Birth Plan / Intention

Written by admin on January 20th, 2011. Posted in Delivery

To Safely Deliver your Baby Letting Go of All Expectations
One website describes a “Birth Plan” as “…a way of communicating with the midwives and doctors who care for you in labour. It tells them about the kind of labour you would like to have, what you want to happen and what you definitely want to avoid. It’s not written in tablets of stone because the best birth plans acknowledge that things may not go according to plan. Sometimes people prefer to call the birth plan a set of ‘birth wishes’ or ‘intentions’.”

I wholeheartedly agree with this approach. Make a very loose idea of a ‘birth plan’ as it’s an oxymoron. Everything can rapidly change before and during the birth despite the best of ‘plans’. I prepared a birth plan but was told at my last scan around 35 weeks that one of our twins was breech and they strongly advised I have a cesarean wrapped up neatly with a warning scenario of only taking one baby home if I attempted a natural birth. I was in tears in the doctor’s office because I so wanted a natural birth.

Letting go of all plans is best as an alternative ending can leave you feeling like you’ve failed or been robbed which brings with it a world of emotional upheaval at a time when your hormones are fluctuating wildly. Make your ‘intention’ to “Safely Deliver your Baby Letting Go of All Expectations”. Focus on steeling your mind and your body ready for anything. Keep physically strong with yoga and low impact exercise and mentally strong with practiced meditation or prayer (whatever your thing is). The more time and energy you invest in strengthening yourself the better the big day will be.

Unless you have a severe medical condition that necessitates a pre-booked cesarean, focus on what is within your control and decide on everything else as it happens. They have drugs on hand if you change your mind, you don’t have to put them on backorder! The emergency cesarean staff are on call if things get difficult. So take care of what you can control: your body and your mind, and let the rest fall into place as it happens. We’re women, we’re built for this task. The medical profession have instilled a silent but deadly mistrust in ourselves to be able to confidently see this natural task through from start to finish under our own steam. Why? Because there’s no money in a woman laying in their birthing ward for 12 hours or more not consuming anything from the drug industry or validating the anesthetist’s salary. Nor is it very convenient playing the waiting game for her to complete the task herself. But with a cesarean – wow! “I’ll be finished up here in about 20 minutes and home in time for dinner honey”. It’s a very convenient route for doctors make no mistake.

If I hadn’t had twins and it wasn’t suggested to me that there was a chance if things went wrong only taking one home I would have rejected a cesarean until during birth I was told it was necessary for the babies’ and my safety. I don’t judge women who doubt they are capable of birthing naturally because the industry is so good at manipulating the belief she needs them to do the job safely. Unless you have a medical condition that necessitates a cesarean, research all the help out there for a natural labour before jumping on the “Too Posh to Push” limo.  I’m not implying ‘drug free’ labour here. (It’s not criminal to ask for pain relief. You don’t go to the dentist for a root canal and go a la naturale!) I’m talking about researching various birth assistance like Doula’s, acupuncture, massage, water birth, spinal taps, epidurals, meditation, visualisation etc before you consider going under the knife as the only option because it’s too scary to go it alone (Fear, neatly delivered in a box with a bow by the medical industry).

Between you, me and the ether I’m skeptical my scheduled cesarean was at all necessary. Their advice at that last ultrasound was that Twin 1 was breech and Twin 2 was head down in the birth canal. Problem was that meant they were now saying that Twin 1/2 were the opposite to what they had been my whole pregnancy. So I countered saying no Twin 2 is breech and Twin 1 is head down ready to go. They’re doing the right thing. They’re ready! Twin 2 is up under my ribs out of the way. But the doctor said, perhaps, but are you willing to take that chance they don’t both try to birth at the same time? And I was presented with a previous scenario of twins chins interlocking and dying before getting into surgery. Which is what the compulsion came down to in the end. Fear. So they booked me in for a c-section at 38 weeks 5 days expecting they would probably come earlier, but they didn’t. They were very comfortable in there, in what I believe was the perfect position for birth. But because I hadn’t availed myself to a mother’s group or spoken to a Doula I had no one else to listen to but the doctor…and my own fear.

My Grandmother birthed my father and his twin brother safely back in the day, which back then was probably safer than major abdominal surgery! But I’ve only recently found that many mothers of multiples give birth naturally and even birth breech babies safely but I was lead to imagine practically all multiple births now went the road of cesarean because of the perceived and sometimes inherent dangers of birthing more than one baby. I wish I had questioned the need for a ‘scheduled’ cesarean more heavily and requested an attempted natural birth with cesarean if it were clear it was necessary. I could have then at least given my girls and myself, the chance to experience the natural journey, the intended conclusion of pregnancy.

I really enjoyed this video on YouTube sharing some pregnant mothers’ day of joy birthing their multiples naturally. Even if you have a single pregnancy (which I hope to get next time!) you can appreciate the enormity of trusting your body and your medical support to birth naturally at home or in the hospital. It opened my eyes to follow my instincts more closely even when it comes to a daunting scenario I’ve never before encountered. Like any new mum 1,2,3,4 or more, it’s a big brave new world and there’s SO much to learn.

Unfortunately for me, the painless ‘easy’ cesarean birth so many mothers opt for was nothing of the kind for me. My story “Cesarean: The “PainlessPain“  details my dreadful ‘birth’ experience on the operating table. If I felt that birthing via c-section was somehow less of a ‘right of passage’ to motherhood, I certainly didn’t afterwards. I endured some pain!

But it is what it is and I accept the end of my pregnancy journey as it stands because at the end of the day To Safely Deliver your Baby Letting Go of All Expectations is the beginning of the next beautiful journey. Motherhood. 


