Do You Have a Birthing Plan?

Many women spend the last few months of their pregnancy developing their birthing plan and wondering exactly how the delivery will go. They review all the information available to them and although many know that logically they can not prepare for every eventuality, they hope that their birthing plan will go -- well as planned. I was no different. Even though this was my fourth pregnancy and I had experienced a natural, though hospital delivery; a medically assisted delivery that included medical interventions such as drugs and forceps; and a regular assisted hospital delivery I had never though to have a home delivery or a C-section. Recently, home birthing has become a much more popular option for women with the advent of more and more qualified midwifes and doulas and the desire to avoid medications and interference in what many feel is a natural event. But sometimes nature has a mind of its own and even the best laid plans can go wrong.

It was 5:04 am on a Tuesday morning and I awoke to painful contractions in my lower abdomen and back. This was no different from any other day in the last five weeks of my pregnancy. I had been having contractions on and off for five weeks, with careful monitoring every other day. Progress was being made, however, not enough to warrant inducing the delivery process. The day before I had been to the doctor with such intense contractions, I actually fainted in the doctor's office; however, the contractions were not being successful in preparing for delivery. During this visit my doctor scheduled me for a C-section, as further waiting for a natural induction to the delivery process caused additional complications to what was not termed a "high-risk pregnancy." After shifting my position and walking around for thirty minutes to no relief I started timing the contractions. By 6:00 am, I was certain I was in true labor and that it was time to get my house awake and get to the hospital.

I woke my husband, called the doctor, called the babysitter and got my daughter ready for school. After encouraging my husband to drive our daughter to school first, I laid down to wait for his return so that he could take me to the hospital. After all, how long could it take to drive to the school and back? And I had already had three other children, with twelve hour labors so we had plenty of time, didn't we?

By 7:50, I was twisting in pain on the bed, and desperately calling my husband to hurry and get home. By 8:00 am I was unable to move. He walked into the bedroom and attempted to help me stand, but I collapsed on the floor after only three steps. Upon waking, I told him to call 911, that I can not possibly move from the floor -- that there is something wrong. I heard him on the phone, explaining the situation to dispatch and then heard him calling my doctor, who by this time was already at the hospital awaiting my arrival.

8:10 am. Even now, my mind refuses to believe that I could possibly give birth at home, even though my body says, "Oh yes you are." The paramedics arrived and I ask, "Drugs, please drugs," only to be informed that they do not have those type of medicines available. One paramedic ordered the other to bring the cart down the hallway. He pats me on the leg while telling me he has to take just a minute to check me before they can transport me. A woman paramedic is kneeling down next to me, holding my hand and trying to get me to concentrate on the contractions as well as place an oxygen mask over my face. She continues talking to me, patiently trying to get me to focus on anything other than the intense, mind-numbing pain that is begins in my pelvis and radiates all throughout my body. The lead paramedic says, "Well we won't be going anywhere with this one." Seconds later he is garbed in a yellow smock and has placed medical pad underneath me. He was calling for more lights, issuing orders to one and all; including my husband for more towels, to me to focus, to the woman paramedic for more oxygen, more light in the room and then places my feet on his legs and tells me to start pushing. The woman paramedic is behind me, helping me to rise up and down, providing strength and leverage to do, what comes at this point "naturally" to my body.

8:18 am and the paramedic encourages me to push and hold, push and hold, just one more time, push and hold. Suddenly, an immense pressure is released from my body and the head of the baby emerges. The paramedic instructs me to stop pushing and wait. Those seconds were even longer than the delivery itself as I waited for those first telltale sign of life from my baby. A scream erupts, telling everyone in the room that the baby is breathing. "Ok, one more really big push and this will all be over," the paramedic instructs me. Pulling myself up as far as I can, bearing down with the last bit of my strength the rest of the baby emerges and is wrapped in a towel. The female paramedic leaves me and begins to work on my newborn daughter. Anxiously awaiting the Apgar score I fear for the worst because after all this was not in the plan.

"Five," she states. A five Apgar is devastating, indicating any number of complications and problems for the baby and an urgent need to get to the hospital. But there is still more to come. I still have to finish the delivery. We wait long moments determining the risk to me of transporting without delivering the placenta and the risk to her of not getting immediate medical care. Minutes later no progress has been made and both baby and I are loaded onto the ambulance and transported to the hospital.

Moments after I arrive my newborn daughter is rushed to the neonatal unit and I am sped through the hallways to labor and delivery. My doctor is now issuing orders with the command of a drill sergeant and upon a prick of a needle I announce to the room, "I love you," to the anesthesiologist as I slide into the most comforting sleep I have ever known.

Three hours later I awake to a nurse checking me and one of the paramedics seated next to my bed. She had stayed with me and brought out her camera phone with the first pictures taken of my daughter. After many thanks, hugs and tears she leaves me and the nurse arrives with a healthy, beautiful, and smiling -- yes, smiling baby girl.

There are so many options available to an expectant mother. There are natural childbirth, home-birthing, water births, medically assisted births, induced labor and delivery and C-sections. As an expectant mother you should read whatever material is available to you and listen to the advice of your doctors. Make your birthing plan. Making a plan is helpful. It tells you what to expect. It provides you with thoughts and options. It makes medical decisions for you in the most difficult of circumstances, but remember, it is just a plan. "Best laid plans go astray." And most importantly should your plan not work you should not experience any guilt. Each woman wants the perfect birthing experience for her but the only perfect experience is one which concludes with a healthy mother.