Our All-Natural Birth Plan

Our All-Natural Birth Plan

Given that our due date is so soon, we have been busy preparing for our baby to arrive! One of the most important tools, especially for achieving a natural birth, is having a birth plan written out, and going over the birth plan with anyone involved with your labor and delivery. Make sure especially that your husband and/or birth coach is very familiar with your wishes and can help you make decisions according to your plan, even if you aren’t fully capable of making them yourself at the time. You should include plans for your ideal birth, as well as plans for if complications arise for either you or the baby. Here is our plan (so far!)

LABOR
Labor at home as long as possible (ideal departure: contractions 2-3min apart, lasting 1min)
Eat, drink, and move freely during labor as desired
As few internal checks as possible (none if allowed, one upon arrival is permissible)
Intermittent fetal monitoring only as truly needed
All interventions should be explained and we should be given time to discuss together
Available to labor in tub, on birth ball, birth stool, shower, toilet, outside
Utilize rebozo, oils, rice sock, massage, hot towels, homeopathics as needed

DELIVERY
Push in whatever position is comfortable
Push with body’s prompting, not to timing
Free to deliver in water if desired
Perineal counter pressure, heat, oils- episiotomy only in absolutely emergent situation

POSTPARTUM
Immediate skin to skin
No erythromycin or vaccinations will be given
Vit K will only be given if deemed necessary by birth, after discussion between midwife and Karli. Arnica will be used instead if possible.
No bath given- wipe off face and yucky bits, rub in vernix
No hat unless necessary by room temperature
No pacifier given whatsoever
Breastfeeding as soon as baby is ready
APGAR done on mother
Cord allowed to finish pulsing (minimum of 10 min), then be cut by Matt
Placenta delivered naturally, placed in refrigerator to be taken home and encapsulated
Sitz bath as soon as possible (may be once we get home- fine)
Baby will use cloth diapers only (with liner) all brought with us
Family allowed to return home as soon as possible

CESAREAN
Only spinal anesthesia given
Shield lowered to see baby delivered
Cord allowed to stop pulsing, if possible
No erythromycin, vaccinations, Vit K only if deemed necessary
Skin to skin and breastfeeding ASAP
Room in with baby at all times

SICK BABY
Breastfeed baby, expressed breastmilk if necessary
Free visitation by mother and father
Allowed skin to skin if possible
Parents handle as much of care as possible

Did you write out a birth plan? If not, do you wish you had? If so, is there anything additional you would include, or wish that you had included?

Call the Midwives

We began my pregnancy by seeing my normal OBGYN, one member of a large practice in Owings Mills. The practice delivers at Sinai and I’m sure would’ve provided me with state-of-the-art medical treatment. This is the same practice that walked me through my missed miscarriage last year, as well as the scary diagnosis and eventual removal of the large mass on my right ovary.

When I went in for my first prenatal appointment, I expected to be met with smiles and perhaps even a shocked reaction- after all, it was less than a month since my surgery, and I was already pregnant! However, I was met with blank stares, eyes staring at a computer screen that didn’t recognize me or remember me. In fact, the very doctor who I had seen just a month before several times for my ovarian mass had to look at my records to confirm that I did in fact have the surgery I claimed to have had. The doctor had no recollection of me.

My second appointment was the “ever-important” internal exam. Little did I know that I had been switched from my normal female doctor (who, unbeknownst to me, retired from OB practice) to a male doctor without my permission- and had to endure yet another uncomfortable situation as my poor husband sat in a small chair while I was examined. It was mortifying for us both.

It was around this time that I began researching other birth options in Maryland- everything from simply switching OB practices to home birth. I quickly learned that Maryland is an extremely difficult place to have an intervention-free birth for several reasons:

-Having a midwife attend a home birth is “illegal” unless it is a Certified Nurse Midwife who is backed by an Obstetrician. To my knowledge, there are only a few that practice in the entire state, and I’m not sure that any of them are taking new clients, particularly first time mothers. This leaves mothers with dismal options for home birth- having an “illegally attended” birth with a midwife (which many women do and have great success and healthy babies), or having an unassisted home birth. I’m not exactly sure what the “illegality” of the whole thing can lead to- probably that you can be charged with negligence if something happens to your baby, or perhaps the midwife can be held liable- I’m not 100% sure. But, I think that, for some women, these are the right choices- to have a home birth, with a midwife or unassisted- but not for everyone.

