When Things Don't Go As Expected

Today I am sharing from the heart. Just over a week ago I gave birth to our 5th child.

It was so hard. 

Why? That is what I have been wondering. Overall this pregnancy, birth and recovery have been very rough for me. Perhaps with having 4 relatively easy births and immediate bounce back recoveries I had too high of expectations. In fact, I think what I have experienced this time is more the norm. But it's not normal for me and I'm having a hard time even processing it.

I have loved giving birth in the past, but not this time. I have previously felt amazing as soon as the baby was born, but not this time. I have struggled a lot mentally this time and that has not happened before.

Now I'm trying to figure out how to move forward with reality. Why didn't things happen as I expected? Why did I expect things to go as they had before? I know every pregnancy and birth is different, and I have to remember that I was given a gift. Nothing was taken from me because I did not have the birth I wanted. But it's easy to feel that way.

Does anyone relate?

Megan's Pregnancy and Simon's Birth

    I was not a fan of pregnancy. I know there are a lot of women who love being pregnant, who thrive while they are with child, I however was not one of them. I had a very unique and complicated pregnancy, which added to the typical discomforts of a “normal” pregnancy (if there is such a thing). 

    A little background history… I was born with Biliary Atresia. I was the 1 out of every 15,000 children born with it. What is Biliary Atresia? Well, long story short I was born without any bile ducts connecting from my liver to my small intestine. This left the bile with nowhere to go. Most Biliary Atresia children are born with blocked ducts but I was one of the babies who didn’t have any. This is where my hero Dr. Nagaraj stepped in and performed the Kasai procedure (attaching a piece of my small intestine to my liver) on my fragile 9 day old body, which would give me roughly another 2 years of life, if I even lived through the surgery. The chances of my body returning to a normal state were less than 30%. Back then this wasn’t a procedure done that often and well, here I am 29 years later, off the transplant list, no sign of my disease, and still baffling doctors. Really the only difference in me is that I have a very low platelet count. This means my blood doesn’t clot as fast as most peoples. The normal platelet count for a person is roughly 150,000-400,000. Mine hold pretty steady somewhere between 60,000 and 80,000. 

    Back to the pregnancy. When I first told my OB about my medical history she freaked. I mean, people with this disease don’t typically live to a reproductive stage, let alone have babies. I was immediately under the microscope of all my doctors, and let me tell you they did NOT take this lightly. I can really tell that they THRIVE on cases like mine! I was very closely monitored by my OB, my gastrointerologist, and my hematologist. I mean, with a platelet count as low as mine the chances of my bleeding internally or bleeding out during delivery were pretty great. My GI doctor kept a close watch on my liver, which meant getting a few scopes done, as well as seeing him bi-weekly, my Hematologist kept a close eye on my blood count bi-weekly, and my OB saw me bi-weekly. Basically I LIVED at the hospital. When cases like mine come through they always prepare for the worst, and they also prepare YOU for the worst. You know, it’s really scary when you are told the chances of your survival rate during delivery. Those 9 months were the most trying 9 months of my life physically, spiritually, and mentally. How do you stay excited or joyous when people are preparing you for some scary truths? Every time I heard the statistics I felt like I was walking towards the gates of death. 

    After a group meeting with my OB doctors every thing became a blur. It was a unanimous decision that I needed to deliver cesarean, but not only cesarean, I would need to be put to sleep. And not only cesarean and knocked out, I would be sent downtown to deliver with doctors that I had never met before. This was all decided roughly a month before my due date. The next week i went downtown for routine ultrasounds and was told I needed to deliver early at 37 weeks, which was NEXT WEEK. I knew the name of the doctor who would be deliver my sweet boy but I still had never met her. 

    Fast forward to next week, my husband and I are walking into the hospital at 8:00am on Halloween morning knowing that at 10:30am our lives would be different. I am immediately swept so that the show can begin. When you have a million doctors around you poking you, giving you instructions, sharing the details of what they are doing, asking for blood transfusion permission, making you sign a ton of papers, you really can’t do anything but silently panic. But let me tell you, there was one person there who I really felt was sent there by the Lord to be with me during all this. It was my anesthesiologist. I never would have thought that a person like him would be my rock. My husband was not allowed to be with me during any of my prep or any of my delivery and I know that the Lord knew I needed someone. I hate that I cannot remember his name but this man is responsible for keeping me together. He took the initiative to stay with me not only for emotional support but he did more prep on me than any of the nurses put together. Did I mention that I still hadn’t met my delivery doctor?

