Self Advocacy: Making a birth plan & avoiding the cracks

Why is it when it comes to saying what one wants for their own body, their own birth, their own baby we get shy and go the “it’s ok, whatever you say” route? I am realizing the importance of standing up for myself (or at least telling my husband what that is so he says something since he’s not as apprehensive about it).

My OBGYN let us know at my 34 week appointment that after struggling with osteoarthritis for several years, he will be undergoing shoulder replacement surgery on April 25–my due date is April 26. A surgery of this kind will require a prolonged rehabilitation process which will make him unable to return to work. Since my due date is so close, with our permission he wanted to induce us before his last day. We may be his last baby delivered after 24 years working for that office.

I have had some apprehensions about size and such for this baby so I am grateful for the 39 week induction. That being said, I am scared of induction that early. Will my body be ready? Will I need more medical intervention than I did for Stella’s? Will doing this far out affect my pain management? These questions got me thinking that I really need to make a plan to talk to my doctor and get a birth plan in place we both feel safe and comfortable with–but I have to say what I want.

Birth Plan

• I do want to have pain management-epidural.
• Strep B Test was run at this appointment (still waiting on results) and antibiotic decision should be made then (I am allergic to amoxicillin)
• I want to try and start with cytotech to open cervix. I contract all the time so maybe once I start dilating I can go on my own.
• If cytotech isn’t doing everything it could, I would like to break water next–again hoping water breaking and cervix opening will be what I need to go into labor on my own.
• I want to put off the use of or completely avoid Pitocin (if it is safe for everyone)
• I want to get the epidural when I am actually in pain-I have been encouraged to get pain management before Pitocin (which is what I did with Stella and I ended up getting the epidural before I ever actually felt pain). I would like to delay both if possible.
• As long as baby is healthy, dad announce gender
• As long as baby is healthy, dad cut the cord

Seven days after giving birth to Stella, I was woken up with intense abdominal pain. It was worse than cramping from nursing and uterine contractions as it shrinks. We ended up in the ER. They did contact my doctor (same one I have now) and then ran tests. Test after test didn’t really reveal anything so they were about to send me home. I had my discharge papers in hand, I was dressed and a few feet out of our ER room when I was literally met in the hall by our ER doctor saying me OBGYN called back and with the post partum bleeding I had can lead to this infection and we should treat my pain accordingly. Knowing my doctor is retiring literally 3 days after I give birth, I wanted to have in plan of who he was passing my case file off to (as well as has a loose idea of what labor was like for me) so if something like this should happen they can swoop in and know what is going on again. This will also be the case for me 6 week post partum visit.

File and Postpartum care plan

• Find the doctor I plan on moving to BEFORE I go into labor so we can keep that doctor in the loop of labor as well.
• Be considered a patient of that new doctor the day I leave the hospital so my file isn’t just on record but in the new doctor’s record.
• Make 6 week appointment with new doctor before leaving hospital

I went into my appointment with a lot of anxiety and apprehension, but after getting my concerns out with my doctor, I feel much better. I did feel scared and pretended to “forget” and let my husband start the conversation, and then I elaborated once the conversations started. Why I was apprehensive I am not sure, but I am very appreciative I spoke with husband before hand and he knew my personality to take the initiative. I may have done it backward, but I did it. Make sure you do too.

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