8.13.2010

Getting to Plan

So, as many of you know, I like to plan. Ok, I love to plan. So, imagine my surprise when I discovered that there's something called a birth plan. This was about the most exciting thing I had heard. It was not only something I could do while waiting for the weeks to pass by, but I could plan! I knew that my week 32 visit would include a discussion with my nurse practitioner to go over my "plan" and put it in my chart, so I wanted to be prepared. I did what I imagine most people do--I Googled "birth plan." Yowzers, are there lots of results. Ultimately, I found what I thought was a good site and began to look around. They had this nice checklist of things--do you want an epidural (yes), an episotomy (no), special music (how should I know), etc. I didn't quite understand all the options, so I didn't make an "official" plan at that point, but I certainly thought I was well on my way. I began to feel slightly smug--Look at me, I am informed and I have a plan. Then, my friend posted a link to an article about birth plans. Imagine my surprise when the first tidbit of advice was:
1) A birth plan does not replace the need for birth preparation.

Going to an online “birth plan mill” and checking off a bunch of boxes (“yes” to the epidural! “no” to the episiotomy!) is not the same as preparing for birth.

Ack! I thought to myself. This is precisely what I have done. As I continued to read the article, I realized that I was doing precisely the wrong things. I wasn't exactly researching my options, which is really the point behind birth plans. I found a link at the end of the article to a blog called Nursing Birth. It's written by a labor and delivery nurse, and she had two great posts about birth plans: Writing your birth plan and Top 10 Dos. I found her tips extremely instructive. She also provided links to other great sites with sample birth plans. Ultimately, I distilled all the information from various sources down into four main points:

1) It is better to call this document "birth preferences," rather than a "birth plan," because it helps us all remember that birth pretty much happens the way it will and there's not much you can do about it (a VERY important point for us control freaks). The point is really to have done the research ahead of time, so that it doesn't all have to be explained to you while you are in pain and/or on drugs.

2) You are better off selecting a practitioner that already automatically does 90% of the things you want. Spending more time researching and selecting the right practitioner for you will provide better results than a detailed birth plan, because you won't be fighting an uphill battle. It also means that you can include fewer things in the plan, because they are already SOP for your provider.

3) Make it a single page and only include the most important things. To me, I inferred that this also meant, if you don't really have a preference, don't include it.

4) Make it personal. Above all else, don't just copy someone else's plan and make sure you know exactly what it means to have made the selections you have made.

Armed with this information, I did what I do best. Research! I went to lots of sites and discovered that there are lots of things I don't really care about one way or the other. There are other things, however, that I didn't even know I had a choice about, but quickly discovered I had a preference for or against. Putting this research in context with viewing various sample plans, I was able to craft one that I think really suits me. Phil and I then discussed and adjusted it until we understood why we had made the choices we made and were in agreement (another important point). I am still open to persuasion on some of these issues and we may change our minds about some things as time goes by, or discover additional information we didn't have before, but at least we have something to take to the doctor's visit to start the conversation. Always a good thing in my book.

At this point, I feel more in control and more informed. Both good things. But I think the most important lesson from all of this is, don't plan. The truth is, my daughter will arrive when she is good and ready, and I have no control over that. I also can't control whether I will be able to birth naturally or need a C-section. The only thing I can control is how knowledgeable I am about my choices so that when the time comes, I make them with informed consent. It's not much, but for a control freak/planner like me, I'll take what I can get. Bring on the knowledge!

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