    Once prepped, i was wheeled into the delivery room. If I thought I was scared before, wow, I had no idea. There’s nothing like florescent lights, a million doctors, and a laying naked on a stainless steel table, and the thought of never waking up, to get the tears flowing. There she was, my doctor. She was very sweet and I knew she was good at this. I was sent specifically to her. Everything was so fast paced, I was shaking horribly, everything hurt, I was strapped down, naked, and freezing. But that’s when my anesthesiologist gently grabbed my head and started whispering in my ear that I was going to be okay and that he was going to take care of me. Then he told me to keep my eyes on him while the doctors did their work. I kind of felt like I was in a factory. I was the product and they were the assembly line. Anybody been there? Next thing I know he tells me I will soon be asleep, which I am glad for but also scared to death that maybe I wouldn’t wake up. I have been put to sleep more times than probably most people and it has never bothered me. If anything I find it very peaceful. This however, was different. But you can’t just not go to sleep so off I went, to dream land…

    Guess what! 1 hour later I woke up and was immediately holding a beautiful baby boy in my arms. The love i felt for him outweighed any fear of death. It was worth it. He was worth it, and I will do it again with the Lord’s blessing. Recovery was super painful and definitely the worst part of my experience. Just when I think it couldn’t get any worse! I was in the hospital for I think 4 days? I longed for daylight. I longed for no pain. I longed to be able to walk down the hall by myself. I am not one that likes to sit around, let alone lay around in a super uncomfortable hospital bed! But you know what, at the end of the day God was glorified through my pregnancy, He showed himself to the doctors, to me, He used my circumstance to glorify himself and I am honored I could be a part of it. I have never publicly shared this story because it’s not always what people wanna read when they are pregnant. I am also very private person. I never think people want to know the details of my life. I always think pregnant women want to laugh about all the silly food cravings, giggle over the belly kicks, relate to all the back pains and swollen ankles. My story is different. It’s not something most people relate to. But here I am and I hope this was in some way encouraging. Pregnancy is beautiful and it looks so different to so many people. Thank you for letting me share my experience. 

~Shared by Megan B.

Proverbs 3:5-6

"Trust in the Lord with all your heart and lean not on your own understanding. In all your ways acknowledge Him and He will make your paths straight."

As you prepare for pregnancy and/or labor and childbirth, this verse should bring you comfort. God is in control of all things and He will guide you in all of it. Trust that God knows what He is doing in all of it, no matter how good or challenging things are. God is good and He is in control.

Labor Playlist

For many people, music can help us to relax and focus. Obviously everyone is different, but there is something about music that speaks to the heart. I talked about memorizing a hymn to help you focus in labor, and today I want to talk about music to listen to. We all have different tastes, so your final selection is up to you, but I would encourage you to have many songs that call you to worship. Why? Because birth is an experience of worship. Without God birth would not be possible. No matter what kind of birth you plan or hope to have, you should be focused on and worshiping the giver of all life.

When reading Redeeming Childbirth by Angie Tolpin, she talked about the Ultra-Sound of worship that is a play list of worship songs to help you focus on God during your labor. For her list you can find it here. I do not have a play list typed out as I have only prepared one this time by going through the music we had and making a list. In fact I have only had music at one of my births and we played a Pandora station of classical music, so I'm looking forward to actively worshiping through song as I labor and deliver this time.

What would you have on your labor playlist?

When Satan Attacks

From the moment you find out you are pregnant, it is crucial to be on your guard. Why? Because Satan likes to attack pregnant women. I have had many conversations about this recently as well as battling it myself. The surge of hormones, the changes in your body, the complete lack of control. All of it can be so overwhelming and Satan loves to use these things to whisper lies to us.

"If God was good you wouldn't be sick." 

"Your husband thinks your unattractive."

"It's OK to lose it since you don't feel well."

"No one is here to help you. You are all alone."

"You were too sick to clean the house today? You're worthless!"

He likes to use our insecurities to feel isolated, ugly, and that sin is OK. But none of these things are true! Because of Christ, we are never alone. Pregnancy is beautiful! And sin is never OK. 

