October 29, 2010

A Labor Nurse's Birth Plan - revisited

Ah, my "birth plan". I was laughing to myself (yes, I'm easily entertained) about the birth plan I had come up with when compared it to what actually happened with Caleb's birth. It is a good idea to have an idea of what you want and don't want, but once again it shows that even with the best laid plans, things may not go your way, even if you write a kind of "anti" birth plan, to ward of any unfavorable vibes for the labor/birth. Guess the labor gods decided to take me seriously and grant me some of the items on my birth plan. Figures, right?

Just for fun, let's look at my "birth" plan:

1. I want lots and lots of Magnesium Sulfate. Gee, I guess I got that, didn't I?!? My whole sense of time the day leading up to Caleb's birth is a bit of a blur, but I got a nice hefty 6g bolus and was on Mag, I believe, about 18 hours, and a nice big maintenance rate of 3g an hour the majority of that time. Good times, good times.

2. I'd like to have an emergency c-section without anesthesia due to a uterine rupture at my old incision site. (yes, unfortunately, we have done c/s sans anesthesia, luckily not often) - Thankfully, I did not have to have this. No emergency, no uterine rupture. And Doc told me after the c/s that my uterus did not look like a uterus that had 2 prior c/s. Nice to know the ole' girl healed well after c/s 1 & 2.

3. If I don't get a emergency c/s and can VBAC, I'd like an episiotomy with a 4th degree extension, please. Wasn't given a chance at a VBAC, heck, it seemed like it was a huge deal that I wanted to wait until Husband was there before I was taken back to the OR. When one of the other docs I work with heard I delivered, (according to a coworker/friend) by c/s, and had a vaginal delivery with my first baby (perhaps a breech in HIPAA, but I don't mind) he said he would have let me VBAC. Go figure. But, in reality, I would have been too nervous to VBAC after 2 c-sections.

4. I also would like to be tethered to the bed for the duration of labor with internal monitoring. No internal monitoring, but I was, in fact, in bed from the time I changed out of my scrubs and into a hospital gown right before they started Mag. However, I wasn't in any shape to stand after a certain amount of time, remembering how weak my muscles were just trying to move in bed and when I tried to get to the wheelchair for my ride to the OR.

5. I desire lots and lots of cervical checks - I did have several exams, but I realize they were all necessary to make sure I wasn't changing my cervix.

6. I also would like my baby taken from me straight away for at least an hour so it interrupts with breastfeeding and bonding. I had wanted Caleb to stay in the OR with me...but that was on the condition he was term and healthy. My coworkers tried their best to keep him in the OR, but I told them to take him to the nursery, make sure he's just fine. I did get to see and touch him before they took him to the nursery, so that was nice. Thankfully he was fine and it had no effect on bonding or breastfeeding. That boy latched easily while I was on the recovery room cart.

So, like I said in the original post, be flexible with your birth plans. You just never know what labor and delivery will bring.

No comments: