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smcdonald2
05-20-2010, 07:15 AM
I'm a first-timer, due in November, and my doctor is encouraging me to take prepared childbirth classes and make a birth plan. I've scheduled classes (the hospital ones, and Bradley ones) and I've been reading a lot. I've done online research and read Dr. Sears' The Birth Book, etc. I also attended an anesthesiology class with a pregnant friend of mine.

So my question is, how on earth do you make decisions about what kind of birth you want when:

a. You've never done this before and have no idea what it's really like,
b. Everyone has an agenda and wants to convince you their way is best?

The Bradley folks tell you all these scary stories about side effects of medication, the hospital folks tell you all those stories are outdated and untrue, and mamas I know range from "it didn't hurt at all; it was over before I knew it!" to "I was in labor for 4 days and it wouldn't have lasted nearly as long if I'd given in and gotten a epidural!"

In short, dear friends, I am confused. So I am reaching out to the Good People of the Internet for some advice. How did you/are you making your birth plan?

SnuggleBuggles
05-20-2010, 07:27 AM
I made a birth plan...with my 1st it was a monstrosity of a check list from Baby Center. :) I learned a lot from birth #1 plus tons of subsequent reading and research (I became a certified birth junkie!) and had much better birth plans with #2. I broke my birth plan up into straightforward, easy birth- induction- c-section- minor complications that meant I had to go to the hospital vs birth center. That way no one was bombarded with useless, irrelevant info. I have them all if you want to see them. My doula with ds1 was helpful in somewhat narrowing down my birth plan because she knew my CNM and the hospital so she could tell me what sort of things were non issues.

I found that with almost every birth book and class that you had to take everything with a grain of salt. Find neutral, reliable sources to fact check on. American Pregnancy has some neutral info on pain meds and other things that I really appreciated.

I dislike fear mongering about birth and wish that people, books and classes wouldn't do that. Facts so parents can make informed decisions. I would dislike if any of the classes I went to said the other one was wrong but then didn't back it up with evidence vs anecdote.

Even though Marsden Wagner can be biased, I found "Creating your Birth Plan" to be pretty helpful. I have lots of other books and website info if you want them as well as sample birth plans.

Basically you need to find neutral sources to back up the 2 extremes you are dealing with. :) The Birth Book isn't bad but it's a bit outdated (unless a new edition came out and I missed it).

Beth

smcdonald2
05-20-2010, 08:55 AM
Yes, please! I need samples, neutral sources, the works. I am normally an organized person (low-key, but organized) and I'm surprised at how difficult this is.

I planned my whole wedding, with no drama, in about a month. But then, I've been to weddings before, and it is relatively easy to predict how they'll go. Also, there's not a lot of propaganda.

truly scrumptious
05-20-2010, 08:59 AM
I agree that you need to take everything with a grain of salt. Everyone has strong beliefs about how they prefer to do things, but the truth is every birth experience is different (some intentionally so, some unintentionally.) The best you can do is inform yourself as much as possible so you know what *could* happen, and you are better equipped to make decisions if something unexpected happens.

Think of the different perspectives as options you have, and you can choose which ones you want to focus on. I agree with Beth that your birth plan should be simple, no irrelevant info. Remember, you will probably have a number of different nurses and doctors caring for you during labor, and you don't want all of them to have to sift through pages and pages of info. It also helps for you to clarify early on the most important thing(s) to you, so you can verbalize them quickly and clearly. Although I had a birth plan, my water broke early, and I had to be induced (not in the plan.) I kept my request simple and to the point - "If possible, please place him on my abdomen as soon as he comes out." I said this to every single nurse and doctor who cared for me. Their response was usually - "We can't promise (based on the medical situation) but we'll try." That was good enough for me.

The best piece of non-propaganda advice I heard was from a nurse in the childbirth class who said basically - "Be prepared with a birth plan, but don't try to control the process to much. The baby will decide how your labor goes, so if you try to make it happen your way, you'll always be disappointed. Be aware of all your options (i.e. breathing, Bradley, epidural) and choose which one you want as you need it."

Good luck! And :hug: - I know it can be overwhelming.

PearlsMom
05-20-2010, 09:17 AM
FTM here, so I'm in the same boat as you. One thing I've heard that is helpful is that it's really hard to do a non-medicated birth without mentally preparing for it -- so even if you're not sure you want to go that way, try to prepare for it so that it's an option; if you don't have non-medical comfort measures that you've thought through, you'll most likely end up with the drugs (not that there's anything wrong with that). It sounds like you're totally doing this by taking both sets of classes, and I hope you have the resources available to have a "just right" birth, no matter how it happens.