We must fight these lies with the Truth of God's word. To know the Truth, we must be in the Word regularly. We must share our insecurities with our husbands, family, friends, anyone we trust to speak the Truth of God into our lives. We must remember who we are in Christ. We must fight sin, through the power of the Holy Spirit living in us. We must also give ourselves grace to know we cannot do it all. 

God is gracious and merciful. He will help you, His precious daughter, to do what you need to each day. If it's taking a nap, preparing a nursery, cooking a meal, or keeping your tongue in check, God will give you the ability to do it. Cry out to Him! Every moment of everyday ask Him to help you over come. 

If God is for us, who can be against us? No one! 

Cooper's Birth

On the other hand…. I did NOT love being pregnant with Cooper.  I was SO hungry the first few weeks, and then extremely nauseous until about 17 weeks.  The funny thing about the start to both of my labors is that my husband and I had eaten at our favorite hibachi place the night before!!  I think it must be something in the pink sauce!  The Friday that I went into labor with Cooper, I had just put Tyler down for a nap.  My husband was at work, of course.  I just sat down at the computer, hit send on an email, and literally 2 seconds later, I felt that same pop – but this time at the bottom!  I ran to the bathroom again, but this time I was not so lucky about the mess!  Luckily, it was not on any carpet!  Again, a HUGE gush of water flooded into the toilet.  I hadn’t been contracting at all (that I noticed!), so this was a huge shock to me.  I was 38+5 when my water broke.  I was not expecting this yet!  Unfortunately, my phone was in the living room.  I sat on the toilet a few minutes, trying to calm my nerves and let more amniotic fluid drain out.  I did a mental nurse check – did I feel the baby move?  Yes.  Did I feel any cord hanging out?  No, thank God.  Was the fluid clear?  Yes, definitely.  Ok. (As a nurse, I felt very guilty about forgetting any of this when my water broke with Tyler.  But, that labor was VERY different and fast.  I was thinking as I SHOULD have been thinking at that time – a pregnant woman – a MOM – who was in labor.  This time, I had been a nurse 2 years longer, and I wasn’t actively laboring, so I COULD think those things!)  

When I felt like I could walk to the living room, I got up, dripped all the way to the living room, leaned over the couch as far as I could and grabbed my phone.  I think I called the answering service first, then my husband.  He immediately packed up his stuff and headed for home, but it was Friday afternoon about 3:15 or so… in Atlanta.  Then I called my parents to come take care of Tyler.  Meanwhile, my midwife was trying to call me back, but kept getting the busy signal because I guess I was trying to make and receive phone calls from my panicked husband and parents (Dad: “It’s Friday afternoon!  Is Joseph going to get home in time?!  Do I need to take you to the hospital?!”  Seeing as how Tyler came pretty quickly for a first-time baby, and my mom and sister both have a history of VERY fast labors, this was a real concern of ours!)  Finally, I get off the phone and see a text from Amanda: “call me”  When I called her, she said, “Now you know better than to get on the phone after you page me!”  We decided I should go ahead to the hospital for the whole fast-labor-family-history concern that I just mentioned.  My parents arrived at my house first, and my husband shortly after that.  I guess he went upstairs to get our stuff, or change clothes or something.. I don’t know what he was doing, but my mom and I were standing outside, and I was wiggling my hips back and forth with the contractions, wishing he’d hurry up and come on!  I did not want to have this baby in the car on 285!!  I felt a lot of back labor, but I was not having strong, or consistent contractions – everything indicative of Cooper being OP (or sunny-side-up – NOT the optimal position!)  Since I wasn’t in hard-core labor like I had been with Tyler, I remember the car ride pretty well.  I was uncomfortable, but I think it was more stemmed from anxiety.  

