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“The best laid plans of mice and men often go astray.”

This quote is over-dramatizing my thoughts of today, as I don’t feel quite the heartache Robert Burns conveyed in To A Mouse, but it was the first thing I thought of upon receiving some test results today. The midwife says I’ve tested positive for Group B Strep – no big deal, really, but it does add a small wrinkle to my lovely birth plan.

I’ll step back a bit. What is Group B Strep? The midwife has brought it up a few times in our group appointments, but of course I scoffed at it completely because I’m always thinking that kind of stuff doesn’t apply to me. “No, no; my labor and delivery will be smooth and perfect with no complications whatsoever,” I say inside my head. Sigh. I am a naive one sometimes! Here’s what I remember, with a little help from the American Pregnancy Association:

  • Group B Strep is a bacterial infection found in the vagina or rectum (it was a fun test to find it, let me tell you). It affects about 25% of healthy adult women.
  • It isn’t an STD or a hygiene thing or anything; apparently the bacteria can come and go (it just happened to be present in me on the day of my test!). There are no symptoms – anyone can be a carrier.
  • As a precaution, to combat the chance that Baby2 could develop an infection as a result of being exposed to Group B Strep, antibiotics are delivered during labor every four hours.

So no big deal, really, as long as precautions are taken to prevent Baby2 from getting sick (those precautions are the antibiotics).

What does this mean for my lovely birth plan? Not much, thank goodness.

  • First, things first, I can still labor and deliver in the water, if I so choose.
  • Second, I have to come in to the hospital a little earlier than I may have wanted to (as soon as my water breaks, if that happens; otherwise, call the midwives when I think early labor has been established so they can direct me from there).
  • I’ll have to be hooked up to an IV every four hours for the duration of my labor. Luckily my hospital is cool and I can have a hep-lock device so the IV tube can be taken in and out without me 1) having a constant drip in my arm or 2) having to get stabbed and re-stabbed to establish the IV line.
  • Most likely I’ll be able to move about while the IV is in and it shouldn’t take too long to administer the antibiotics, so I can still have an active labor.
  • Baby2 should only need monitoring for 12-24 hours post-delivery (assuming no other risk factors, like fever, are present) so we shouldn’t have to be prisoners guests in the hospital for too long.

Again, not so bad. (Does it sound like I’m trying to convince myself that this is No Big Deal? Because I think I am.)

All in all, this small set-back is kind of nice, in a way. It’s good to find these things out now while I can get over them rather than during the throws of labor when my emotional state is… compromised. Also, this small setback is helping to prepare me mentally that things *might not* go completely my way. There could be other things that happen to derail my lovely birth plan. And guess what? I’m not going to know what the hell those things are until they happen!

This stanza will most likely not “leave us nothing but grief and pain for promised joy.” It is but a wrinkle in my “best laid plan,” and nothing more.

Birth Fears, Expectations and A Plan

Apologies if you receive this post twice. It posted this morning before I was quite ready – oops! I added some things, but didn’t take away anything. Blog burp!

Apparently birth plans have become a controversial subject. Some of the books I’ve read completely support them (like Natural Hospital Birth) and some have basically said, “What’s the point?” (like Birthing From Within). I like to be a bit prepared AND our midwife recommends covering some basics in a written plan, such as if we want to breastfeed and how we want Vitamin K delivered (there are several options these days!).

I really liked the strategy suggested in Natural Hospital Birth about having three birth plans (fantasy, reality, abridged hospital version). I’m going to just stick with two, though: one that gets Mr. Handsome and I on the same page and one written version for the hospital staff to keep on file.

Before I get to our expectations for this birth, though, I thought I’d “talk” out some of my fears about birth. First off, I feel a thousand times better about this impending birth than I did in the weeks leading up to my first birth with Kiddo1. Nine years ago I was freaked out beyond comprehension! All I could focus on was how much it was going to hurt. Because of this, my birth plan was basically, “Give me the epidural as soon as humanly possible.” (Actually, my birth plan was pretty hilarious with lots of unnecessary stuff like, “I would like dim lights and soft music.” My OB even laughed at me a little bit.)

Nine years later (haha, had to sneak that in!), I don’t really fear pain. Having made it through a birth before, I know more of what to expect which helps me feel way, WAY more comfortable. I believe that I have the power to make it through this time. I believe this because my last labor was assisted with Pitocin, making the contractions way more frequent and intense. Also, I made it to 9 cm before getting the epidural, so I know I can push (haha, pun intended) just past that mark this time. I also believe that the pushing phase will go faster because I’ll be able to feel what’s going on (I didn’t have any feeling whatsoever last time).