The place where I've been really surprised by contradictory information is breastfeeding -- I've been going to LLL meetings and our Lamaze-based childbirth classes does a session on BFing, and I was shocked that there were such different views! Like LLL seems to be all about watching the baby and feeding on demand, while our childbirth lady said it's possible to overfeed a breastfed baby. I think those two views can actually be reconciled (i.e., make sure that baby is actually hungry when you feed him, but go for it if he is)...but it's kind of upsetting to get such different views on something that seems so simple.

lizzywednesday
05-20-2010, 10:57 AM
...

The place where I've been really surprised by contradictory information is breastfeeding -- I've been going to LLL meetings and our Lamaze-based childbirth classes does a session on BFing, and I was shocked that there were such different views! Like LLL seems to be all about watching the baby and feeding on demand, while our childbirth lady said it's possible to overfeed a breastfed baby. I think those two views can actually be reconciled (i.e., make sure that baby is actually hungry when you feed him, but go for it if he is)...but it's kind of upsetting to get such different views on something that seems so simple.

FWIW, breastfeeding may be natural but it sure as crap isn't "simple"!

Sometimes you have to work a bit more with your baby to get him/her to feed ... like my nephew was a super high maintenance baby and my sister wasn't up to the patience it would have taken to get him to start feeding. My daughter, on the other hand, had latching problems because she was bottle fed in the hospital due to a medical issue she was born with, so it took us a couple of weeks and a visit with an LC to work out our problem!

In my short experience as an EBF mama, I'd say the best BF advice is to watch the baby for his/her hunger cues. Crying is a super-late cue, so watching for earlier signs - lip smacking, fist chewing, etc. - helps you identify actual hunger rather than generalized discomfort or another issue. My DD's hunger cue is actually a vocalization (eh-eh-eh, like she's trying to say "eat") with a big, wide, open mouth and she gets REALLY pissed if I don't feed her when it's about that time!

Also, to the OP - I wanted to do Bradley classes because of what a good instructor will help you with learning about your own body, but never fully intended on a medication-free birth. I was comfortable with that idea and I don't think I would have been frightened by any well-intended misinformation from an instructor.

When my DD's medical issue was diagnosed at 21 weeks gestation, most of my plans went out the window because I had to learn about her condition and treatment and make plans for her first few days that differed from what I had wanted. My original hospital pretty much insisted that I would HAVE TO HAVE a C-section, which wasn't something I wanted to pursue as an absolute, so we switched hospitals for my OB care. I felt that, at the specialized hospital where DD was born, I had a greater chance of delivering vaginally, so I was more comfortable with whatever would happen there because the docs, midwives and nurses had such a positive outlook that it would be OK to deliver DD vaginally and a C-section would only be used as a last resort intervention, rather than a mandate.

In the end, I was induced and ended up with a C-section after failing to progress beyond 7cm dilation. Because I knew this was a possibility and I liked and trusted my doctors, I felt at peace with this result despite not having planned on it. My doctor also made sure my incision would allow for me to be a good VBAC candidate for my next DC, so I am going to look for an OB/CNM who specializes in VBAC for my continued GYN care.

catsnkid
05-20-2010, 11:28 AM
My plan was this- I'm open to pain meds if I need it. I was induced- I started having contractions in the middle of the night from cervidal.. Walked around for a bit. They wore off. Didn't get the pit until noon due to staff issues. I cried uncle around dinner time. Relaxed for several hours, unfortunately I got to 4 cm and stayed there.. Had C-section just after midnight. DS was oblique and I apparently have an android pelvis- that combined with a large headed baby probably caused my situation.. My ob said that this would probably happen again- I am a-ok with scheduled c-section next time. Things don't go as planned. I was the only one in my birth class that was induced/ c-section. Several in the birth class were planning drug free births- I think only one or two actually had no epidural.

larig
05-20-2010, 11:37 AM
Things don't go as planned.