Anyway, we got to the hospital sometime around 4:30.  Renata came in to get me admitted, and since I was standing, leaning over the bed (which I had raised up to my desired height), she offered telemetry monitors for me, so I could be free to move around in the room.  I graciously accepted and continued to labor, standing for the admission, and then walking around the room for a while.  This labor was SO different from my first.  Eventually, I started to get a little more uncomfortable, so I decided to go ahead and get an epidural, because I was still convinced this labor was going to just take off!  Around 8, Amanda checked me, and I had not made any change from what I was when I was admitted.  I REALLY didn’t want to have any Pitocin – I didn’t have any with Tyler and I just really wanted to avoid it if at all possible.  I asked for more time.  We tried putting my leg up in a stirrup, but by 10 PM, my contractions were coming every 8-10 minutes.  I pressed my nurse call bell, and said to go ahead and start the pit.  Sarah started me at 2 milliunits/hour (our standard starting dose) and never even increased it.  After an hour, I was complete and ready to push. Pushing went very smoothly again this time, and Cooper was born at just 3 minutes after midnight on Saturday.  Interestingly, I remember SO MANY more details about laboring with Tyler, but Cooper’s delivery is the one I remember the most.  I remember having that rush of, “Oh my God!  My baby!!” when I first saw him and heard him cry.  I remember asking Amanda if he had an extremely long cord because he moved so much and flipped around so much early in my pregnancy.  He did end up rotating, and he came out the “right” way – OA, and not sunny-side-up.  But as a result, his little face was VERY bruised and swollen.  He weighed 9 pounds, 1 ounce, and we were completely flabbergasted to see his RED HAIR!

~Shared by Lauren K

Labor Contractions

The only way to know for sure that contractions are true labor is to have cervical change, but many times you can have contractions for awhile before that happens. So how can you tell from your contractions if it might be labor? These contractions tend to be more intense and can be felt both in the front and in the back. They start at the front and move to the back or vice versa. As time goes on they will get closer together and feel stronger. Both walking and relaxing will not effect the contractions. Feeling an increase in pressure in the vaginal and/or rectal area is also prevalent as labor progresses. You may have some bleeding, called bloody show, that is indicative of cervical change. If your contractions cause your water to break, that is a very good sign it is real labor.

Every woman is different and will have any combination of these things. Some labors are less intense than others. Some women's water never break. These are just guidelines. If you think you are in labor and are wanting to be checked out, call your provider and they will tell you if they think you need to go to the hospital or not. If things get intense quickly, feel free to go ahead and make your way there, calling your provider to let them know.

How do you know when you're in labor?

Braxton Hicks Contractions

Today I want to talk a little about Braxton Hicks Contractions, also known as practice contractions. Being at the end of my pregnancy, I have contractions on the brain. I'm always evaluating them and wondering if this could be the start of labor.

Braxton Hicks are very common and, as the common name implies, helps your uterus practice for labor. Generally speaking Braxton Hicks are contractions that feel like a mild cramp. They are not regular and they do not get stronger over time. These can happen at anytime. Changing positions, especially sitting down if you have been on your feet for awhile, will generally help them subside. Also drinking water, emptying your bladder and relaxing will generally cause them to go away.

These are all general as you can have contractions that are strong and do not go away and it still not be real labor. In fact you can have contractions that feel like the beginning of labor for hours and it not be labor. This is better called prodromal labor, but still falls into the Braxton Hicks department as they are not real labor.

What is your experience with Braxton Hicks Contractions?

Preeclampsia

Preeclampsia is a condition in pregnant women marked by high blood pressure and high levels of protein in the urine and can be accompanied by swollen feet, legs and hands. It usually occurs in the second half of pregnancy. The exact cause is unknown.

It is most commonly seen in first time pregnancies, teen moms and women over 40. Other risk factors include:

• History of high blood pressure, 
• History of preeclampsia in other pregnancies, 
• Mom or sister having preeclampsia, 
• Multiple pregnancy (twins, etc)  
• History of diabetes, heart disease, lupus or rheumatoid arthritis. 

Other symptoms of preeclampsia include:

• Rapid weight gain caused by increase in body fluid
• Abdominal pain
• Severe headaches
• Change in reflexes
• Reduced or no urine output
• Dizziness
• Excessive nausea and vomiting

Seek immediate medical attention if you have the following:

• Sudden/New swelling in your face and eyes
• Blood pressure greater than 140/90
• Sudden weight gain over 1-2 days
• Abdominal pain especially in the upper right part of the abdomen
• Sever headaches
• Decrease in urine output
• Blurry vision, floaters or flashing lights

When caught early, preeclampsia can be manageable with blood pressure medication, but if it goes undetected it can be serious for you and your baby. In extreme cases it can become eclampsia, which causes you to have seizures. There can be other effects as well. 

