Sunday, August 7, 2011

Birth plans

A couple of days ago, I sent a draft copy of my birth care plan to my doula for review. She got back to me with some really good questions and further information which has got me thinking. As I look at the plan as I'd originally written it, I realize that I made a lot of concessions, particularly when it comes to interventions like induction and pain medications.

When I first found out I was pregnant, I started reading Ina May Gaskin's book Spiritual Midwifery, which I found in a cupboard behind the bar, of all the strange places. The first part of this book is a collection of hippy homebirth stories. While at first I giggled at all the pyschedelic, far-out language, I realize now the importance of these stories. Many of the concessions I was making in my plan had to do with the "normal" progression of labour. For example "IF there is no change in dilation after 4 or 5 hours, THEN administer prostaglandin gel" or "IF I become tired during a long labour, THEN narcotics may be used". But as long as my baby and I are under no real stress, in no real danger, who is to say how long a "normal" labour should last? Those ladies giving birth in their homes 30 or 40 years ago (and the women before who gave birth in their homes, cabins, birth tents, caves...how far back do you want to go?) weren't concerned with how far their cervix was dilated and effaced, or with how they were progressing. Why should I be? Instead, I think I'd like to trust, fully and completely trust, that my body can do this, that I can do this, in my own time.

I think I'd like to defer vaginal exams during labour (or have the option to request one if I choose). I would like to be left alone, myself and my family and my doula. I don't want to have to lie down on my back and have my body invaded by a stranger every hour or couple of hours, to satisfy the doctor's curiosity regarding my cervix. I feel like this will slow things down for me. I feel like it will be akin to watching a kettle, waiting for it to boil. A watched pot NEVER boils, didn't your nana ever tell you that? If I'm not watching the clock, but rather am following my body's own rhythm and pace, I won't get to this point of feeling "stuck" in labour...I won't feel the need to request induction or pain meds.

There are so many factors that need to be considered, researched, carefully weighed before entering into a hospital birth. So many procedures that are routine and often not questioned, that I'm questioning now. Beyond my own care during labour and delivery, I'm now considering the battery of drugs and tests that could potentially be administered to my newborn baby. Vitamin K injections, eye drops, blood tests...it's good to be informed, and I'm so glad my doula got me asking more questions!

I don't have a real choice between home or hospital birth. I pretty much have to have a hospital birth because I live in rural Yukon, because midwives are not covered (I heard of one woman in town who had a home birth in Whitehorse...she had to rent out an entire B&B, rent a birth tub etc...to the tune of $10,000)....so while I must go to the hospital facility to give birth, it doesn't necessarily mean that I have to go along with all of their routines and procedures. I am in full control of this experience, and I will have the the birth experience that I desire!

2 comments:

  1. your birth will be majik. I have heard such good things about having a baby in the Whitehorse hospital. Like that they totally leave you alone if you want. i guess its all those tough informed Yukon women going in and out of there!
    also, just knowing your options, being informed and having a doula. your good.
    the most important thing to remember is that at the end of it, you'll have your baby in your arms!!
    as with the whole thing about how long a labor should/can go on, i was "in labor" for 4 days, at home, with a birth tub, midwife and doula. had about a million contractions before I decided to go to the hospital and get the epidural (which of course lead to induction drugs). I wasn't dilating for whatever reason.
    the two things I was most scared of, happened. (medical intervention and c-section)
    and it was an amazing experience anyways!

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  2. i didn't realize you had a c-section! that's my biggest fear, too. but i'm trying to keep in mind the outcome: the safe arrival of a healthy babe!

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