouraged within the medical establishment. Where midwives run the show, view birth as a natural process, and have experience and enthusiasm for natural, non-medicated births. I don't belittle or begrudge those who have a medicalized birth - I think that it is much safer for a woman to have an epidural if her experience of birth pain is excruciating and she is unable to cope. There are also many things that can go wrong in labor that require immediate medical intervention. There is a reason why getting pregnant used to be the most dangerous thing a woman could do!  Before modern medicine your chances of dying in labor were quite high. However, the medicalization of birth has been taken to an extreme in the US and I really dread having to give birth back home next time, unless I can find a birthing center! (I would have a home-birth next time, but our insurance wouldn't cover that.) I am also so lucky to be giving birth in the UK because all my care is completely 100% free. Even though our US insurance covers 100% of "wellness visits" - it only covers 80% of pregnancy and delivery related visits. Because apparently pregnancy is a "condition" and not a natural, normal part of life. So we are saving a lot of money by having this little guy in London at an NHS (National Health Service) hospital.

So I am so thankful to be giving birth here. So thankful that the following birth plan will raise ZERO eyebrows in the hospital birth center.

I AM SO EXCITED TO GIVE BIRTH. I know that sentiment makes many people cringe and innerly (or directly) call me crazy. Fine, think that I am crazy! But I just cannot wait for this empowering, emotional, most uplifting and dramatic moment of my life. Every time I watch a video of a baby being born I tear up. I just cannot wait to meet our baby boy.

Oh, and please excuse the British spelling in the following...

ta-da! here is my...

Birth Plan

Mother: Olivia Stevens
Birth Partner: husband, Chris Stevens

Key points:
-     natural birth, gas & air only
-     water birth
-     GBS positive, wants antibiotics asap
-     SPD
-     Spontaneous pushing
-     No episiotomy
-     delayed cord cutting
-     physiological third stage
-     immediate skin to skin contact
-     immediate breast-feeding

I am GBS positive – I would like antibiotics as soon as possible in labour.

I have SPD and am limited in the movements I can make. I would like to deliver in the water, or on all fours or on my side. If in case of an emergency I need to have an epidural, great care needs to be taken to ensure my legs are moved in parallel and not moved too far apart (my partner has a ribbon marked to how far I can move my legs without pain).

I do not want any medical pain relief, except gas & air. I plan on managing the pain through breathing, visualization, vocalization, massage, and water.

I want to push spontaneously – no directed pushing please.

Crowning – please remind me not to push through crowning. I want to avoid tearing and do not want an episiotomy.

I would like immediate skin to skin contact with my baby immediately after birth.

We want a delayed cord cutting, please wait until the cord has stopped pulsing before cutting the cord.

Physiological third stage of labour – I want to deliver the placenta naturally, please do not give any drugs, and do not use controlled cord traction. If the bleeding has become excessive or the placenta does not deliver naturally within 30 minutes, then we would like to re-evaluate.

I plan on breastfeeding immediately after birth.

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