Birth Plans, Life Plans
Posted by Elizabeth
“I went…because I had to go. It may have been a messy and botched experience, but that doesn’t mean I shouldn’t have gone. Sometimes life is messy and botched. We do our best. We don’t always know the right move.” ~ Elizabeth Gilbert, Committed
I nestle into my nubby cranberry sofa across from my doula, a professional labor attendant, who asks me what I want to do with my placenta. Normally the kind of question that would give me the willies, I’ve grown accustomed to answering all manner of questions about my birthing preferences – even those that involve human biohazard. Over the course of the evening, my doula and I hammer out the fine-toothed details of my “birth plan,” a reverential document outlining the minutiae of my intentions for labor, delivery and post-partum that will be ceremoniously submitted to the hospital staff. By the end of our meeting, seven months of research has been distilled into a single white sheet of paper humbly titled “Birth Preferences,” the simplicity of which belies my tangle of emotions. After two and a half hours of answering a series of questions, I emerge exhausted, feeling as if I have outlined not my desires for birth but the complicated terms of a peace treaty. And in a way I have, because I wonder if I’m not preparing for birth so much as readying myself for war.
Before I became pregnant, I had never heard of a “birth plan.” It sounded like an absurd paradox: how do you plan for something as unpredictable as a human birth? But as I dutifully plowed my way through What to Expect When You’re Expecting, talked with friends, and quizzed my midwife, I came to understand the complexity of the decisions to be made in this dizzying game called labor and delivery. Slowly I began to form opinions about “pain control” and “comfort measures,” heparin locks versus continuous intravenous drip, pushing positions, cord cutting and banking, breastfeeding, skin-to-skin contact, and supplemental bottle feedings. I even had to make decisions about how I wanted to breathe, a fundamental human skill that I’ve never given so much thought to.
I have also come to understand that, like most plans in life, a birth plan is rarely carried out to the letter. The spirit of a birth plan is to provide an opportunity to state your preferences, but when it comes to down to it, things will unfold as they will. “Be flexible” is the mantra of my perky birth instructor, Kathleen, who seems to direct these words squarely in my direction as I dramatically scrunch up my face when she announces that we will be placed on an IV upon admission to the hospital. I’m the one in my birth class who interrupts at every turn to ask how I can maneuver my way around hospital policy and procedure. I am constantly searching for chinks in Kathleen’s steely armor, and when I find them, they immediately become a part of my birth plan.
For someone like me who has a difficult time leaving things to chance, a birth plan – like any plan I make in life – is the ultimate security blanket. It helps me to battle the ambiguous vagaries of birth and provide an illusion of control, especially in a situation riddled with uncertainty. Because over the months an uneasy feeling about birthing in the hospital environment has slowly emerged, doubts which I thought I had kept safely to myself until my friend, Heidi, said I was talking like “a home-birther in disguise.” Then, a few days after the meeting with my doula, she called me out of the blue. “I can’t get you off my mind since we last met,” she said, “and I just wanted to ask why you haven’t considered a home birth?” A woman who beautifully balances intuitive empathy with level-headed reason (she could have been a fellow counselor in another life), she said she wasn’t sure that my ideal plan was one the hospital environment could wholly support. She worried that I might feel as if I was waging a personal battle during the throes of labor – one that I would likely lose.
I was afraid to admit that she might be right, that I had made the wrong decision for a hospital birth in the first place. I thought my iron-clad birth plan and my doula, a professional advocate, would be protection enough against the creeping uncertainties that I was feeling. But I wasn’t choosing my battles so much as crafting a battlefield, and it dawned on me that I was trying to harness the best of both worlds: the luxury of making all of my own decisions within the safe “just in case” cocoon of the hospital environment. I needed to give up control in one domain, either by placing myself in a position to make my own choices without the security net of the hospital, or surrendering some of my personal autonomy by submitting to the whims of the hospital.
She continued. “I’m not saying you should give up on having a hospital birth, but I think you might feel more settled if you walk down the path a little to see what the reality of the other option looks like. Often times, when I walk down the second path, the right decision just emerges.” She was right, of course, and this wasn’t just solid advice for birthing: it was perfect counsel for life. It’s also the kind of advice that is useful to dispense but hard to swallow. Once I’ve arrived at a decision, no matter how imperfect, I am terrible at changing plans midstream, which is what entertaining the possibility of something new was asking me to do. I am threatened by new information, wondering how it will shake my resolve, afraid of what adding more variables to the equation might reveal. But sometimes in life we owe it to ourselves to see what the road not taken looks like – even if we end up turning around a few steps into our journey and returning to the safety of our well-worn path.
