The Plan

23 Jul

Ok – so first of all, some updates after my previous post. I got some amazing feedback and advice, and I’ve made a few decisions. All of which I’ll talk about in a post probably later this week. But I really wanted to thank everyone who commented and emailed – you were a huge help in putting things in proportion and putting together a plan.

So… I’m 34 weeks. Which is totally crazy, right? I never EVER thought we’d make it this far. Granted, I’m still terrified (in fact I had a whole freaking out episode today which was fun), but holy crap you guys – 34 weeks.

My high-risk OB told me last week that he wants the cerclage out at 38 weeks. That’s in FOUR WEEKS. I think he suspects that removing it will jump start labor so he doesn’t want it out sooner. So I could be in labor in FOUR WEEKS. Some days it feels like that is FOREVER from now, but other days that’s like, really soon.

With that in mind, it’s time to make a plan and make some decisions, and I thought I’d share some of that with you guys.

A small disclaimer here – this is not a “birth plan” per se, but I know women can get kind of bitchy touchy around birth plan talk, so let me just say that my opinions are what’s right FOR ME. Whatever you think is good for you – knock yourself out, I’m not one to judge. So don’t judge me either. Ok? Ok. So here we go.

We’ve kinda-sorta chosen a hospital. There are 3 in my city, and we toured all of them. I was hoping to come out with a clear-cut “feeling” about one of them, but that didn’t end up happening. Each of the hospitals has upsides and downsides. In the end, we went with logic and the process of elimination: of the three, there is only one hospital in which I HAVEN’T had a loss. Since I don’t know what my mental state will be during labor, it’s best to keep me away from triggers. So we chose the one “loss free” hospital, even though it’s far from perfect. Plus – it’s closest to our home and our doula knows it really well, so that will help.

Now for the birth plan.

There isn’t one.

I’ve got some thoughts, but nothing that really feels like one of those detailed “plan” type-things. I don’t think I’m the “birth plan” type – if there is a type for that. And even if I was, let’s be honest: I’ve been through too much shit to think that anything I plan out will actually happen in the way I want it to. So no “plan”.

So here are my thought type-things instead:

Here’s the truth of the matter – my big thing is that I’m kind of terrified of getting a C-Section. Here partners aren’t allowed in the room in the case of an emergency section and that only aggravates my fear of it. I know it’s irrational, I know it won’t be the end of the world if it happens, but it still for some reason really scares me.

Which I admit is weird, considering I’ve had surgeries up in my lady parts before. But that’s neither here nor there.

So I’m scared of that and I want to avoid it. But again – I don’t think I’ll feel like a failure if it happens. At the end of the day I will do anything to get B5 here safe and sound.

But yeah – I really don’t want a C-section. It scares the crap out of me.

So at first I wanted to go au naturale just to minimize the risk of an emergency section. But after talking it through with my doula, I’m totally not there anymore.

My doula is anything but the crunchy granola type. She specializes in high-risk, so she’s very practical about medical interventions. It’s good because I’m not really crunchy granola either, so we work well together.

She’s all for avoiding C-sections, but pointed out several stories to me where an epidural actually helped relax the mom enough to move things along, and helped avoid a section that may have happened otherwise.

Once I heard that, the idea of pain relief seemed like a darn good one.

Then again – I’ve been through labor before. Nadav was of course much smaller, but I did cope with that pain without an epidural, so I know I can. The question is – do I want to?

The answer is that I just don’t know.

Here’s the thing – GD means I’ll have an IV line no matter what happens, and that I’m going to be monitored whether I like it or not. So there’s no use fighting against that kind of stuff.

What I want is a healthy, screaming baby, hopefully with minimal cutting and stitching. How I get there is less important to me when it really comes down to it.

So in the moment – if I want an epidural, I’ll ask for one. I don’t think it’s any sort of failure on a woman’s part to have pain relief, so I’ll take it if I need it. If I see that I can cope without it, I’ll avoid it, just because that will cut down on recovery time, but not because I think an epidural is some evil thing. I really don’t have an opinion on it either way except that it’s probably kind of weird to have your legs numb like that.

The one thing I don’t want is Pethi.dine. It’s a drug that kind of gets you loopy and supposedly helps with pain relief that they sometimes give here. I was given it when I was in labor with Nadav (and it didn’t help with the pain at all, so that’s a crock) and I hated the way it made me feel. I’m also afraid it will cause flashbacks. So that is definitely out.