:yeahthat:

have a plan, but keep in mind that it will potentially need to be altered (by you or others) if circumstances dictate. Be mentally prepared for that. My SIL was devastated when her carefully crafted plan had to be abandoned. Things happen. My "plan" was to go in mentally prepared for anything.

hellokitty
05-20-2010, 11:59 AM
I did not know there was a bradley class in our area until I was pg with baby #2 and by then we were unable (nobody to watch DS1) to take the class. I do not think it hurts to take more than one childbirth class, esp if this is your first baby, if you want to take the class for subsequent pregnancies, you may run into problems like us about getting childcare for your older child. I took the hospital one and it basically was all about the epidural and assumed EVERYONE would get the epidural. There was no talk of ANY other options than going with an epidural. If I had known about the bradley class I would have taken it, it would have helped me so much. I haven't run into a single woman who took bradley and regretted it, even ones who didn't end up being able to give birth w/o meds.

newg
05-20-2010, 02:11 PM
I agree with PP about having a plan or "idea" of what you'd like....tell the nurses and doctors around you, but be prepared that (for whatever reason) they may not be able to follow the plan.....or you may change your mind.
Just 'cause you have it written down, doesn't mean you have to stick to it either.

I was totally up in the air about an epidural and I couldn't make up my mind. It was a nurse who told me I don't have to "make up my mind" up until the very end....and that she would let me know when that time was approaching. I ended up getting one about half way through because I started to feel like I was going to throw up...and being in labor and throwing up was not a combo I wanted to experience. I also wanted to hold DD right away, but I had a semi-emergency c-section and was shaking so badly from the whole day's experience I didn't want to hold her because I was afraid I was going to drop her. DH held her for me so I could see her.
I didn't have anything set in stone about what I wanted/needed and was ok with a go-with-flow type plan.

You are going to hear all kinds of stories, just like you would with anything else. If you are delivering at a hospital I would get a tour and ask questions of your docs and on the tour. It is possible that many of the techniques you'd learn in a class (of any kind) wouldn't even be possible where you're going to give birth (like taking a shower, or sitting on a ball).........at least if you know what you can/can't do ahead of time, that's less stuff you have to think over as you make your plan.

Tanya
05-20-2010, 05:21 PM
I was the same way! I took a hypnobirthing/natural childbirth class and liked the idea of going natural, but found that I wasn't able to actually use the relaxation tapes very well. I knew I had a low pain tolerance and was nervous that I wouldn't be able to do it.

So, I did write my birth plan, but I kept it hidden in my bag at the hospital. I did end up going naturally and the darn nurse kept asking me every few minutes if I wanted drugs and I was already close to hitting her anyway. I think a part of me was soooo afraid that if I told them to stop offering the drugs that my option of getting them would also be taken away.

Anyway, it's just a plan. It doesn't mean you can't change your mind or adapt as you go along. It just gives the nurses an idea of your goals. Some women come in wanting the epidural immediately, so they just like to know if you want to try without, etc.

For my second baby, I whipped out that same exact birth plan and handed it to the nurse. It was sooooo much more pleasant not having her ask me constantly if I wanted drugs. I had made it before and I was more confident.

But yes, that first time is a bit scary when you don't know what to expect. Once you take a decent childbirth class, you'll have better ideas of what you'd like. And even if you give your birth plan to the nurse, it doesn't mean you can't change every single thing on it if you want to. After all, it IS your first time and you don't really know what to expect. But going in with a plan for different situations can be less stressful than trying to figure out what to do on the spot.

tmahanes
05-20-2010, 06:15 PM
The best piece of non-propaganda advice I heard was from a nurse in the childbirth class who said basically - "Be prepared with a birth plan, but don't try to control the process to much. The baby will decide how your labor goes, so if you try to make it happen your way, you'll always be disappointed. Be aware of all your options (i.e. breathing, Bradley, epidural) and choose which one you want as you need it."

Good luck! And :hug: - I know it can be overwhelming.

:yeahthat::yeahthat:

SnuggleBuggles
05-20-2010, 06:18 PM
Books:
Easy Labor:
http://www.amazon.com/Easy-Labor-Womans-Choosing-Childbirth/dp/0345476638/ref=sr_1_1?ie=UTF8&s=books&qid=1274392895&sr=8-1

Baby Center Essential Guide:
http://www.amazon.com/BabyCenter-Essential-Guide-Pregnancy-Birth/dp/1594862117/ref=sr_1_1?ie=UTF8&s=books&qid=1274393220&sr=1-1

Pregnancy, Childbirth and the Newborn:
http://www.amazon.com/Pregnancy-Childbirth-Newborn-Complete-medically/dp/074321241X/ref=pd_sim_b_1

The Birth Partner:
http://www.amazon.com/Birth-Partner-Third-Childbirth-Companions/dp/1558323570/ref=pd_bxgy_b_img_b

Websites:
http://americanpregnancy.org/
http://www.childbirthconnection.org/
http://pregnancy.about.com/
obvious unmedicated leanings:
http://www.birthingnaturally.net/
more hospital based, pain meds leaning:
http://www.storknet.com/

I have loads more but hopefully that is a decent starting point.

