Taking control of your birth plan when it has to change (Birth Story Part 2)

Before I start, and in case the title isn't clear enough. This is a birth story, if that's not your cup of tea don't worry there are plenty other posts on my blog to chose from. I never wrote the birth stories of my first two previously (you'll find them & why I wanted a home birth in part one HERE). For a lot of us mothers our story means a lot, and so it should, your baby and how you met is precious to you. Some love to share it like a battle wound whilst others keep it to themselves. For some of us our birth plan means a lot for others it's not the journey and how you meet your baby, just meeting them is enough. This is a two part post where I will touch briefly on my first two births in part one purely because I think those experiences put me on the path I ended up on for my third pregnancy and birth. But in honesty it's my third birth that is the important one. Not because I treasure it more than the others but because it was different from everything I had planned and hoped for. I didn't make plans for my first two, I just wanted to get through labour. But the third time my plans mattered a lot to me which made it all the more difficult to cope with the massive change we had headed our way. I hope that sharing how I coped might help other mothers who have to deal with big changes to their birth plan, whatever the reason. It has taken me almost a year to write it all down, at first it was too raw, then I was too wrapped up in the three kids. Now that I have a blog and a voice I want to do something with it feels like it's time to write it down as his first birthday looms.

PART II

At our 20 week scan we got told that my first trimester blood tests had flagged a risk for pre-eclampsia and our second trimester scan was showing that our son was measuring behind where he ought to be so we were to be given a third trimester scan just to make sure everything was as it should be. Neither my midwife or myself felt any concern because of this (I was only excited that we'd get another opportunity to see our baby in the womb to be perfectly honest); she explained that she had lots of her women flagged as risk for pre-eclampsia but that the likelihood was still minimal as I showed no other signs, the scan was just a precaution. As for the baby measuring small: both our girls were born at 40+1, weighing in at 2.8kg (6lbs) & 3.2kg (7lbs) and measuring 48 & 50 cm; I am only 165cm (5ft4") and was also on the smaller side at birth so we weren't expecting our third to be large either. My midwife and I continued our plans to stay at home with full force. As I had a history of long labours she was even going to make sure I had extra gas & air canisters at home. The birthing package is delivered at 37 weeks here in Angus, Scotland - and I must add the home birth team here is outstanding, we couldn't have been luckier! They've clearly put a lot of work in to their home birth team and we were fortunate enough to have our lovely midwife come to our house for EVERY appointment barring the booking and our three scans (this was a godsend to me as I was so sick throughout and driving was a struggle). I was also lucky enough to have the same midwife for the whole pregnancy, birth and my postnatal care. 

Below is my original birth plan, as I have mentioned before I never so much as wrote one out for the other two. But when I found these amazing visual aids I fell in love (they come from the book: The Positive Birth Book - to download just the icons for free click HERE you order it and it gets emailed out to you). Unfortunately my original birth plans disappeared with my folder when I was in hospital, but this gives you an idea of how I set it up. I colour coded it in GREEN, BLUE & RED, with green being my utmost priorities in my birth plan, blue if necessary, and red as the very last call of action. I also added that I still wanted green to be prioritised as and where it was possible should we need to move to plan blue or red. It meant that I felt I had not only explained my wishes in a best case scenario but that way I also felt I had outlined my feelings on other things should our plans change during labour and I was unable to fully speak for myself. I thought I was only preparing for a "what if" scenario but it turned out that doing this would help me when our plans changed completely. Remember, anything can happen in labour and a birth plan can not be set in stone, it is really important that you are prepared for changes.

At 34 weeks we went in for our third scan, I was prepared to argue with them if they said my baby was still measuring behind. I didn't want to do anything that might endanger my son or myself, but I felt strongly that I wasn't on the verge of getting pre-eclampsia; I had shown absolutely no signs of it during my pregnancy, and hyperemesis gravidarum aside, the baby and I had been doing really well during all our check ups. My plan of action was to insist that they have me in for another scan in the coming weeks so we could confirm that the baby's growth was increasing as it should be so that they didn't try to convince me to come in for early induction.

I could tell almost immediately that something wasn't right with the ultrasound and remember blabbering on about how our two first babies had been tiny. After taking measurements over and over again the sonographer said that she needed to get one of the obstetricians down for a second opinion but that the limbs were all measuring short and head large which to her implied achondroplasia. She asked if we knew the term (we didn't) and explained it was a form of dwarfism before heading off to call the obstetrician. It felt like an eternity waiting on him, all I felt was intense worry. What did all of this mean? What about my home birth? Literally the one thing that had made me push through all the vomiting and nausea during the 8 months up till then had been my plans to be home with my family. 