Everything else is fair game as long as it gets B5 here safely.

So the plan really is: No Pethi.dine, try to avoid stuff that involves stitching if I can, get through labor with minimal freaking out, and bring B5 here safely and hopefully without my head exploding from that outcome.

Honestly? I’m a bit worried about the freaking out thing. One of my biggest fears outside of a section is that I’ll start having flashbacks and panic attacks while in labor. Right now I’m counting on the fact that I have a tendency to get calm and collected during a crisis, and therefore I can keep my feelings in check. I’m hoping that in my psyche, labor with B5 will be one of those cases where I somehow miraculously keep my shit together.

I’d like skin to skin and all that bonding stuff afterwards. But again, no hospital will guarantee that because of the GD. If my sugar levels are good during labor, then chances are I’ll be able to have that at least for a bit before they whisk B5 off to get her sugar levels tested. But if my levels are too high or too low – she’ll be at risk, so screw skin to skin and immediate breastfeeding. Just do what you have to do to make sure she’s ok.

Ahhh breastfeeding. I’ll be posting about that this week. But I think I’ve rambled long enough and made my point.

High-risk pregnancy really brings out the Practical Polly in me. I just hope I’ll be able to roll with the punches and keep my sanity in the process. We shall see.

18 Responses to “The Plan”

  1. Wannabemom July 23, 2013 at 02:24 #

    Mo, it makes my heart happy to read that you’ve made it this far. It gives me hope!!! For what it’s worth, I don’t think you’ll freak out during delivery. I think our bodies know what to do and you will kick into Momma over-drive and be able to focus on what you need to focus on.

  2. Amanda E. Perrine (@amandaea129) July 23, 2013 at 03:57 #

    I was one of those woman that the epidural relaxed them so that labor sped-up (1.5 hours from 5cm to fully dilated). Hoping everything goes how you want it! 4 weeks is going to fly by.

  3. Christina Williams July 23, 2013 at 05:07 #

    One thing that I pulled away from our birthing class was not to call it a “birth plan” but rather your birth preferences. If you are interested I could email you mine. it was a lot of “I want natural XYZ, as long as we are both doing well” and “if I need or want pain meds etc, I’ll ask.”

    Just remember that your Doula will be there to help you and your wishes be respected and to assist you in staying in a good mindset, etc. Whatever you think it would take to do that, right on! I think a lot of women think of birth and labor in a “pain olympics” sort of way. Don’t buy into it. Do what you need and want to and as long as you and B5 come out in the end, be happy 🙂

  4. robinflynn July 23, 2013 at 05:07 #

    First off I love your non plan plan seems like a good way to go. I just wanted to share my experience with the epidural so you have that to mull over. I labored for a long one with no pain reliever like 9 hours and dilated maybe 1/2 a cm after the epidural I immediately started dilating so I was definitely one of those people who probably avoided a c-section by getting the epidural. I also was a little freaked out by not being able to feel my legs so when they went a little too numb I had the docs turn it down so it wasn’t so strong. I was feeling absolutely no pain with contractions and then that way I was able to keep some feeling in my legs which also helped me when it came time to push. I was able to still feel the pressure and sensation to push because of my turned down epidural I then felt that pain and burning too but I ended up pushing for only 45 min.

  5. slese1014 July 23, 2013 at 06:34 #

    I think your no plan is a perfect plan for you. You’re open to options should they arise and I think that’s your best bet. GD definitely changes things, but you’ve got one heck of a plan here….I might just copy it when I sit down with my doula 🙂 I can’t believe this will all be coming together in 4-6 weeks…so excited for you and B5!!

  6. Lise July 23, 2013 at 13:14 #

    To have no plan is the best plan in my opinion. My only preferences for the birth was that if I felt that I needed pain relief I would like to get it (and I did, good decision) and lots of monitoring of our baby(I made it very clear that all I cared about was that our girl would come out healthy). In my experience, those of my friends that made the most plans about how their births should be (yoga, birth pool, whale song or butterflies coming out if their vaginas) were the ones that got disappointed. And for me the idea of getting disappointed when you get a living healthy baby is ridiculous. We ended up with an emergency c-section, but it was actually not bad at all. Baby was stuck, but she came out screaming and healthy and my husband was holding my hand during the surgery. No plan is a good plan!

  7. ozifrog July 23, 2013 at 14:50 #

    I’m totally with you on the pethidine. NO PETHIDINE was in big bold letters in my birth plan. Horrible stuff.

