Birth Plan: Part 1

So, I've had in my head the idea of posting my birth plan publicly because I thought, more than anything, it would be fun - and my birth plan is pretty atypical, so posting it publicly would also expose people to a different side of birth than I even knew existed before I was pregnant.

But, I've realized that there is actually quite a lot of debate and misinformation or lack of education about birthing in general - so before I actually make my "plan" public, it's probably a good idea to publicly state where I stand on a lot of things birth-related.

First things first: I don't believe that pregnancy or birth represents a state of medical emergency. When I first got pregnant, this is one thing my mom (a nurse herself) warned me of: don't let books or websites or even people trick you into thinking that you are suddenly in a non-natural state. Women have been doing this for years. That doesn't make it easy or painless, and it definitely doesn't mean shunning medical support, but I can stand firm in the knowledge that I'm one of hundreds of millions of other women who have done this before.

Correct! (Source)

Second thing: I am pro-"whatever works". 
I haven't done this before, I don't know what it feels like, and I have no high-and-mighty attitude (please stop me if you notice one!) about how birth "should be done". Whatever you think will work best for you, then do that. I've just done a ton of research into birthing and have found that for me, evidence-based research is the best research for me to base my birthing plan on. I have found this is a really good intro to home birthing and provides a really great broad overview of what goes down.

That could be me! (Source)

Finally: My personal plan is to have a natural, drug-free birth at home with a midwife.

If you had told me more than 28 weeks ago that I would somehow be at this point in believing what's best for me, I would have thought you were crazy. When I first got pregnant - and I'm on the record saying this - I believed that I would have an in-hospital birth using all the graces of an epidural and with a "get this thing out of me ASAP" attitude. I cited low pain tolerance as my number one excuse, but really I was just misinformed about my options. I didn't know that there was anything other than induced, in-hospital epidural labour with the chance of C-section.

Who knows what's really going to happen - maybe this is exactly how my first childbirth will go. Maybe I will be screaming and writhing in pain with an IV and a needle in my back, lying on a hospital bed and swearing at all of the hospital staff. But, at least for now, that's not the plan.

In most parts of the world, home birth is normal, if not the norm. In the Netherlands, with the lowest rate of infant or mother mortality in the developed world, 1/3 of births are in the home with midwives. Statistically, home births have less interventions overall: less need for Pitocin inductions, less episiotomies, less tearing, and are, at the very minimum, exactly as safe as low risk in-hospital births.

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So, with the understanding that what I want to do is safe when in the presence of a University educated midwife and provided that my pregnancy maintains its low-risk status (and I still keep a get-to-the-hospital-quick plan on hand - we live 5 mins away from the hospital, walking) I looked into other reasons why a home birth might be appealing:

1. I can be in the comfort of my own home, my own bed, bathroom, living room, kitchen.
2. I can be in the comfort of my own clothing.
3. I can control the sights, sounds and smells which should help me get into a relaxed state.
4. I am less likely to need interventions.
5. My husband won't be kicked out to go home for the night.
6. I will be less likely to scream "Get me the epidural, NOW!", actually get the epidural (I might scream it but if I'm at home, it's just not an option) and therefore have my care transferred from my midwife, to whatever OB is on call.

I am not anti-intervention, if that's what I or you need. If you need an epidural, a C-section, pitocin or an episiotomy, then get one - same goes for me! It doesn't represent weakness, ill-preparation, or a lack of empowerment, it just means that that's what you (or I might) need.

However, my preference for myself would be to abstain from an epidural or other pain-relieving medication (narcotics) because research has proven that these interventions rarely relieve the pain entirely, and instead produce more of a numbed mental state for the mom. (Obviously I haven't tried this myself, but I've heard from a few friends that this is more or less true.) Using an epidural also increases the time needed for pushing out the baby because the mother doesn't have the full sensation of "when to push".

The use of an epidural would also cut off my ability to walk around - and gravity needs to be on our side when trying to birth. I love the idea of walking around, squatting, getting in and out of water, and standing in different positions during labour.

I also have a thing about hospital lights. They give me a headache.

In terms of using Pitocin to induce or speed up a labour (because when you are in a hospital, you are on a 12-hour time limit): the reason I would prefer to avoid using Pitocin is because Pitocin inhibits the release of endorphins, and therefore the immediate post-birth morphine-like euphoria that women can often experience when delivering naturally. Even though your body is still in pain, the endorphins which would normally help you through labour can't be released. This isn't to say that the use of Pitocin means you won't experience that immediate mother-child bond with your baby, it's just that the hormonal mix that "should" go on, often doesn't in the way it was naturally intended.

And episiotomies... well, if you know what that is, you understand why I definitely don't want this... but many women do receive them because the medical community tends to believe that the use of an episiotomy will quicken labour. This isn't proven, however what has been proven is that episiotomies take longer to heal than natural tearing. I have a friend who had one, and uh... yeah, I don't want that.

All that said: my birth plan is based around evidence that shows that natural, drug-free, at-home birth in low risk situations is simply the best way to go. This doesn't mean I won't end up in the hospital or with interventions, or that I won't go against what I've learned / decided in the last few months, and it doesn't mean that mothers who choose these interventions are wrong.

If you still think I'm crazy, watch a home birth. You'll see it's not that weird. They're available for viewing at this website, in tons of documentaries like "The Business of Being Born" (which admittedly is a little Lefty and biased, so take it with a grain of salt), on websites such as BabyCenter.ca, and believe it or not, they're all over YouTube. I wasn't convinced until I saw 5 or 6 and learned that the woman-on-the-table-screaming-and-swearing stereotype is actually just a Hollywood thing: birth doesn't really look like that.

Voila! That's the reasoning behind my decision to have an at-home birth with a midwife. I'll post a birth plan later, and then in another 12 or 13 weeks I'll laugh at myself thinking I had everything together and watched how it all fell apart because - if what they say as true - this is going to HURT LIKE HELL.