Despite the increased level of comfort and knowledge this time around, I still have fears. I fear that I won’t be in control. I fear that my wishes won’t be followed because I won’t be able to make them known. I fear the “fog of labor” which will impair my ability to communicate.

I know I can alleviate my fear, though. I can talk to Mr. Handsome, in depth, about my desires and his expectations. I know that Mr. Handsome will be a great supporter and will fulfill every need I have. He did an amazing job last time without any real direction from me whatsoever. I need to give up my need for control and allow him to take over. I need to trust him to do what’s best for me. I recognize that my fear lies with my own willingness to let go, not his capability to do what I need.

So what are my own expectations then? Well, I need to make myself move around, change positions, etc, but I expect myself to get lazy and fight that a bit (last time all I wanted to do was lay on my side and cry/scream). So I’ve asked Mr. Handsome to keep me moving. I want to get in the birth pool, but I don’t know when I’ll be ready for it. I’ve told Mr. Handsome that the pool should be filled when I’m able to get in (5-6 cm) but I may not want to get in right away.

As for everything else, I’m trying to just keep an open mind and not expect too much. I have ideas for birth positions but I don’t know which one I’ll like or will work best in the moment. I want to try to remain as relaxed as possible about the whole thing. We’ll see how that goes!

I’m keeping myself sane and giving myself license to relax because we have a birth plan. The hospital philosophies very much align with what I’m wanting, so my birth plan should cover any lingering questions the staff has. Also, I’ve been reading up on tips for the hospital birth plan. Here’s a couple things I’ve learned:

  • Keep it short. Nobody has time to read a twelve-page treatise – it’s more likely that things will get overlooked this way, too. But a short, well-organized plan will allow the staff to follow your wishes more closely.
  • Be nice! A negative plan that says “I don’t want this” and “I don’t want that” feels very, well, negative to the staff. Frame desires in a positive manner: instead of “I don’t want to be confined to a bed,” state, “I would like to be as mobile as possible during labor.” (There are a couple exceptions that our midwife told us to specifically add, such as declining an IV/hep lock and eye ointment.)
  • Don’t belittle the staff. Don’t tell them how to do their jobs.
  • Avoid ambiguous statements such as “I prefer” or “If necessary.” Be assertive! But still nice.
  • Customize it! Don’t just take one of those “form plans” off the internet and check some boxes and call it good. Really think about what you want, what is necessary to ask for and what your priorities are.

So here it is, the Hospital Birth Plan:

  • During labor:
    • I would like to be as mobile as possible.
    • I would like to avoid pain medication. Please do not ask about pain levels.
    • I would like to enter the birth pool when appropriate.
  • During delivery:
    • I would like to give birth in water.
    • I would like my husband to be in the pool, “catch” our baby and bring her to the surface.
  • Immediately after delivery:
    • I would like to donate cord blood and preserve the placenta (for encapsulation).
    • I would like to exclusively breast feed.
  • Infant care:
    • We prefer a family practice consult to evaluate our baby post-delivery.
    • Please administer Vitamin K via injection.
    • Please do not provide eye ointment.
    • We would like the Hepatitis B immunization. We were immunized for Whooping Cough (TDap) at 36 weeks gestation.

I think we’re ready for this. Mr. Handsome and I have talked about it (and will probably continue to talk about it here and there). We have everything written down. All the reading I’ve done has mentally prepared me very well. Now we just have to get down the aisle, so to speak.

Book Review: The Waterbirth Book

As you may know, I’m very interested in pursuing a waterbirth so, naturally, I’m reading up about it in order to prepare myself and Mr. Handsome.

The first book I read, Choosing Waterbirth, was a great primer and helped prepare the emotional side of my brain for this experience. This next book, however, took my preparation to a whole new level.

PhotobucketMuch like her book Active Birth, The Waterbirth Book, by Janet Balaskas, is a comprehensive account of every detail of waterbirth that I could possible thing of, and then some.

Ms. Balaskas not only goes over a brief history of waterbirth, cultural uses of water during birth and pain management using water, but she also walks the reader through every stage of water labor and delivery. Any question that was lingering in my mind after reading Choosing Waterbirth has now been answered. Now I’m only left with a list of questions for the hospital about their policies. And an incredible excitement for what we could experience with this birth plan!