Cesarean: The “Painless” Pain

Written by admin on January 20th, 2011. Posted in Delivery

Are you giving birth vaginally or having a cesarean? If it’s a planned cesarean or your vaginal birth eventuates into an emergency cesarean be sure to talk to your doctor about the two anesthetic options. Spinal Block -vs- Epidural. The spinal block they gave me didn’t work very well and although I didn’t feel the ‘sharp’ or ‘cold’ as promised I felt enormous pain and braced groaning through tears and gritted teeth throughout the 30 minute operation clutching desperately on to my partner on one side and a nurse on the other.  Here’s how my doctor-recommended safe and “easy” cesarean birth of our beautiful twin girls went south, fast.

The Gold Coast Hospital registrar anesthetist working on the day (who looked about 21) administered my spinal block. She had many attempts inserting it into my spine and at one point I heard the overseeing senior anesthetist say “Is that bone?“. Now THAT’s the last thing you want to hear. Needless to say I was in some pain and it wasn’t long before anxiety began to wash over me. I finally said to the senior anesthetist “You can step in anytime!” to which she replied “No she’s doing fine“. So I continued leaning forward and holding on to the nurse in front of me. After another 10 seconds or so I said to the nurse holding me “I’d like her to stop practising on me now please” to which she replied “I’m sorry. This is a training hospital“. I was speechless. I could not even after a full minute or so of enduring “practice” request someone senior to step in upon reaching a point of concern. I was already nervous facing major surgery (not by choice) and about to become an instant mother of two and certainly did not need a novice fiddling with my spinal cord…but it was about to get worse. She continued and by the time I was wheeled into surgery and met my partner I was visibly shaken and on seeing him broke into tears. I composed myself and got focused on the task at hand only to find the spinal block had indeed not been administered well at all.

Although I didn’t feel the ‘sharp’ or ‘cold’ as promised, I felt the blade open my skin like a zipper and I felt the doctor’s hands inside me pulling and shoving trying to get to the babies and at one point felt like he’d pushed his foot up in there for good measure. Alllllll the way up to my ribs. My organs felt as though they were squashed in a vice and shoved up and down and back and forth within my abdomen. That is the only way I could describe it to my partner afterward. Then the horrible stretch of the skin and pop as their heads were pulled through the cut.

I experienced enormous pain and remember it was a guttural, primal type groan coming from me that I couldn’t contain nor hold any focus to meditate through it. (It’s one thing to prepare yourself for the pain of a natural childbirth but quite another to face intense pain during a procedure you’ve been told has none!) The senior anesthetist said to me, “I’m going to have to knock you out with a general if you can’t be quiet! The doctor can’t work like this!” to which I replied through the pain “DO NOT knock me out I want to be conscious for my girls’ birth!!” and she said “Well you’ll have to control yourself, you have to be quiet!“. So I held my breath but I couldn’t contain the noise of the pain, it was impossible. A primal response. It was like asking a woman going through natural labour to be quiet! Looking back it was disgusting treatment of a completely vulnerable woman.

My entire shoulders, neck and head seized up as I clutched tightly on to my partner on one side and a nurse on the other. They begged me to keep breathing and focus on releasing my shoulders to no avail. I was clenched up from my feet up my legs through my chest and shoulders to the top of my head. I could have swung my legs off the operating table and ran and I can tell you I wanted to! Even when the doctor was stitching me up and wiping me down with antiseptic fluid I was begging the nurse to ask him to stop. “Stop. Stop. I’m clean enough!” is all I could say. The vigorous rubbing on my skin whose nerves were firing off after being severed was almost electric and blinding. I was near passing out.

To top off the horrid treatment I received from the senior anesthetist during a vulnerable and powerless event, as I was wheeled out of surgery I heard the doctor ask her what had happened there?! And she responded to him oh she was just hypertensive. I was  physically shaking in shock from the ordeal and couldn’t say anything or express any anger at the time. I had my girls finally safely delivered to my arms and that was all that mattered at the point.

I don’t know why a spinal block was administered and not an epidural but I certainly wasn’t offered a choice nor told the pro’s and con’s of both. I know of two other mothers who had a similar to more intense experience than this. One felt the sharp slice of the blade and screamed out only to be told there was nothing they could do now they had to continue.

In short, epidurals are different to spinal blocks. The needle for an epidural is thicker and so there is slightly more risk of spinal fluid leakage which can give you migraines after birth, but the risk of feeling all the cutting and pulling of the baby inside your body is removed. You’re completely numb from the high waist down. Whereas with the spinal block I really could have swung my legs off the table and ran in the middle of the operation. Survival instinct is screaming RUN and the only force stronger than that was the need to protect those little babies tucked away inside my body.

If it weren’t for two other mothers within my circle reporting terrible results with a spinal block I may have put it down operator error. But hearing of other cases it’s certainly something that should be discussed and shared with others. On the flipside, a friend who had an epidural for two cesarean births didn’t feel a thing for either. So talk about the pro’s and con’s of both anesthetic options with your doctor and make an informed choice.

If you’re considering an elective cesarean, before you believe your own internal doubts and fears of not being strong enough to birth vaginally research it thoroughly. Look at all it’s options including anesthesia choices, water birth, acupuncture, doula assisted, home birth etc before you take the cesarean path. Watch some vaginal births. Watch some cesarean births. Watch some home births. YouTube is at your disposal. It’s a difficult watch initially but the more exposure you get to it, the less it will affect you. And that’s a good thing. Embrace it. It’s the road you’re on and there’s a fork up ahead.