NanaKim

For all generations, the plan for a pregnancy is to have a healthy baby after a wonderful labor and delivery experience. Nowadays there is a written plan reflecting the information presented in ante natal classes, which were first offered in the mid 20th century. The last century saw birthing gradually shift from the midwives assisting at home to doctor’s making decisions on tools and practices in hospitals. Giving birth later shifted a little again to take into account the mother to be herself, and indeed the father. I was in the first generation, baby boomers, to have family members, my husband and my mother present at the birth.

I’m sure that having a baby in hospital where the father was asked to wait outside the delivery room would have been fine for everyone in most cases, based on the cultural norms of the time, but not always. Today it seems unthinkable to exclude a parent from the birth of their own child like that. Before health insurance companies decided otherwise, medical professionals used to keep women in hospital for rest and recovery for up to a week before going home. There’s a lot to be said for that kind of care, but of course, no modern health insurance company is going to pay for that, leaving some women and infants vulnerable to health problems that end up in the emergency room. Even so, back in those days, the quality of the lying in experience was very variable depending on the staff, the hospital, and the other mothers sharing the ward. My mother had my sister at home partly because her first experience of birth at a hospital and been cold and uncaring. The second hospital experience was better but not enough to make her think that going to a hospital a third time was worth it. My younger brother was born in a very modern military hospital in Europe. I don’t think she had any input into that decision.

Looking back, the prevailing mindset when I was having babies, which I totally went along with, was that you checked into hospital and followed directions. I had some control: I refused an enema to the horror of the nurse, I insisted on a location that worked for me for the site of the port into the vein and I did request and get an epidural.

All of my three children were born in hospitals in the United States at the location best covered by our health insurance policy. Even though I had developed ideas of what I would like, a sort of unwritten birth plan, it turned out that staffing, limited availability of birthing balls and the policies in place at the time really didn’t give me much of a choice over my experience of labor.

My daughter lives in a new time, where women are advocating more strongly and effectively for themselves. She developed her own birthing plan with her husband, discussed it with every doctor she had an appointment with on her OB/GYN team and them provided everyone with a copy. I got a copy. There were extra copies to take into the hospital since you can never be sure of getting a doctor you have met before when it’s time to deliver. Also, the many nurses who account for the majority of care definitely need a copy each. You don’t know ahead of time, how long it’s all going to take and how many different shifts of nurses will rotate through your room who all need a copy of the plan.

It’s a wonderful thing to have normalized listening to the wishes of the woman giving birth. Discussing the plan with doctors beforehand is vital so that professional input is included and any potential issues are worked out in advance. My daughter felt confident that even if she ended up unconscious in surgery, her words would be on paper to guide people in making decisions.

It takes research to get all the information together to make your birth plan. There’s plenty of information that the doctor’s can provide and there are good books and websites to go into more detail about anything you want to know. It will be very individual to each person. I wouldn’t wish for anything else and I do hope that this kind of communication and partnership between the family and the medical team only gets better going forward. I approve of this progress!

So what does my daughter’s birth plan look like? It is organized under clear headings.

“Basic Information” includes her name, her support person’s name, the name of the hospital, the due date and the practitioner’s name.

“Before Labor” lists health factors including food sensitivities, her preference for vaginal delivery if possible, including my name as part of her birth team and updates such as needing to update a vaccine after giving birth.

“During Labor lists preferences for eating and drinking if possible, being able to be out of bed during labor, music and TV, exercise ball and other equipment, and freedom to try out different positions.

“Medical Interventions” include whether or not to have an episiotomy, not to rupture the membranes, and external electronic fetal monitoring.

“Pain Relief” lists the preferences regarding using an epidural, breathing exercises, massage, meditation and gas.

“Delivery” in my daughter’s case was very short. She asked for her partner to cut the cord.

“In case of a C-section” includes asking to be conscious, one arm free of equipment to make holding the baby easier, and to breastfeed as soon as possible.

“Newborn Care” asked for skin to skin contact immediately after birth and then breastfeeding, a lactation consultant to be available, stipulating that the baby is to be fed breastmilk only, rooming in with the baby, and permissions for the baby to receive vitamin K and antibiotic eye treatment. My daughter also added that her husband would hold the baby immediately after birth if she were unable to.

This is all important information for all the medical professionals and family who would be working with my daughter at the hospital. I wish I could have created a birth plan myself all those years ago, and I’m sure my mother and grandmothers would have benefited too if women’s voices could have been taken more seriously.