    I used a TENS machine I hired up
    Until about six cm (loved it), then it was calm birth breathing, hot baths, and finally gas. Going inwards really helps, thinking of it as pressure not pain, and thinking about what the pain is achieving all helped. I didn’t have any iv with my GD, but different country I guess. Cannot emphasise enough the importance of a good playlist. We had music in the delivery room and the repeat play of the Ramones “I wanna be sedated” and acdc “it’s a long way to the top” made for some funny memories and took my mind off things / helped me focus. Mind you, three and a half hour labour, not a lot of time there for thumb twiddling. I didn’t think of it as pain olympics so much as quickest way out, and the whole cascading intervention thing (intervention leads to more intervention). So I was anti epidural, but I respect it’s different for everyone. 34 weeks…you rock.

  8. Hurricane Laura July 23, 2013 at 15:16 #

    I just wanted to take a moment and let you know I’m reading. You once wrote me a very nice note after my loss and I’ve read your blog ever since. I just had a baby after recovering from my loss and my emotions during the pregnancy were very similar to yours, so when I read your posts I just ache for you – I know how it feels to be so tantalizingly close but still really unable to fully accept that it might all work out. I too counted the days until viability, but then still didn’t fully feel that it would be okay afterwards. I couldn’t really even prepare the nursery until after I came home from the hospital with the baby. I’ve also cried over all the things I feel like were taken away from me. But now that my son is here, I’m starting to heal and it feels amazing. I can’t tell you how much I want that for you and how I hold my breathe when your next post appears, just hoping that you’re still okay, the baby’s still okay, and you’re that much closer. I just wanted you to know that you have one more supporter out there, rooting for you. Keep going, Mama. You’re almost there. Oh, and my birth plan – was no plan also. I just told the doctor that he should do whatever it took to get him out safely. I ended up with a C section, and yeah, the recovery isn’t great, but as long as you have some help the first two weeks, you’ll be fine. I’m very much hoping that you’ll have no problems breastfeeding because that might help you heal as well – the emotional benefits of breastfeeding to YOU as well as baby cannot be overstated. It was deeply cathartic to me to have something go right for once, to realize that my body can actually do some of this on its own. But in the end, the only thing that matters is that baby’s face when she looks at you. You will start to feel yourself healing a bit when you see that. Keep going, almost there…

  9. Amy July 23, 2013 at 16:29 #

    My stated plan was: be flexible. Well, we had to fill out a birth plan/preferences form for the birth center, but I didn’t even consider trying to come up with some other flowery document detailing every, um, detail that I could imagine. I had goals of no pain meds and a water birth (which I am still somewhat shocked we were able to do) but I also knew that we were in the birth center right across the hallway from regular L&D, so if at any time I wanted to change my mind or if we needed any interventions, they would be available pretty easily. I made sure to never say never to any possible scenario, hoping I wouldn’t be disappointed if something opposite to my preferences happened. I would bet that if you’re able to labor at home with your doula for as long as possible (or does the GD also mean you have to go in as soon as contractions are regular?), you can probably get through early labor into active, and will be less likely to stall out when you hit the bright lights and bustle and anti-privacy of the hospital, and maybe you won’t feel like you need the epidural after all. But by all means, if it seems like the way to go, I think you’re very smart to give yourself the definite option ahead of time. I too read of several cases, especially when the labor gets to be long and exhausting, where an epidural can help you get needed rest and maybe even sleep, and then be turned down to give you a bit more feeling back (and help your legs be numb for a shorter time) when it’s close to time to push. I also remember a woman from my prenatal yoga class who planned sort of the opposite. She labored unmedicated until almost the end, but knew she wanted an epi for the pushing part. So if your care team is willing to be flexible along with you, I think you are right to trust your tendency to be calm and collected and you will just deal with one contraction at a time and make decisions based on how you are handling everything.

    34 weeks! That is so amazing. You and B5 are rocking it, and will continue it right into her new life on the outside!

  10. BB July 23, 2013 at 18:53 #

    That sounds a lot like the plan I was thinking of before I couldn’t have a plan any more. Difference is I was more afraid of the birth than the c-section. I’m not sure if they gave me that same drug the day after or something different, can’t remember – but it was horrible – my head was so fuzzy and I knew it so it only aggravated me. So happy you have made it so far and I hope you get to that 38 week mark uneventfully. You obviously know that a healthy baby is the most important aspect – and THAT is the plan!