The doctor came in and did more measurements and was in agreement with the sonographer, all the signs pointed to achondroplasia, however they could not confirm with certainty if it was that or another form of short stature (there are over 200 different forms of dwarfism). Whilst worried about the measurements they both agreed that the baby was very happy and healthy in there and that all organs had grown as they should have. Knowing that he was HEALTHY was a very important lifeline to my sanity. The fear and worry was overwhelming and pounding at me. We were brought to another room to have a chat. I didn't care what condition he had all I wanted to know at that point was what it meant to my birth. I remember being worried they'd insist that I birth at hospital. I felt like I had been punched in the stomach when I was told that cesarean section was the preferred birth choice for those with neo-natal diagnosis. (I have since found out that many aren't diagnosed till months after their birth - please head over to my Dwarfism Awareness page where you can find the other posts I've written about what we've learnt and experienced in the last year)

Now, before I continue, I don't want to take anything away from other women's births! I know women who have chosen sections, who've had multiple and are happy with it and I think that is amazing. Thing is I am a HUGE advocate for women having a CHOICE of where they want to birth, doing it in a way and place that makes you feel safe is so so very important. To me, a section was terrifying. It was everything I didn't want. I didn't want to be in hospital, I didn't want to have to stay there for potentially several days; I just wanted to be home with my children. I didn't want to be cut open, I didn't want to heal for months after, to not be able to carry my 22 month old and 4 year old, not be able to drive (and you really have to be able to drive where we live), I didn't want to be a burden to my husband who'd already been my caretaker throughout the pregnancy. I didn't want to meet my baby on an operating table, not be able to hold or feed him straight away. I wanted to go through labour. To my husband that sounded crazy, but hard as the other ones were they were part of my journey to meet my babies and holding them as soon as they came out of me still fills me with such complete joy. In short I was scared. 

To those women who have ended up with emergency sections, you are my heroes. I never thought a section was the easy way before I had one anyway, but now I can tell you that it categorically is definitely the opposite. At least I had time to prepare myself for it, it must be terrifying when things are completely out of your control, it is all very surgical and probably worlds from what you'd imagined your child's birth to be like. After my first two births I was up and moving and feeling myself straight away, the section came with an internal infection and constant fear of tearing, I got the migraine from hell due to a leak into my spine. And the pain, so much pain when I just wanted to cuddle all my children and had to ask the older two to not come to close. Pain when you sneeze, cough, and most of all laugh. It's but a memory now, my scar has healed nicely, but it is a daily reminder of everything I didn't want and I still work hard at coming to terms with the events.

Our son's diagnosis I found much easier to deal with. It worried me, yes, of course, and it was new and scary. It hurt to think that there are people out there who will be mean because of his height, and that there are many health issues that come with achondroplasia. But I knew that we'd just have to tackle all of that when he came, I knew that it would be easier and less scary when I held him. It was getting to him that scared me. We were warned that there was a risk for brain bleeding, lung collapse and spinal damage if he was born vaginally - there was literally one course of action and I still mourn the home birth I didn't even get to attempt. I mourn that I couldn't hold him right away, that I saw him wanting to feed for over half an hour before I was stitched up and could hold him. But he's here now, healthy, beautiful and oh so funny. We were snowed in for 7 days due to the "Beast from the East", we managed to get out in time to get to hospital for our section and it was such a horrible week worrying about going in to labour I was almost happy to be at hospital for the operation in the end. Funny how life works out, eh? When I remember to look at the bigger picture I see how incredibly lucky we are and were, I don't think that means I can't feel sad but it is important to remember that many others have much tougher journeys (believe me it was NOT easy to see at the time).

As you can tell I don't have a fix for the hard parts of our birth plan changing so drastically. However I did one thing that, even though none of it worked out like I had originally hoped, made an immense difference to my own mental health when we went into hospital. After a week of feeling extremely sorry for myself, I packed away the birthing pool and all the other home birth stuff (it's sitting under the stairs as I write this, maybe we'll get to use it one day. If not I hope another family will, when I'm ready to let go that is) and decided that I had to take control. I knew I had to have the section and I could either hate it and be sad, or I could make a new plan. So I looked at my original one, spoke to the hospital staff and my wonderful midwife to see how we could make sure I still got as much as I could from my first birth plan.

My midwife went above and beyond, despite being on annual leave she came to the hospital and was in the theatre with my husband and I. Having her familiar face there was invaluable, it also meant I felt my voice would be heard should there be complications. Even though our son seemed happy in there they simply did not know if he would need extra attention once born. We requested for the lights to be dimmed at the birth, to be honest I can't decide to this day if I think it made it more or less surreal. The room was dark, screen down and a spotlight on this being coming out of me despite me feeling numb. I wish I could have held him properly, but I hug him extra now instead. That one moment in our lives was worth not risking him harm. We also requested music to be played, we had our own playlist (make sure you ask what kind of speaker they will have in the theatre if you do this) which the staff loved. It was full of upbeat songs, just what I needed to focus on while I lay there hating every moment and just wanting my baby. Our son was born to "I'm a believer" by the Monkees. I had a hand made cord tie which I was very insistent that I wanted them to use instead of the plastic ones, my husband still got to cut the cord. I pretty much insisted on a private room because I felt that after the crazy month we'd had full of worry, the last thing I could've coped with was to share a ward room with other mothers and their babies. We got all the really important things and our baby is healthy, at the end of the day that trumps everything.

It's not the birth I wanted but we did what we could to own it. So that is my advice if you're put in a position where you have to change your birth plan. Take time to mourn but also try to take control of what you can. I know it's easier said than done, especially when you're overwhelmed and scared by medical jargon. Make sure you know your rights, know what is SAFEST for you and your baby, and try to make the birth your own even if it hurts to let go of your dreams.