If you are close to term when symptoms occur, it is likely they will induce labor. If you are not close to term and it is not yet severe they will likely try to control your blood pressure with medication and bed rest. If severe, they may deliver you even if you are early. 

Have you had any experience with preeclampsia? 

Normal Discomforts

Throughout pregnancy, your body is changing as your baby grows. These changes can cause many discomforts that, under normal circumstances, might be something to be concerned about, but are quite normal for pregnancy.

Round ligament pain
The round ligaments are several thick ligaments that surround and support the uterus. As the uterus grows during pregnancy, the ligaments are stretched and can cause pain in the lower abdominal and groin areas. It is usually a sharp sudden pain and can be very uncomfortable, but will go away relatively soon. Sudden movements are the most likely to cause it to occur, such as sneezing, turning quickly, coughing, laughing and rolling over. Doing things slowly is the best way to avoid this discomfort, but there are times when it is unavoidable. When you feel it, just stop for a moment and wait for it to subside.

Mild Cramping
As your uterus grows with a growing baby, it will often times cramp a little here and there. This can also happen after having intercourse or doing strenuous exercise. As long as there is no bleeding or worsening of the cramps, this is normal and part of the expected discomforts of pregnancy. Drink lots of water and if it is bothersome, use mild heat to help alleviate the feeling.

Sciatic Pain
The sciatic nerve is the largest nerve in the body that provides sensory and motor function to the lower part of the body. This is some of the worst pain during pregnancy that can be quite normal. You feel it at the top of the gluts and it often radiates down the leg(s). It is sharp and stabbing. This nerve can easily be pinched as the baby grows and moves around causing this pain to happen. The best way to alleviate the pain is to lie on your side opposite where you feel the pain. If it gets worse or you are unable to get comfort from the pain, notify your provider. Generally speaking, this pain is short lasting like round ligament.

Mild Swelling
Later on in the pregnancy, you may notice mild swelling in your hands and/or feet. As your body fluid increases, it can be challenging for your blood vessels to hold it all and some fluid will seep into the intercostal space causing swelling. The best thing you can do for swelling is drink water and put your feet up. If the swelling becomes severe and effects more than just hands and feet it could be a sign of high blood pressure and that should be checked out by your provider.

What mild discomforts have you dealt with?

Is Vaginal Pain and Pressure Something to Be Concerned About?

This question comes from a friend who was experiencing this.

There are a lot of new feelings and sensations that can come from being pregnant. It is not unusual to have twinges of pain or pressure in the vagina throughout pregnancy. Toward the end of pregnancy pressure will increase as the baby puts more pressure into vaginal canal, especially as the baby drops. Often being up on your feet all day can also increase the amount of pressure you feel and can even cause sharp pains. Try lying down. If it begins to subside it is normal. As the baby moves pains can come as the baby hits different areas, particularly the cervix. When the baby hits the cervix it often feels like a sharp stab that lasts for only a moment. All of this is normal and is not anything to be concerned about.

If vaginal pain is accompanied by bleeding call your doctor immediately and get checked out. If pain is not resolved after lying down I also recommend calling your doctor and get their recommendation. If it is not during office hours and you are concerned you can go to the hospital to get evaluated.

Have you experienced vaginal pain or pressure?

Tyler's Birth

The Saturday Tyler was born, I woke up at about 1 am to my first ‘strong’ contraction.  I thought, “Hm.  That was a contraction,” And went back to sleep.  30 minutes later, I woke up again – same thing.  So this time, I got up and messed around on my computer for a little bit.  I continued to have some irregular contractions, but eventually went back to bed and my hubby and I slept until about 9 am.  Then, we got up, had breakfast and for “some reason,” we decided to clean the ENTIRE house.  I mean, mop the floors, vacuum, clean the bathrooms.  Everything!  Around 11 or noon, I was still having contractions, but nothing that was difficult for me to manage.  I decided to get in the shower.  I was also starting to notice some light spotting, but I really didn’t think too much about it. (Silly pregnant lady – my nurse-self never did kick in!!)  Meanwhile, my husband decided to get some exercise in!  After my shower, I started timing my contractions and laboring on the birth ball.  My husband got a call from an old college friend, and I encouraged him to take the call.  I still wasn’t completely convinced I was actually laboring.  I was even texting Lori (my friend and coworker, who Emmie also worked with).  I even have the dialogue saved on my computer (I typed it up after the fact because I thought it was so funny!!).  I told Lori I was having contractions every 3-12 minutes (I was waiting for them to get more regular!!) and that I was having some bloody show.  

