I was 37 weeks pregnant and had just completed a busy Monday in the OR, my last scheduled shift before maternity leave. While relaxing in front of the TV that night, I found my fetal kick count to be significantly lower than normal. I spoke with the on-call OB team, and after going back and forth, we decided it was best if I go to the hospital for further monitoring. I threw on my slippers and jacket (was already in pajamas) and said, "See you in an hour or so," to my husband. I never made it home that night, and six days later I brought my baby girl home from the hospital!
The fetal non-stress test showed that she was ironically doing well, but my blood pressures and urine sample showed that I had developed preeclampsia. My leg swelling was increasing over those last few weeks, but things just got real. My husband dutifully showed up with my pre-packed bag and birth plan. Yes, I had a birth plan - but not the long, detailed essay that some women present to eye-rolling hospital staff, replete with all sorts of unrealistic demands involving birthing balls, hot tubs, candles and music. As an anesthesia resident on the obstetric service, we used to joke that those women with the most detailed and rigid birth plans would inevitably be the women who ended up with "emergency" epidurals at 3 AM, or worse in the OR for a crash C-section.
The feedback I got from nursing and on-call staff about my birth plan was good; they seemed appreciative of the precise and explicit set of preferences that could be passed on through numerous shift changes. I will say, however, that even with my minimal birth plan as a "good luck charm", things still didn't go the way we had originally hoped. And yet, once my daughter was born, none of that mattered one bit. Meconium was present on delivery so she was handed off for resuscitation instead of immediately placed on my chest as I had hoped, we couldn't do delayed cord clamping, etc. But she was healthy! I was lucky to have a smooth albeit slow induction with no complications and a quick period of active labor (only 45 minutes of pushing). We didn't have to go to the OR. I only needed two stitches post-delivery. Again, she was alive and she was healthy! After experiencing a pregnancy loss, I admit that a fear had persisted deep inside me even into the late months of gestation that I would lose her without getting to see her face.
Nothing went exactly as expected, and yet everything turned out fine. Nothing went exactly as expected, and yet everything turned out fine. This is my new mantra, and it would be a good one for all pregnant women to adopt. Because in the instances of labor and childbirth, resistance and rigidity pose potential risks to both mother and baby.
Have you had an experience with a birth plan, either yours or a patient's?