On Friday night I had dinner with my friend, Mark, who finds himself facing similar uncertainties in his own life, wondering if a big decision he made was the right one – and if it’s too late to change course. I reminded him that sometimes our decisions don’t turn out how we’d like or hoped for, but it doesn’t mean that it was necessarily the wrong decision. One variable he never counted on, he said, is that “I’ve changed.” Isn’t it amazing how we don’t account for this most basic, fundamental truth when we lay our plans? We forget that we change in the process – that the process changes us – and none of us can be certain of where that winding path will deliver us when we set out on our journey, even with the best-laid plans clutched tightly in our fists.
In turn, Mark reminded me of an exchange between Alice and The Cheshire Cat in Alice in Wonderland. “Which road do I take?” asked Alice. “Where do you want to go?” countered The Cheshire Cat. “I don’t know,” Alice answered. “Then,” said The Cat, “it doesn’t matter. If you don’t know where you are going, any road will get you there.” The lesson is clear: we must know what we’re seeking in order to make a decision. It’s too soon to say what I’ll ultimately decide, but I’ve taken the first tremulous steps in setting aside my well-developed birth plan (and life plan) to explore the other, misty path that disappears into the underbrush of my future. Today I’ll meet with a homebirth midwife to see what she has to say and feel how it “sits” with me. I have no way of predicting the future, no way of knowing what the “right” decision might be. The Buddhists say there is no right or wrong decisions, only decisions that lead us down different paths. Until I know what I’m seeking and the answers tiptoe out of the shadows, that is enough for me.
How do you handle reevaluating decisions? Do you use your reasoning, emotion, or a combination of the two? How tightly do you adhere to plans, and how easily can you give them up when reassessment is necessary? Do you agree that decisions that don’t turn out like we’d hoped weren’t necessarily the wrong decisions in the first place?
June 21st, 2010 at 7:18 am
I’m very decisive. To a fault. I admire you for considering all the options but just a caution: the danger is that you’ll drive yourself nuts equivocating over all the choices. But probably not. Let us know how it all turns out.
June 21st, 2010 at 7:34 am
The Ricki Lake documentary about home birth was very convincing (I think it was called The Business of Being Born). I still don’t think I’d be comfortable doing it though.
The older I get the easier it is to let go of plans. Now that I can look back and see how nothing ever turned out how I planned, it’s easier to let go!
June 21st, 2010 at 8:05 am
I am glad you are exploring all the options to see how each feels for you. I had three hospital births and one at home. The home birth was by far the easiest, least stressful of all of them. No one pressuring me for interventions I didn’t want, it then felt not like waging war as the hospital births had but simply a journey to meet our new babe. Of course, I had three previous easy birth experiences to know that I would not likely need any intervention.
I have two pieces of advice that I give to moms to be: one (like the Chesire Cat pointed out) The journey is not the destination, regardless of your choice of directions the end result is your beautiful child, no one will give you a medal for doing it one way or another. two: when you reach the stage of unbearable pain it’s almost over. this is important to remember; labour is such a mind game (because you can’t see the finish line) and if you know you are reaching the end you can hold tight to your plans of less intervention.
Happy (belated) Father’s Day to the soon to be Dad!!
June 21st, 2010 at 8:39 am
I very much like a plan and deviating from said plan often throws me into a frenzy. However, with childbirth, my plan was not to be and after two hours of pushing, no baby, and a falling heart rate (his not mine), we went for the emergency c-section. And I was totally fine with it — no regrets about not doing it naturally. Of course, I then scheduled the c-section for the second one (talk about ease of planning).
I don’t think I could ever have the guts to do a home birth after my first delivery. I would be terrified that something would go wrong. I’m sure they have all the answers — and they do these all the time. But I needed the comfort of doctors around me just in case. I’ll be interested to understand how they address the safety issue. For me things went downhill while pushing and Im not sure how they would have transported me at that point if I was at home. I know you will make the right decision for baby girl Thomas.
June 21st, 2010 at 8:49 am
I was reading that post and thinking the entire time you should watch the documentary that Anne is also recommending; The business of being born. If there is one thing that it really shows (besides the pain) it is the unpredictability. You will do fine! and I agree, the journey is not the destination!
June 21st, 2010 at 9:22 am
Like a typical analyst, I instinctively rate the pros and cons which change as time passes and my knowledge grows. So, I often abandon plans for better ones.