  11. SRB July 23, 2013 at 19:51 #

    I view “plans” as “preferences” as well, and this really helped me to stay flexible. It was a low-stress way for me to visualize the typical ways a birth could possibly unfold and sort of mentally prepare for each. But anyway… you’re having a BABY really SOON. I’m just without the words to tell you how thrilled I am for you guys. My deepest wish for you is a birth experience that brings you peace and a happy, healthy, hell-raising little lady. Because oh yes, she will be bad ass.

  12. pjsarecomfyn July 23, 2013 at 21:28 #

    Dude, that’s totally a birth plan…just because it isn’t all crazy specific the fact that you have “wishes” makes it a plan. My hope for you is that B5’s birth is a great time of healing for you. Healing from the past tramas and a time when you can just really focus on you, on your body, on your baby….what an amazing experience it will be to bring her into the world. Something no one else will ever do for her. It makes me weepy just thinking about it (although I am like super extra emotional lately).

    I think “going with it” is one of the best plans a person can have for birth. There can be a ton of unexpecteds or none at all, but either way, being relaxed about it and giving yourself any and all options takes any added pressure off.

  13. Kathy July 23, 2013 at 21:41 #

    Great News
    Four weeks will go by before you know it. Your plan sounds very practical and with your husband and trusty doula by your side you’ll get through with flying colours !

  14. kerry July 24, 2013 at 04:46 #

    I was so scared and convinced that I would never even make it to the birth that I really didn’t even bother making a birth plan. (I also didn’t bother setting up the nursery, so really, I know how you feel!) I honestly had never even given it much thought, but when it came down to it, I had to weigh the pain of getting an epidural put in (something I had worried about for YEARS since I had started watching 16 and Pregnant–yes, I have issues) and against the potential of pain with tearing (honestly, the very thought of stitches is why I didn’t go to med school–much less getting them on myself!!). These were 2 of my biggest fears in life and in the end the epidural was a no brainer. They initially gave me a shot that did absolutely nothing (except make things start going in circles) and when I was finally able to get my epidural it was the. best. thing. ever. It really did enable me to relax, calm down and be in the moment (even if I couldn’t feel a thing). I did end up needing some stitches, but it didn’t even matter because I couldn’t feel a thing (and was dstracted by holding my baby and all). I don’t think it prolonged my recovery time because the effects really don’t last all that long after they turn the drip off!

    Like I said, it really allowed me to be in the moment and not worry about the pain–I figured I had gone through enough physical trauma to even get to that point, so it was about time for me to enjoy some of the situation!

  15. melissa July 24, 2013 at 21:52 #

    I had an epidural to avoid a c-section. After almost 2 days of hard, active labor and almost no progress, the midwife gave me that choice. Sometimes that’s the right tool, you know? You got this.

  16. psychsarah July 24, 2013 at 22:01 #

    I love your non-judgey acceptance of differences, and I’m glad others are fulfilling that spirit in the comments! All things pregnancy, birth and parenting seem to get so heated and ridiculous. I hesitate to tell some people my birth experience sometimes, because then people react like they feel like I’m saying that’s what you should do, which is not my intent at all! I think of the expression, “whatever gets you through the night” (or birth in this case) is cool. I’m thinking good thoughts for you and B5, and hope this month goes by at just the right pace (not too fast, not too painfully slow).

  17. newmom July 25, 2013 at 19:30 #

    I didn’t get far enough in my pregnancy to have a birth plan, but I did have an emergency c-section. Meaning they cut a larger incision. Yay. However I will say my recovery went well, I walked about 24hrs after. Not far, maybe ten steps but each day I went a little farther and the recovery went well. So I guess that’s my advice! I’m happy for you at 34weeks! I hope I get that far.

  18. Alissa July 26, 2013 at 06:35 #

    Hey Mo, having been in your position before I can say that I am glad I opted for an epidural. I associated labor pains with loss and by 6cm I was having flashbacks and crying. Not a complete freakout, but I was scared and couldn’t see a positive outcome. I told the nurse at 7cm that I wanted the drugs. As soon as the Epi kicked in I was able to calm down and think practically instead of being muddled by the pain. I was able to relax and barely knew I was dilating until they told me I was ready. Because the situation had become different than I remembered having with the twins (when I was completely dilated and in pain), I was able to center myself and prepare mentally for the pushing part.

    It may be different for you, but honestly whatever gives us a good experience and a healthy baby is the priority. You are going to be fine and so is B5. Almost there my friend.

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