Beth

Indianamom2
05-20-2010, 06:56 PM
I agree that you need to take everything with a grain of salt. Everyone has strong beliefs about how they prefer to do things, but the truth is every birth experience is different (some intentionally so, some unintentionally.) The best you can do is inform yourself as much as possible so you know what *could* happen, and you are better equipped to make decisions if something unexpected happens.

Think of the different perspectives as options you have, and you can choose which ones you want to focus on. I agree with Beth that your birth plan should be simple, no irrelevant info. Remember, you will probably have a number of different nurses and doctors caring for you during labor, and you don't want all of them to have to sift through pages and pages of info. It also helps for you to clarify early on the most important thing(s) to you, so you can verbalize them quickly and clearly. Although I had a birth plan, my water broke early, and I had to be induced (not in the plan.) I kept my request simple and to the point - "If possible, please place him on my abdomen as soon as he comes out." I said this to every single nurse and doctor who cared for me. Their response was usually - "We can't promise (based on the medical situation) but we'll try." That was good enough for me.

The best piece of non-propaganda advice I heard was from a nurse in the childbirth class who said basically - "Be prepared with a birth plan, but don't try to control the process to much. The baby will decide how your labor goes, so if you try to make it happen your way, you'll always be disappointed. Be aware of all your options (i.e. breathing, Bradley, epidural) and choose which one you want as you need it."

Good luck! And :hug: - I know it can be overwhelming.

:yeahthat:

Tammy
05-20-2010, 10:47 PM
Congratulations! My recommendation is to have an idea of what you feel strongly about (e.g. breastfeeding or bottle) and be willing to be flexible and open-minded because really, you don't want to make yourself more stressed out with the situation. If it helps you- then be prepared with those details. But keep an open mind in case things change quickly and you don't have control over them. Good luck!

Uno-Mom
05-20-2010, 11:27 PM
I'm no expert - 1st time mom as of last November. But here's my thought: you are NOT going to become a different person during childbirth. So think about your preferences in life and what comforts you, and plan accordingly.

For example, I opted out of meds because I've always disliked meds. I hate that fuzzy feeling more than I dislike pain.

BUT, I also appreciate the help meds give when you really need them. I am not afraid of them, if I have the facts first. SO, after 24 hours of labor, when my midwife finally put her foot down about augmenting (there were some signs of possible baby distress - but all was totally fine in the end) I decided to accept an epi. I knew I was strong enough to continue if things were progressing, but I was excruciatingly exhausted when I found out we weren't making progress.

So, it was me making the first decision, and me making the 2nd one. Both were consistant with my lifelong beliefs and personality. I'm glad of both choices now, and I'll do the same next time if there is a next time.

There's this image of the birthing woman becoming someone other than herself. That's BS, in my opinion. So make choices based on your life experiences, not some expert's opinion.

Oh, and find a doula if you can. I'm not sure if I was more glad for the support she gave ME, or the support she gave my husband! She calmed his stress so he could strengthen me. Does that make sense?

MacMacMoo
05-21-2010, 05:50 AM
Make a birth plan. Make sure the hospital even allows your decisions.

And always remember nothing is final until everything is said and done.

Everything really comes done to timing. with DS1 I thought I'd be fine without and epidural, in the end I got one.

With DS2 they didn't have time to give me and IV let alone any meds.

MamaMolly
05-21-2010, 08:23 AM
...snip... One thing I've heard that is helpful is that it's really hard to do a non-medicated birth without mentally preparing for it -- so even if you're not sure you want to go that way, try to prepare for it so that it's an option;

...The place where I've been really surprised by contradictory information is breastfeeding --

:yeahthat: Yes, and YES!! I've done it twice, and it was totally different both times. Both birth and breast feeding.

With DD1 I went into labor at 36 weeks and was totally unprepared. With DD2 the epidural didn't take on the right side, and again I was totally unprepared. I wish I'd had some techniques to deal with the pain, it was frightening and overwhelming. The nursing staff were kind, but telling me 'try to breathe' isn't particularly helpful. Looking back I'd say that none of us in that room were prepared to go with an unmedicated birth! :)

On to breast feeding, with DD1 I was really surprised how annoying and painful it was in the beginning. I didn't know enough to ask for help, so I struggled for a long time. With DD2 I called in the reinforcements the first week. Don't be ashamed or try to 'brave' it out. Pride got in the way of me enjoying the nursing experience the first time around. So please, please ask for help!!!! Remember, both you and baby are going to be learning how to do this.

