Birth Plans

[Contents: medical, tmi, needles, pain]

OH BUT DO YOU HAVE A BIRTH PLAN

yes i have a birth plan okay

Birth plans come off to me as this odd mix of super-trendy "empowering" crap, and a good exercise for thinking through and stating your care preferences. My care provider's office and hospital use them, and have a form (although it's a terrible form and I hate it... which has been such a theme for every piece of paperwork I've gotten from them), which I have duly filled out and have in my purse so that it is handy for when I go to the hospital and am actually in labor.

The thing about birth plans is, you can state your preferences all you fucking want, and then they are going to run smack in to what ACTUALLY happens while you're giving birth, which may not even remotely resemble what you were hoping for, and in fact has decent odds of giving you a situation you did not even consider.

When I filled mine out... mmm, probably about six to eight weeks ago, one of the things on there was "if baby and I are fine, I want to let the pregnancy go to 42 weeks before being induced", which, now that I'm past 40 weeks and kind of thought it would never be relevant, I am a little boggling at my dipshit self. It's not that I disagree with it - I tend to be of the "don't fucking intervene unnecessarily" camp, just that wow, this is not a thing I was told I even had to worry about.

Probably the biggest thing on my birth plan that People Have Opinions About is about pain management. Yes, People Have Opinions about lots of stuff during pregnancy, birth, and child rearing (and boy, do they loooooove to share them unsolicited, holy shit), but oh my fucking god, do People Have Opinions about epidurals.

There is the camp that believes epidurals are the universe's gift to pregnant-person kind, and who remembers or will gladly tell you about what a fight it was to get any sort of pain relief offered regularly to people in labor. And, there is a point - there was a lot of rank misogyny and sexism to overcome on the part of getting a population mostly of women effective, safe pain relief during something that a great number of people think SHOULD goddamn hurt.

Then there's the camp that promotes "natural" birth, and "natural" pain relief methods, who write things like "90% of US babies are born with drugs in their system" completely uncritically (I saw this on an article on Pinterest, and I should have repinned it, because JESUS GOD), who will tell you all about how "your body knows what it is doing" and "it's empowering" and etc. and so on. Which, I'm not knocking (much) of that either (I'm definitely knocking the bullshit OMG DRUGS shit), because yeah I do think birth is something that generally, yeah, bodies are at least kind of made to do that shit.

What I do hate is the implicit or explicit "virtue" that gets ascribed to having a "natural" birth, like you're somehow a better person if you don't use painkillers. That is some shaming bullshit, and it needs to stop.

Personally, I don't want an epidural. Not because I think I'll be a better person, not because I think I'll be more empowered or whatever, but because I have had needles in my spine and I don't really fucking like them, so if I can opt out, I will.

Seriously.

I am fully aware of how effective drugs are, especially when injected in to or near your spine - I had a spinal with my cerclage in December, and prior to that, I've had cortisone injections in my spine because of my disc problems. Shit works! I will be the FIRST to tell you. I really just fucking hate needles in my fucking spine.

That, and honestly, I'm not really concerned about pain levels during labor.

This has been kind of a struggle during any sort of care I get, because my personal pain scale is not the same as everyone else's. Okay, let's be real - no one has EXACTLY the same pain scale as anyone else. But mine is... particularly skewed, it seems. I come to this conclusion after years of dealing with pain and describing it, and having many if not most people be like "and that's only a WHAT for you?"

Like with the cerclage removal. If you read stories about it, most people are like "yeah that was super fucking painful I wish I could have had drugs". Mine went on for over half an hour, it was complicated, we're lucky it could be done in the doctor's office, and I described it afterwards as "unpleasant". Like, if we use that ubiquitous 1-10 pain scale with the stupid faces on it, the removal hit maybe a 1 for me. In other words, I noticed it, but it didn't get anything out of me besides a brief wince. When I told this to the nurse, her jaw dropped.

Likewise, I have a history of herniated disks in my lower back. This can cause excruciating pain, including sciatica, muscle pain, and joint pain. A symphony of pain, if you will. The first time it happened to me, basically all I could do was lie on the floor, crying and occasionally screaming, praying for death. I fucked up my disks again the last semester of graduate school. I couldn't sit or stand up straight, I was in pain for a good six months. It sucked and I hated it, and I still went to class and wrote papers and did dishes and basically was extremely angry but got on with my life. It's exhausting, but I had trouble getting a diagnosis and referral for physical therapy this last round, because the doctor I saw didn't believe I was in that much pain or in that bad of shape, because I walked in to their office under my own power and was able to calmly hold a fucking conversation.

So labor pain? Doesn't fucking scare me. I have lived through way fucking worse, that has lasted way fucking longer.

This is also why all of the advice in childbirth classes for how to tell you're in labor, like "oh, yes, it'll be really painful, you won't mistake it", I am somewhat skeptical about. I've already had a few contractions that sure, have made me go "fuck, ow".... and I've talked to my mother, who seems to have a similar pain scale to mine, and from her experience, active labor and pushing and all that isn't much worse. Like, it's painful, and it sucks... but it's not OMFG THE WORST PAIN EVER GOING TO DIE. Also, it only lasts a few hours, which, in comparison to literally months, hahahah yeah fuck it that ain't shit.

I am not opposed to painkillers, and (at least partly to reassure The Man, who does not like seeing me in pain) I am open to having a dose of some IV narcotics if things get horrible. And obviously if I wind up with a c-section, yes please, anesthesia all the fucking way. But... yeah, nope, no epidural please, and thanks.

Other than that, my birth plan is basically summed up as "OMFG LEAVE ME THE FUCK ALONE". Don't give me eight thousand vaginal exams, don't touch me unless I ask you to, don't do shit to me without my express consent and without explaining it, don't induce me, don't let students peer up my vag, let me move around during labor, don't force me to lay on my back, leave me alone. I will let you know if I need anything, I promise, I've gotten REAL good at communicating my needs.

Do I know how things are going to go? No. Sure, I can make some guesses, but they really are guesses, even if they are based on my mom's experiences. She and I are a lot alike - including down to hey, prodromal labor, FUN TIMES - but that's no guarantee either. So we'll see what happens. That shit may all very well get thrown out the fucking window (except the no needles in my fucking spine part, seriously, I hate needles in my spine), but so long as The Kid and I come out the other side okay, sounds good.