Sunday, October 11, 2009

Thoughts on the birth plan

I met with our Bradley Birth instructor yesterday to pick up some books that she wants us to read before our private classes with her in early November. It turns out she is also a doula and is available for our EDD. So I really want to book her. DH has his reservations, but I am convinced that having her there for our labor and delivery would be awesome. Right now, I cannot tell if he's worried about coming up with another big chunk of change before the baby arrives (to pay for her services) or if it runs deeper, like he's afraid she might take his place or something. For now, it's on the table for discussion and I hope that, in time, he'll be more open to my desire to have her there.

From before I was pregnant I knew that I wanted to plan for an unmedicated and intervention-free birth. I hesitate to use the world "natural" since I feel that ALL mothers who give birth, in whatever form they end up doing so, have gone through a natural process in that their body produced another living being (or two or more)! That said, what I want is a natural birth in the conventional sense of the meaning of that term. No scheduling. No induction. No pain medications. No IV. No continued monitoring. No instruments. And certainly no surgery.

I know it can be done. Women have done it for generations and two of my best friends have done it recent years. Both delivered in a hospital setting with obstetricians and both had limited interventions. But I also know many women who hope for an unmedicated/intervention-free birth in a hospital setting often end up with exactly the opposite. And that scares me. And angers me too.

I have just read "A Thinking Woman's Guide to Better Birth" by Henci Goer and am also finishing up Ina May Gaskin's "Guide to Childbirth." Both have just reinforced my belief that birthing is a natural and normal process that our bodies are built to handle, given the right environment and plenty of time. So, in talking with our Bradley instructor who's a trained RN and doula, I want to hire her to come to our home and help me labor for as long as possible here, before transferring to the hospital (which is 7 minutes away).
Honestly, I'd prefer a home birth or even one at a birthing center (they just recently opened one up in Tulsa), but it is cost prohibitive. It would cost several thousand dollars and just doesn't make sense when my insurance will cover my birth at the hospital for $15. Add to that, this is my first baby and although I am not considered "high risk" I will be 35 when I deliver and I am considered obese, two factors that some doctors consider on the riskier side of "low risk."

Of course, this means I may be risking a birthing process riddled with medical interventions, especially because my hospital is tied to a Level III NICU and therefore is used to dealing with higher risk deliveries overall. The rate for epidurals here is 90% and for inductions is 70%. Those odds alone leave me in a very small minority from the start. I wonder how experienced the staff is with "natural" childbirth? When I interviewed my OB/GYN at my pre-conception visit, she said she will support my desire to have an intervention-free birth. But now that I am close to the third trimester, I want to broach that subject more in-depth, so that if, in the end, she really isn't in line with my wishes, I have the time to come up with a plan B, which will probably mean finding a new provider.

All of this is very overwhelming and sometimes I feel myself questioning my desires in the first place. It's so easy to justify an epidural and pitocin drip. Everyone (seemingly) does it. And I certainly wouldn't have to fight to have them at my hospital (where their use is very routine). But I don't want to just "give in" because I am afraid of being perceived as high-maintenance or difficult. I want to allow my body to experience the birth process and then, if need be, make decisions along the way, always with the intent that it be as minimally invasive as possible. Being from San Francisco, I feel overwhelmed by the lack of support here in Tulsa. But I know it's here. In little nooks and crannies, and I am seeking it out. I have four months to get my support team and plan in place. And if it just comes down to my DH and my mom and our doula, well then so be it. We will proceed as planned and see where it takes us...naturally.


  1. I am so glad to hear you say all of this! I also read the Goer book, and it lined up quite well with the thoughts I was already having. I'm fortunate to be working with a Birth Center, where I'll automatically be supported in my beliefs. I'm glad to hear more women making the choice for an intervention-free childbirth - I think it's slowly making a resurgance.

    And please do be confident in your choices, and don't feel high-maintenance with them. I know you'll be glad for it afterwards. And if it were me in your position, I'd strongly consider hiring the doula. Probably not as necessary at a birth center (ours, in fact, discourages them, because they work to help the father fill that role), but it never hurts to have one more advocate with you in a hospital setting - especially one with the medication and induction rates that yours has.

  2. Thanks for sharing your thoughts. It has given me much to consider for the future (I hope!) I admire your commitment to a natural childbirth. I hope you are able to find the support you need. Good luck!

  3. Stopping by and saying 'HI!' from SITS! :)

    Wishing you all the best in your delivery options and preparations!

    Just to say you are one brave girl. I went for the easier route and gave birth in a hospital, with an epidural administered :P

  4. I feel the same way about child birth. My SIL hired a doula and thought it was best decision she made but she also didn't have the most supportive husband. Good luck.

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  6. I deleted my last post because I just realized you said where you live!

    Anyway, have you asked your insurance if they cover the cost of a midwife and home birth? I just ask because in the states of California and Florida it's the law that insurance companies must cover a certified nurse midwife the same as an OB. Other states are creating similar laws. I don't know about Oklahoma's laws but it's worth looking into.

  7. This is something I've been struggling with myself, lately. I've wanted a natural, drug and intervention free birth since we started TTCing, but twins have kind of changed things.

    There is absolutely still a chance that I'll be able to go the natural route, but my odds are about 50/50 of needing a medical intervention (an emergency C-section is the most common - often the first twin will be born with no problems, but the second can't be delivered naturally without risking their life). I'm still hoping to go natural, but ultimately, our goal is for healthy babies, however they may be delivered...I have to keep reminding myself of that.

  8. Thanks for sharing this, Divasaur! We are not PG just yet, but I've been thinking a lot about this since my then-supervisor had a successful, "natural", home-birth last year. My naive self didn't even know these things were possible these days! I'm not sure which route we'll go. I'd like to be in a hospital for those "just-in-case" scenarios, but I also don't want to be pressured into any unnecessary drugs or procedures. And I really would like the environment to be as Rockasaur described in her post below about her first home birth. I absolutely don't want to be stressed out, which, I assume, can complicate the birthing process. Can these two worlds really mesh into a perfectly balanced birthing environment? I have a lot of homework to do....