Then, literally, about 2 minutes later, my water broke at 1:15.  I immediately texted Lori again, “WATER BROKE!”  I ran to the bathroom, and a HUGE gush of water went in the toilet!  I don’t know HOW I made it to the bathroom without a drop of water on the floor.  Feeling my water break was so cool to me.  I felt it in the front of my belly.  It felt like curtains being pulled open from the middle.  It didn’t hurt at all.  I just felt a little pop, then the separation.  Anyway, I yelled at my husband that my water broke, get off the phone and get a shower!!  He swears it only took him 9 minutes to shower and grab the remainder of our things for the hospital bag, but to me, it felt like forever!  I called the answering service for them to page my midwife.  They asked me how far apart my contractions were.  I think they were probably every 1-2 minutes then, but I said, “I DON’T KNOW!  MY WATER BROKE!!”  She insisted she needed a number to give to the midwife, so I just blurted out, “5 minutes!”  I  think I texted my mom and sister that we were headed to the hospital.  I called the hospital on my way to let them know I was coming and that Lori was going to be my nurse.  For some reason, I ended up calling the hospital 3 or 4 times!  Ms. Debbie finally started answering with, “Yes, baby?” because she recognized my phone number!!  The last time I called, I said, “I’m so sorry!  I didn't mean to call!  I just accidentally hit the button!”  but Ms. Debbie asked if I needed a wheelchair when I got there and I puffed out, “yes!!”  My contractions were coming fast and furious in the car.  I’d take a big breath in and blow it out, and as my contraction was on the downward slope, I’d breathe out, “It’s ok… It’s ok… It’s ok…”  Other than that, I really don’t remember the ride at all.  I do remember, as we were heading out the door to the car, my husband asked if we should eat lunch (HA!  Are you kidding me?!), and asking me which route I wanted him to take on the way there (I didn’t care!).  

We got to the hospital around 2 or 2:30.  I remember Ms. Debbie and one other person (a tech, but I can’t remember who!) sitting outside, waiting for me with a wheelchair.  I put my towel in the chair and they whisked me off to the labor room.  Darla met me in the room, helped me get undressed and into the hospital gown.  I don’t remember getting in the bed.  The next person I remember was Wendy coming in to place my IV, and I remember smiling and saying, “Hi Wendy!”  All these silly little details always make me laugh, especially because I just really don’t remember very much – just little bits here and there.  I was having a hard time getting comfortable in the bed.  I didn’t know if I wanted to sit up or lay down.  I couldn’t think straight.  I don’t remember feeling pain.  I just remember feeling very intense.  That was the only word I could use to describe it.  Intense.  Just intense. Eventually, I felt like I was starting to get some coherence back, and I noticed the monitor was showing my contractions every 1-2 minutes (or maybe someone showed me after I got my epidural?!).  I couldn’t believe it!  My awesome midwife, Amanda, came in to check me.  I was 4 cm, and SO excited to hear that I was not 1 or 2 cm!!  Next thing I knew, they were getting me positioned for my epidural – I never even asked for it, but I was planning to get one.  My contractions slowed down, but still continued pretty consistently at about 3-4 minutes apart.  At 5:30, Amanda came in to check me again.  I had been feeling some discomfort down in my hip, and Wendy had put in a catheter to drain my bladder.  In retrospect, I wondered if she felt some resistance (if Tyler had been very low), or if it was just signs on the fetal monitor that prompted Amanda to come back when she did.  At any rate, I was completely dilated and Tyler was quite low.  Six pushes later, he was out at 5:58 pm, 8 pounds 2 ounces.  I am that lady that everybody loves to hate.  I loved my pregnancy – I loved being pregnant, I loved wearing my maternity clothes!  And I LOVED my labor and my delivery.

~Shared by Lauren K

What Should I Put In My Birth Plan?

