The New Birth Plan

The nursery is ready, your suitcase is packed, and the neighbor is on high alert to take care of the cat, but once in labor, what can you really control?  Is giving birth something you can plan for, or are you at the mercy of hospitals, insurance companies, doctors and ultimately, your own body?

Cyndi Whitwell, a Sacramento Doula of 25 years who has attended over 740 births, most in hospitals, says she prefers the term “birth preferences.”  She encourages couples to make their plan simple and to allow for changes. “Labor is a constant negotiation, there are cross roads where you need to re-evaluate goals and plans.”  Whitwell likes to work with parents and give the pros and the cons to procedures, like an episiotomy.  “I try to keep the big picture in mind…a doula works with the pieces of the puzzle and focuses on a good birth experience.”  Whitwell is seeing less birth plans but more “visions and goals, often written on the big white board in the hospital room.”

Birth plans can be helpful according to Dr. Mwanga Kazadi OBGYN, M.D. with Mercy San Juan Hospital, especially if this is your first baby.  “You can voice your wishes, but keep in mind that every birth is a case by case situation and sometimes a procedure has benefits that you may not know about.   Ultimately, it is the patient who makes the final decision.”  Dr. Kazadi recommends talking to your medical team, keeping an open mind and understanding that sometimes nature takes its own course.  Do your homework ahead of time, learn your options then appoint an advocate, someone who will speak your wishes when you might not be able to.

Sacramento mom of 3, Katherine G had her first baby in a hospital, but didn’t have a good experience, “I was young and offered pain meds as soon as I got there…they kept asking if I was ready for my epidural, the whole experience felt violent.”  Her next two babies were born at home in a birthing tub assisted by a midwife.  “I felt secure and valued, like my family mattered to them.”  Still, Katherine acknowledges that she would go to a hospital should something go awry, “I am not so earthy-crunchy that if something was wrong I would refuse to go, no birth choice is worth my life or the life of my child!”

Foothills mom, Juliana G did not have the birth experience she planned for. “My birth could not have been more opposite than what I had actually planned for. We had been studying the Bradley method and made arrangements at The Birth Center. After laboring for many hours and implementing all that I had studied, I was horrified and heart broken when I was transferred to the hospital and had a C-section.  However, the staff at UC Davis Medical Center was amazing and they were all very understanding and respectful.”

You may not be able to choose whether or not you have an episiotomy or a C-section, but you can communicate with your doctors and nurses to ensure your birth has a good ending, one that you are satisfied with.  As Dr. Kazadi reminds “sometimes moms are afraid of hurting someone’s feelings, but this is about you.  This is your experience!”