-There are only a handful of free-standing birth centers in the state- two that I am familiar with. There are various hospital “birth centers”, staffed by midwives and outfitted with more natural birth tools, such as tubs, but because they are attached/part of hospitals, their clients must adhere to hospital guidelines- which, depending on the hospital, can significantly change the birth experience for many mothers (though many mothers absolutely love this experience, and I don’t discount that whatsoever). This also effects the after-birth experience for the parents and baby, with certain interventions being much more routine (vaxing/Vit K/eye gel given without parental consent, pitocin for placenta delivery and uterine shrinkage, formula supplementation without parental advisement). Again, these choices are completely right for some families, and many people choose to include all of those things in their after-birth care plans. However, not every family chooses these things.

-Lastly, C-Section rates throughout the state of Maryland are higher than the national average. Nationwide, close to 1 in 3 women
gives birth via cesarean- and that’s not including elective/planned cesareans. Induction before truly necessary is wildly popular, even though a recent Harvard study found that the average gestational period for a caucasian woman is 41 weeks 1 day. I have seen far too many family members and friends get induced, get epidurals, and get cesareans- it just seems normal at this point. I think that’s the problem- in most places, it IS normal. And sometimes it is completely necessary. But it doesn’t have to be!

So, taking all of this into consideration, we have decided to birth our sweet baby girl at Special Beginnings Birth Center in Arnold, MD. This is perhaps the most controversial choice that Matthew and I have made thus far (at least that I’m letting you in on haha)!  Staffed with Certified Nurse Midwives with years of experience, complete with three beautiful birthing suites with big beds, tubs, birth stools towel warmers, and a full kitchen, the place is absolutely stunning.  The only drawback: it’s located almost exactly an hour away from our apartment!

We began our research into this birth center first by talking to people we knew who have been there- most of whom gave glowing reviews, and those who didn’t were really looking for a home birth experience, and ended up going that direction in the end.

Next, we took a tour– and this is where everything changed. We were given a tour of the birth center and then given the opportunity to ask the midwives questions.  It was amazing! So many of the things I was prepared to fight with an OB about- movement and eating during labor, Vit K and eye gel, vaccinations, routine circumcision, delayed bathing, etc- all of the choices that I wanted to make for my child were encouraged, and even assumed to some degree, by the midwife staff. It was like breathing a sigh of relief as I realized that I could have the natural birth I wanted without having to fear that the baby would be stuck or smeared with something or treated in a way I didn’t feel was necessary.

We have had two appointments with midwives at the birth center so far, with a third coming up next week. The experience has been so encouraging and healing! I love the focus on nutrition and exercise as well as medical information. I can have as few ultrasounds as I would like (though we have actually had many more than I intended). Their holistic approach to pregnancy, as something that is natural and not a illness or medical emergency, brings so much peace to my heart as I remind myself that the Lord created women to bear children. Pregnancy isn’t a bad thing, and with the right preparation I can trust my body to do the work it needs to do.

A huge part of this decision has been learning to “insert grace” into our birth plans. Do I fault mothers who make choices that are different from my own? Absolutely not. Is it totally possible that something goes wrong and I need to have a medicated birth or a cesarean? Yes. And if that’s the case, I will take it in stride, as I know that medicine is a good thing and saves many lives- perhaps my own, or my baby’s. It’s the grace that I am striving to understand that will allow me to accept what happens, but also strive to be as prepared as possible and make the most sound decisions I can with the information I have now. It’s not easy! But I am glad to be questioning and learning and growing in this process.

I’m so excited for this journey and I can’t wait to share my experiences along the way!