OBGYN | Gynecologist | Chicago | OB GYN Blog

Not According to (Birth) Plan
When Your Birth Plan Goes Astray
By Teri Brown

Women love the birth plan concept – it gives us the illusion that we, not our bodies, are in control. But it’s hard to be prepared for everything. Just ask Sarah Skofield, mother of three from Bowdoinham, Maine. She was having a planned C-section and thought she knew how everything was going to play out.

“It was a complete shock when the anesthesiologist couldn’t get a spinal and told me he needed to use general anesthesia,” says Skofield. “I consented and wasn’t aware of the birth of my son until I woke up an hour later. My husband had been waiting for me to wake up and he made sure the first thing I saw was our baby. I cried, but not happy tears. I was so confused and in pain. I felt cheated. Things definitely did not go the way I thought they would. It never occurred to me that I might need general anesthesia. I think if I had thought of that possibility, I would have been more prepared and it would have been a little easier.”

Elizabeth Thelen, mother of two from Rochester, N.Y., also made plans that didn’t turn out exactly the way she wanted them to. “We got the nursery set up, painted and got it all accessorized,” says Thelen. “I remember going to the doctor, a Gynecologist/Obstetrician in Chicago on a Tuesday, and my son was breech. I could feel his head in the middle of my chest. Well, later that week, he turned and broke my water. He was born five weeks early.”

The Benefits of a Birth Plan

Dr. Shelley S. Binkley, a board-certified OB/GYN with 16 years experience delivering babies and caring for pregnant women in Glenwood Springs, Colo., says that creating a birth plan can be very empowering. “If you’re going to develop a birth plan discuss it with your Obstetrician provider in the last month of pregnancy, before you actually arrive in labor,” Dr. Binkley says. “If you address it ahead of time questions can be answered and you’re more likely to make your provider aware of your wishes and align her behavior with your goals.”

If you want special music, bring it. Lighting can be adjusted by you or the labor staff. Remember that a birth plan is a wish list, the things you hope will happen, but don’t get too attached to it.

“There are some things to be aware of regarding birth plans,” Dr. Binkley says. “You, the labor nurses and the Obstetrician provider are, to a large extent, at the mercy of your labor. There are some things you and they can affect, and others that are completely out of their and your hands.”

Keep Expectations in Check

Often times, high expectations cause high frustration. If things don’t go as planned, the disappointment can be devastating. “It seems to me, after years of delivering babies, people with detailed prescriptions about how things will go often have more difficult labors and are more likely to wind up with a Cesarean section or difficult birth than families who approach labor with a relaxed but positive attitude and are willing to make adjustments in their expectations,” Dr. Binkley says.

It’s difficult to be prepared for everything that can happen during birth as there are a thousand variables. Most people want a minimal intervention as possible. They want their baby on the tummy, they want Daddy to cut the cord they want to be able to breastfeed right away. But what they want isn’t always what happens.

Dr. Kimberly McMahon, an Obstetrician and Gynecologist at the Northwestern Specialists for Women in Chicago, says it’s good to be prepared no matter what the plan is. “Nothing can really prepare a woman for her first labor, and no one can predict how long or how painful it might be,” Dr. McMahon says. “The best approach is for patients to keep their options open. If she needs pain medication, then she should be given the various options.”

Even second births can be unpredictable. A woman may have a perfect labor that follows the birth plan to the letter and still have a second birth that is completely different. By keeping your plan flexible, you are no only protecting yourself from disappointment, but you are giving your care providers the freedom to help no matter what the circumstances.

“Every woman would like to know when it will happen, how long it will take and whether or not she really will need pain medicine,” Dr. Binkley says. “Here are the definitive answers to these questions: It won’t happen soon enough or it will happen before you’re ready. It will take way too long or will be much faster than you thought; and it will hurt less or more than you expect. Some labors will be quick and uneventful while others may take days and require medical intervention to accomplish the deed.”

So having a birth plan is a good thing – being flexible about your plan is an even better thing.

Birth Plan Do’s and Don’ts

· Do write down your ideal labor experience.

· Don’t be bound by that ideal.

· Do discuss the plan with your doctor ahead of time.

· Don’t be close-minded about your doctor’s thoughts and ideas.

· Do as much as you can to follow the birth plan while in labor.

· Don’t be rigid about possible changes.

Articles Brought to you by NSWObgyn Doctors include:

Dr Bonnie Wise
Dr Kimberly (or Kim) McMahon
Dr Dayna Salasche
Dr Seema Venkatachalam
Dr Melissa Dugan