You’ve got a tough decision to make. One thing to consider, over 2 million babies and mothers die each year during childbirth. It’s a staggering statistic. I think it’s always good when making a tough decision to ask yourself what tradeoffs and risks you’re willing to take.
June 21st, 2010 at 12:05 pm
I loved reading this entry. I had a home birth last April and there was a lot to process before and afterwards. I would welcome you to read our blog and see how we made our decisions. Best wishes for you!
June 21st, 2010 at 12:34 pm
Hi Elizabeth – What a thoughtful post. I wish you the best as you reach your decision on where to give birth. I like what Shawna said about the goal being the same regardless of the path you take to get there. Wherever you give birth, I hope that you are surrounded by helpful and supportive people.
I really appreciate what you have to say here about our tendency not to take into account the ways in which we change during a process. I do not always demonstrate flexibility once I’ve made a decision, but I admire those who seem to be able to rechart in the middle of a journey. They often seem happier and less stressed-out than I do with my stick-to-it nature.
June 21st, 2010 at 12:48 pm
I tend to do poorly without plans. Or at least, it makes me very uncomfortable not to have them. I have such little faith in myself that plans make me feel better.
I’d forgotten about that exchange between Alice and the Cheshire Cat. It’s a good thing to keep in mind.
June 21st, 2010 at 12:52 pm
Liz you are brave, BRAVE! to bare your soul on such a personal issue.
I have had three homebirths and when it comes to the ability to change and go with it, I feel each moment. When I trust and follow my guts,
I know when to go forward, when to stop, and when to turn around.
Following my way I may never know what’s best for others, but I always know what’s best for me.
My mantra: Spear the fear, trust the guts.
June 21st, 2010 at 2:04 pm
I love this Buddhist perspective: “there is no right or wrong decisions, only decisions that lead us down different paths.” Because no matter how much we agonize over a decision, weigh the pros and cons, seek advice, and possibly change our minds, there are things we just don’t know at that moment in time. What appeared to be the rock-solid right choice may later reveal itself to be lacking. But all we can do is make the best choice at the moment, given our information and perspective.
I’m very rational about making decisions. I love data. I love to educate myself about both sides of the debate. And I guess this process probably makes it hard to change my mind. That, and my stubborn demeanor!
June 21st, 2010 at 4:02 pm
About 7 months ago, after hearing about an acquaintance’s home birth, I said out loud to a co-worker, “I would NEVER have a home birth!” I spoke with my husband about it later, and he asked me why and told me that he always though a home birth would be great.
I am now 2 months pregnant, and if all goes well and I am a candidate, I am planning a home birth. After reading about the likelihood of interventions in a hospital setting, the risks to baby and mother of those interventions, a home birth seems safer to me and seems that it will give me the best control over the experience I want to have. There is so much wonderful and empowering information out there that has made me feel confident that I want to pursue this path!
We will have to see what transpires, as the pregnancy progresses. I had better keep my own LIP mindset in mind as well.
Whatever you decide to do, this is a very LIP situation. Good for you for being willing to re-think it all. I hope you feel good about whatever decision you make, and I’m so excited for you.
I really appreciate getting to read your perspectives!
June 22nd, 2010 at 5:09 am
Good luck, whatever path you choose! Birth plans are so personal. Your doula must be very good if she can see these things in you.
June 22nd, 2010 at 7:01 am
This is lovely. I had two midwife-attended, unmedicated births in a hospital, and they are two of the most cherished experiences of my life. I wanted to have a home birth for my second, but my husband was simply not comfortable with it. I think your wisdom in recognizing the ways that a “birth plan” is an emotional and psychological attempt to control something fundamentally uncontrollable is really incredible. The paradox there is profound and I think can trip people up in myriad ways.
I have such strong emotions arouund my births and feel strongly they can be extraordinarily moving and empowering experiences. Good luck – I am jealous of all the amazing road that lies ahead for you! Sending lots of love.xo
June 23rd, 2010 at 8:59 am
I am touched by the idea that so long as we are not overly attached to where we are going…it doesn’t much matter which road we take.
This is important to remember, especially in the heart of the moment.
There are so many voices when it comes to birth plans. So many people with so many ideas. Many of them quite strong. Many of them contradictory.
I have found this is just the beginning with parenting. Many good parents love in profoundly different ways and think their counterparts are doing it “wrong”. But what can be wrong about love?
It is so obvious you are acting with intention, that your intention is born of love for this coming child and your desire is to make the transition from womb to world as wonderful as possible. It will be just what it is suppose to be. Filled with love.
Thanks for sharing this. Nothing to erase.