My third tip: Investigate how the hospital does things (assuming you are delivering there). I was really, really surprised with DD1 that the hospital practices were IMO pretty outdated. Like wrapping baby up immediately, taking baby away, pro-formula, etc. Talk things over with your OB to find out how it is done so you'll know in advance how much of a stink you are going t have to make.

FWIW I delivered DD2 at a different hospital with a different OB and though there was the epidural issue it was a much better birth experience.

Oh, and CONGRATS!!!!

ewpmsw
05-21-2010, 11:34 PM
Lots of great advice on here already. First, congrats and best wishes for a happy pregnancy! Here's my two cents: Pregnancy is just the start of all that wonderful/terrible/wanted/unwanted/contradictory advice and information you're going to get as as parent. It's good practice for what you're going to see and hear from here on out. (I was blown away at how much contradictory advice I got in the first six weeks of my child's life on everything from BFing to reflux to parenting an infant.)

My midwife provides a worksheet (5+ pages) to assist in creating a birth plan. The focus of the sheet is basically, "What do you want and why? How will you achieve it? How do you want to be supported?" The midwife practice I see encourages patients to wait until about month 7 or 8 to create and submit birth plans, mostly because people aren't finished attending birth education classes until then, and they're digesting all the info that's out there. I think there's a saturation point where you've got all the information and just need time to think it over without pressuring yourself to commit to a decision immediately. Educate yourself, but give yourself time to consider your options and (unthinkable!) take a vacation from planning for the birth once in a while. There is so, so much info out there, you can drive yourself crazy trying to take it all in. Don't forget to relax, enjoy your pregnancy and go easy on yourself when it comes to making the big decisions. What you want will come to you in time. (I'm sorry if this sounds lecturey and BTDT. I made myself a wreck trying to plan every last detail the first time around.) Good luck and happy planning!

boltfam
05-22-2010, 10:23 AM
FTM here, so I'm in the same boat as you. One thing I've heard that is helpful is that it's really hard to do a non-medicated birth without mentally preparing for it -- so even if you're not sure you want to go that way, try to prepare for it so that it's an option; if you don't have non-medical comfort measures that you've thought through, you'll most likely end up with the drugs (not that there's anything wrong with that).

That is great advice! With both of my pregnancies, I went into childbirth with the thought of trying to do it without medication but being open to an epidural or other meds if necessary. With both of my dc, I dilated too quickly to get an epidural so it was a good thing I knew breathing techniques and other comfort measures to get me through.

Ditto to the breastfeeding thing NOT being simple (at first). It is natural but it can be difficult, so don't be afraid to ask for help.

smcdonald2
05-23-2010, 11:51 AM
Here's my two cents: Pregnancy is just the start of all that wonderful/terrible/wanted/unwanted/contradictory advice and information you're going to get as as parent. It's good practice for what you're going to see and hear from here on out. (I was blown away at how much contradictory advice I got in the first six weeks of my child's life on everything from BFing to reflux to parenting an infant.)

I think there's a saturation point where you've got all the information and just need time to think it over without pressuring yourself to commit to a decision immediately. (I'm sorry if this sounds lecturey and BTDT. I made myself a wreck trying to plan every last detail the first time around.) Good luck and happy planning!

No, you don't sound lecture-y. This is good to remember! Just like with everything else in life, I'm going to think it over, decide and relax. I'm not a super-Type A person...I like to go with the flow. Not sure why I think I need to plan birth out like this anyway. I guess because it's new and um...kind of a big deal.;)

luckytwenty
05-24-2010, 10:04 AM
I think as long as you keep in mind that your plan may go out the window, and THAT'S OK, plan what seems right to you personally without getting too invested in it. I say this because I had a plan, and then my water broke 3 weeks early, I spiked a fever due to a staph infection at the hospital, had an emergency c-section, had a healthy baby but never expected jaundice, eye infections, etc. in his first week of life, had nursing troubles...and STILL we recovered just fine, bonded just fine, etc. He's a healthy, happy, bright 7 year old boy now and really was a very healthy baby, too.

I'm not trying to be scary--just to warn other "planner" moms to be that sometimes things happen, and there's absolutely nothing you can do about it. Stressing about the plan once it's obvious it's unraveling makes it all worse. I hope everything you want to happen happens, but in the end, as long as you end up with a healthy baby and a good recovery, that's what matters the most. I'm sure it would be great to have a plan go according to plan, but I'm happy to report that when it doesn't, you're so overwhelmed by the joy of having a BABY that the plan is just not that important anymore.