Here are some of my questions for the hospital after reading this book:

  • When do you fill up the pool? When we call to say we’re coming in (based on our assumed progress/timing of contractions)? When we get there and progress has been assessed?
  • How long does it take to fill the pool? How is water temperature regulated?
  • What does the pool look like/what is it made of? (Based on photos I’ve seen, our hospital uses inflatable pools that look about 5-6′ in diameter and maybe 2-1/3′ tall.)
  • At what point during labor is the appropriate time to get in the pool? (The book says 5-6 cm dilated, before transition.) Is there a point at which “the window closes” and it’s too late to get in?
  • What things would cause you to ask a woman to leave the pool?
  • How do you manage fetal monitoring? How often do you monitor?
  • Are partners allowed in the pool? During all stages?
  • Is there a time limit for being in the pool? (This book states most births occur within 3-4 hours of getting in the pool.)
  • Can the entire third stage (birth of the placenta) be done in the water or is it preferable that this is done on dry land? Will cord blood banking be effected? (We’re donating to a public bank.)
  • Finally, the big one, will you let Mr. Handsome “catch” and bring our baby up to the surface?!

See, Ms. Balaskas gives you a whole lot of ammo to make sure you’re fully comfortable with hospital policies regarding waterbirth. I’m totally going to rock our class (coming up in June).

There’s also some great tidbits in here from Active Birth; not so much from a physioloical perspective, more like the reiteration that movement and staying upright is helpful whether on “dry land” or in the water. She also points out that the pool actually facilitates movement as you’re less inclined to get into bed and have greater freedom of motion (one of the birth story quotes talked about being able to move quickly from an all-fours position to a squat which is quite a feat on dry land). Plus you’re in your own little bubble where you can be free to concentrate inward which is a major bonus for me.

Choosing Waterbirth was a great book but there’s nothing in it that The Waterbirth Book doesn’t have, plus it has a whole lot more. If you can only read one book about waterbirth, make it this one by Janet Balaskas!

Book Review: Choosing Waterbirth

A few years ago, a friend of Mr. Handsome and mine told us her waterbirth story (over beers you tend to talk about anything after awhile!). It was such an amazing story that I swore right then and there that I would pursue the waterbirth option in the future if given the chance.

Now that I have been given the chance, ie we are pregnant, have a healthy pregnancy, are seeing the hospital midwives, etc, I’m totally taking the opportunity to birth this way.

Naturally, I’ve been looking for books on waterbirth to supplement the class we’ll be taking in June, however these books are a bit few and far between. Waterbirth isn’t anything new but it has been somewhat slow to gain frequency, especially in this country. I’ve been cruising the local library looking for books on waterbirth. So far I’ve found two so I’ll be reviewing those over the next week or so.

PhotobucketThe first book I found is Choosing Waterbirth: Reclaiming the Sacred Power of Birth by Lakshmi Bertram.

This was a good book for not just an overview and testimony of waterbirth but also preparation for birth and some postpartum tips as well. It has a very “free spirit” sort of vibe – this is good for natural childbirth, of course, but it is very noticible in this book!

The author very much emphasizes natural methods of relaxation not only during birth but as preparation for birth and dealing with day-to-day life in general. There’s a whole chapter on yoga poses which are illustrated and explained well. Plus, it made me feel good that most of the poses I already incorporate in my yoga routine. She also gives a couple great birthing exercises that I’ve been using. They are great!

The chapters on waterbirth helped to answer a lot of the questions I’ve had about this method, such as how big the tub should be, how high the water level should be, when to get in the tub, when to get out, etc. There’s information on some of the perceived risks and how the mother’s body and the baby’s instincts mitigate these risks (such as how babies won’t try to breath in the water and how low the risk of infection is). The chapter on the three stages of labor and delivery was also excellent.

The author publishes six waterbirth stories – all five of her own children’s births plus her sister’s waterbirth. I love reading birth stories. It’s great to hear a first-hand experience. For me, I can’t imagine a better way to prepare than by learning from others’ stories.

This book is a great overview of waterbirth. It helped to answer some of my questions and it gave me enough knowledge to think of more questions, which I think is great. I hope the next waterbirth book helps to give me even more knowledge about what I’m wanting to get myself into. By the time our class roles around in June (and our birth in July!) I think I will be a well-prepared student.

Next Review: Active Birth: The New Approach to Giving Birth Naturally by Janet Balaskas