Writing a birth plan is a common and great practice today.
It helps the mum picture and plan for her soon coming birth and allows the birth team to identify the areas they can participate in while supporting the mum.
What if the birth plan “fails”? Or is ignored and not considered? Birth outcomes can occasionally be a surprise. Anger, disappointment and guilt are some of the emotions that come by when a mum has to deal with an outcome she did not expect. The birth experience to some is not only disappointing but traumatizing.
Here’s a story of how one mum recovered from a birth experience she had not planned for.
I met Eve when she just learnt that she was pregnant. She was excited as she was expecting her first baby. She was looking forward to a great pregnancy and birth, chose the midwife model of care as she wanted personalized attention throughout this season.
She had prenatal care at home and her pregnancy went well. She read a lot from reliable resources and had me answer all her questions during each visit. She was a fine and really nice to be mama who was pretty engaged in what was happening to her.
At week 30, we started Birth Essentials Program, our child birth class which both Eve and her husband enjoyed. During the session on birth preparation, they settled on the option of a home birth and were pretty excited about it. We agreed to discuss the home birth during her week 36 prenatal visit.
During the clinic on week 36, Eve’s blood pressure was high and she had edema (swelling) on her hands, feet and face. She had little protein in her urine too. These were sure not good signs and the decision was for her to be reviewed by an Obstetrician as soon as possible. Her baby however was well and moving as always.
She managed to book an appointment with the obstetrician in a few days. During her appointment it became evident that her blood pressure was fluctuating. She was started on some medication to handle that and the plan was to induce her if she did not go into labor by her EDD. I had to hand her over to the doctor for the pregnancy care and remained as her doula to offer her support.
On week 39, her blood pressure was still high, the swelling persisted and a date for induction was scheduled. Eve was getting really low as now she was moving from a homebirth to a hospital birth, something she had not planned for. I did encourage her to remain open minded and focus on hers and her baby’s well being.
On her EDD she was admitted into hospital and the induction process was started with prostaglandin pessaries administered twice 6 hours apart. She had niggling contractions 12 hours later after the pessaries. I joined Eve and her husband just before the doctor’s next visit. A vaginal exam was done and her cervix had opened to 3cm. The doctor decided to rupture her membranes and start her on the Oxytocin drip. The contractions begun immediately, the pain was intense but she used gravity, different positions, was breathing through the contractions and managed that for 2 and half hours with both her husband’s and my support. The pain was too much for her to handle and during the next review, the doctor advised her to consider taking an epidural. She accepted this and a walking epidural was administered. The epidural made her a lot more comfortable as she only had about 30% of the pain she had previously and this helped her relax more during contractions. After an hour, the labor slowed down as a result of the epidural, Oxytocin had to be increased. After 2 hours, the baby’s heart rate was higher than expected (expected rate is 110-160 beats per minute). By now, too much had been happening in such a short time and the peak reached when the doctor told Eve that she had to go in for an emergency Caesarian section.
The tears on her eyes as she begged the doctor not to do the C-Section, the disappointment on both her and her husband’s faces are a memory I still have. She went ahead and delivered a healthy baby boy who weighed a good 3.4kg. I knew that one of the things to do was help her recover from her failed birth plan.
Here are some tips Eve used that you too can use.
Three days after Eve left hospital we had a debriefing session. We revisited the birth experience so as to initiate emotional recovery.
Creating a safe haven to deal with the emotions is very important. Only surround yourself with people who will support the recovery. The debriefing period allows you to identify what causes the most pain and focus on that for recovery. Letting go and finding a place to forgive yourself, your care provider and any other failure is important for emotional recovery.
Talking to someone you trust and who can help you deal with the emotional upheaval caused by the experience is a great place to start. A Doula or a counselor are people you can talk to, sometimes, sharing your experience with another mum especially if they can relate is a good idea too.
Kick Off The Blame:
“I feel like I have started on the wrong foot…” This is one of the statements Eve made at our debriefing session. She felt that she might have contributed a great deal to the outcome. “I should have exercised, drunk the nettle…” Feelings of self blame are often common when you had an unexpected birth outcome.
You are not to blame. This is a fact you have to embrace. There was no failure, each birth is different. If there was a lesson learnt then an adjustment can be made during the next pregnancy.
Remember, not having a normal birth does not mean you failed. Focus on what went right and keep off from all comments that would cause you to blame yourself.
The physical effects of birth are felt a day or two after. One actually feels like they were ran over by a truck. This is because there were several muscles engaged in the process and they get tired. If you are physically exhausted, that can lead to an emotional unrest.
The best way to deal with this is to allow your body to rest as much as is possible. Focus on what matters most, do as little as only taking care of your baby. Where and if possible, sleep when baby sleeps. Get as much help as you possibly can as this allows you to kick back. Let a relative, or friend help with household chores, bring you dinner, stay with your children. Hire help for the house, pay for school transport instead of dropping the children or better send them to a play group with a nanny.
Eve had her mum’s help, and hired a housekeeper too.
Aid The Recovery:
Rest as discussed earlier is one way to aid recovery, rest your muscles.
Eat right. A balanced diet helps nourish your cells and promote recovery. Lots of fluids, fruits and vegetables, small frequent meals are important too
Keep off infection. Simplest way is wash your hands frequently. Use clean clothes, dishes and ensure the environment around you is clean too. Avoid populated areas for the first month. Ensure to the best of your ability that the people around you are free of germs and disease.
Embrace and Enjoy Your New Season:
You have a baby! You are a mother! And even if you have had a baby before, you do have another chance to parent. Slowly start adjusting to being a mother and as much as is possible, enjoy each moment.
Bonding with and caring for your new born can be motivating, encouraging and rewarding. This helps boost especially your emotional recovery.