This is completely up to you. I have seen very detailed birth plans with very specific instructions for any and all circumstances and those that have the bare minimum. From what I've seen I would discourage the overly detailed birth plan and if you are going to take the time to write one be thoughtful and do not write one that would just cover standard practice.

So what should you include?

If you are not wanting any medication, write that you do not want to be asked about pain medication and that you will let them know if you need something. Know that they have to tell you your options, so allow them to tell you your options, but then you can nicely say, "Thank you for letting me know, I will tell you if you need anything."

If you do not want an episiotomy, make that clear.

Feel free to list your room preferences such as lighting, music, temperature, etc.

If you have strong feelings on induction or breaking water include them in your birth plan.

Write down any preferences for what you would like to do during labor and pushing.

Include anything for newborn care that is different than what is standard practice, such as not wanting them to have they eye ointment or the vitamin K shot.

Write if you are wanting them to breastfeed only or desiring formula.

Write if you want your baby boy circumcised or not.

These are the basic things you can include. As with other things be kind and gracious in how you approach it and know that things can go differently than expected.

Here and here you can find two types of check off birth plans. If you have any good resources for these please share them below.

What do you put on your birth plans?

What Is A Birth Plan? Do I Need One?

A birth plan is a document that tells your healthcare providers what your preferences for labor, delivery and newborn care are. You can pull check off lists from the internet. Two different ones I have found are here and here. There are many out there and sometimes the hospital you are delivering at will give you a generic one to fill out if you so desire.

You can also write your own after deciding what your preferences are. If you decide to write your own be gracious in how you write it.

This document is not legally binding and will not hold up in court if something is done outside of your birth plan.

It is up to you if you want to write one or not. Some people find this helpful to communicate what their expectations are to others. You may find it easier to stick to your plan if it is written down. This is not needed, but can be beneficial.

Do you write out a birth plan?

Advocating for Yourself in Labor

I want to delve a little more into advocating for yourself. Today I want to discuss advocating for yourself during labor.

First off to be able to advocate for yourself you need to be educated. You need to know generally what you want and be familiar with things that can go different as planned. Clearly you cannot know everything, but basic information and prayer can help you prepare.

There are times you may end up with a nurse or a provider that may not agree with your decisions and possibly pressure you into making a decision you are not comfortable with. There are clearly times when things need to be different, but I'm talking about when you are pressured to get medication or have interventions taken or might even be refused medication for some reason.

I want to be clear, you are the only one who can give consent to have medical treatment done unless it is a life or death situation. You are your own advocate. You can have others there to help you make decisions, but only you can make the call. Again, be polite and gracious, but do not be afraid to be firm in your decisions.

You can refuse medications and interventions.
You can ask for medications and interventions.
You can ask to be checked.
You can ask to be left alone.

This can be difficult in labor, but it is still your job. So pray, be prepared, have a plan, make sure your husband is on board with your plan and be ready to stand on your decision no matter what pressures come.

Have you had to advocate for yourself? Did your plans ever have to change?

How Do You Advocate For Yourself?

This question came from one of my friends that I wanted to answer on here. The question relates specifically to going to labor and delivery when not in labor as discussed yesterday.

So, you are having pain that is unexplained and is not seeming to go away, you cannot get to the doctor's office and you are concerned, so you head over to the hospital to see if you can get some answers. What do you do from there?

They will put you on the monitor to check the baby and see if you are having contractions, but sometimes that is all that will happen if there is nothing evident. Throughout pregnancy there are weird pains and twinges that are often unexplainable, and usually if everything looks good there will be no need to do more. It is also possible that the doctor may not come by if everything looks normal.

If you are not comfortable with this and and wish for further evaluation, ask. Remember to be polite and gracious, knowing that sometimes things maybe refused or you may have to wait awhile to see the doctor on call. If your nurse is not working with you, you can ask to speak with the charge nurse, but please only do this in extreme circumstances.

The biggest thing is to not be afraid to ask. You can ask to see your doctor. If you are far enough along and are unsure if what your feeling could be labor related, you can asked to be checked. You can ask for medication. You can ask for anything. Again, be polite and gracious and be willing to listen in case they must refuse your request. This is the best way to advocate for yourself. Also pray for wisdom and peace throughout this time. God is the One ultimately in control and He knows what is going on.