Tuesday, January 26, 2010

Another Quickie and More on Birth Plans

I awoke this morning with a message on my Blackberry that my client had been up all night with gentle contractions, nothing strong and nothing worth waking her hubby up for, and that they had tapered off. I called her a little later in the morning to check in, and there was no answer. She had gone to sleep for a couple of hours. I was supposed to go out to lunch with a friend, and a good thing she cancelled. Just as I hung up with her, my client called saying, "well, things are picking up a little, as my water has just broken, but nothing I have to do more than breathe a little through. I called my husband to come home." I figured I'd call them in another hour to check in, but 30 minutes later I came out of the bathroom after a 10 minute shower, and there was a message on my phone from her husband, "We are going to the hospital, things have REALLY picked up!" I called right back while dancing around looking for clothes, and the husband said, "She wants to push!" "Shit!" I said. I listened for the gutteral sound of real pushing over the phone, but heard more of a howl of transition. It was her first baby, and they were a 10 minute drive away from the hospital. "GO! I will meet you there."

I called a cab and jumped in. I called them again, and the dad sounded focused. I asked him to put the lady on the phone between contractions if he could, because she was wailing, "I'm so scared!" She took the phone and I said, "Hon, all this craziness is just your baby coming soon. You are going to make it to the hospital. Everything is going just great. You're going to be SO happy really soon." The she threw the phone in the corner of the car as another contraction hit, and I was cut off. I figured I'd leave them alone to focus on getting there, sending lots of good vibes their way. It's not that I have objections to birthing in a car. If it were me, I wouldn't worry too much about it (and my husband more about the detailing afterwards than the actual birth happening unassisted). But people who are planning hospital births generally deeply appreciate making it to the hospital.

I got to the hospital and dashed through the hall, the nurses, who all know me, chanting. "go go go, she's pushing!" And there she was, with a sweet baby's head crowning. So beautiful! I did my best to get her really relaxed, told the dad what a rock star he was for holding it all together, and their beautiful son was soon born. He stayed skin to skin on his mom without any disturbance at all, and latched himself on to her breast soon after. "Well," I said, I would have been really happy to have hung out with you for 24 hours if I had to, but for your sake, I'm glad you're all done." Another happy new family!

I went out into the hall and saw a sweet OB I know and two OB residents I like, both new moms. They all smiled, said "hi", and asked if I was with the fast birthing lady in room 8. The OB said something so nice! "She probably gave birth so great from the therapeutic affect of having so much good preparation and support. I tell all my patients who want to know how to give themselves the best chance of having a great birth to hire continuous labour support...get a doula...but NO birth plans!" The other ladies and I all heartily agreed. They were actually surprised that I was not a great fan of birth plans, because the popular belief is that doulas are helpers of birth planning. I told them I wasn't into the concept of them much, but was curious about why they were clearly against the whole idea.

What was interesting about this conversation, was that these ladies are medical doctors, meaning scientific, studies-loving, efficient, logical people, at least to an extent. And their reason for not birth planning? That committing a birth plan to paper JINXED the birth!!!! I thought this was SO funny, and actually very endearing. I love hearing doctor/nurse talk around the ice machine:). What they explained was that their experience showed them that many of those who came in with birth plans actually had more challenges with birth. It's not anything they've studied, and it could just be they are connecting their experiences with challenging births to their memories of the fact that some happened to have a birth plans with them at the time of said challenging births (not noticing if a great birth outcome had a birth plan connected with it too). I found it very very interesting how vehemently they all claimed they saw a marked (though purely anecdotal) correlation between birth plans and hard births. When I think of the 6 births I've attended this month, except for one planned C-section for breech twins, they have ALL been fast, pain med free, everyone seemed quite satisfied with their hospital experience, and not a birth plan among 'em. What the clients wanted communicated as truly important to them, they were able to do themselves in about 3 seconds.

So, in a nutshell, here's the the medical advice I heard today: Don't make birth plans, cuz you may be invoking the evil eye if you put your visions and hopes of your birth down on paper... LOL! My reasons are just to avoid annoying the staff, and not getting too caught up in expectations...never thought of the "angering the gods" reason! You learn something new every day.

Like I've said before, if someone is really gung ho about writing a plan, heck, I'll help them do it. It's not for me to judge. I just don't think, except for a few very important preferences in point form if they are really concerned about clashing with the staff, it's necessary. But hey, it's your birth, not mine. I advocate choice.