Birth Plan! Ha!

In case anyone has missed it, over the past few weeks this amazing (parody) birth plan has been making the rounds: Jamie and Jeff's Birth Plan. It is hilarious, and wonderful, and made me wonder if I should create an actual birth plan of my own now that this whole placenta previa thing may be resolving to the extent that I'm able to attempt a vaginal delivery. After I had laughed at Jamie and Jeff's plan for the millionth time, I headed over to BabyCenter and printed this worksheet. But when I began looking it, I realized that this was, um, not really geared toward me. Demographically I'm probably likely to want the Jamie-and-Jeff spiritual and unmedicated experience, but personally, that sounds terrible to me. Nothing, and I mean nothing, has been remotely spiritual or low-intervention about this conception and pregnancy to date. So when I'm asked questions about dimming the lights and using self-hypnosis, I roll my eyes. It was traumatic getting pregnant and I have no expectations that it will be anything other than traumatic to get this baby out of me. Not to mention that even in a best-case scenario, I'll still have this blood clotting thing to deal with when I deliver, so I would be kidding myself to think that I wouldn't need interventions like an IV or continuous fetal monitoring.

That is not to say that the birth plan exercise didn't raise a bunch of important questions that Harry and I discussed in advance of my OB checkup yesterday (everything looks great with the baby, by the way.) Here are my top three birth preferences, which raised my doctor's eyebrows quite a bit when I went over them:

1. As much pain relief as possible. I know, I know, lots of women decide in advance that they want to get an epidural (or a spinal, or narcotic pain meds, etc.) I'm one of them. I don't want to be in pain. I readily admit that I am scared of the pain of childbirth. I don't care if knowing this makes you think less of me. But I'm also still epically pissed about my experience with egg retrieval and being awake for that painful and humiliating surgical procedure. And knowing that the heparin I will be on after 36 weeks gives me a 12-hour window where an epidural literally isn't possible makes me even more anxious that I will be begging for relief and it will be denied.

2. Authority to kick people out of the room (yup, even medical staff). Residents, medical students, pediatricians waiting to take our kid to the NICU - fine. No problem. Grab a chair and stay awhile. But in the event that any member of my care team makes me feel, even for one instant, like I am being judged for any single one of my choices, I want that person to leave. No, excuse me - that person will leave the room in a hail of verbal abuse. If someone tries to scold me that I'm not pushing right/is skeptical of my decision to pursue pain relief/makes an ill-timed crack about IVF/laughs at my suffering, they're likely to be at the receiving end of the months and months of anger that has been building up in me.

3. I want to be called by my actual name. I noticed when I went to Labor and Delivery at 21 weeks for my most recent bleed that nobody bothered to learn my name. Or, maybe they did know who I was, but they all referred to me as "mom." I do not find this cute, or endearing, or exciting. When the nurse that night said "Oh, that's mom's heartbeat we're hearing," what I heard was "I have no idea who you are. As far as I'm concerned, all you are is yet another woman about to give birth." Why is this okay? I have never heard an oncologist refer to a patient as "cancer lady" or a surgeon call someone "bypass guy." (Well, not to their faces, anyway.)

How did my OB react to my (very politely presented, I might add) list of requests? Um, not terribly well. She can't guarantee any of them, which I knew would be the case. Nobody knows how my labor will progress and if giving me an epidural could paralyze me by causing bleeding into my spine, that's a pretty damn good reason not to do it. She also hasn't really encountered many patients who come in to give birth really, genuinely concerned in advance about personality conflicts with the staff. And when it came to the not-being-called-mom thing, she gently explained that most of the time people are just excited and happy for the delivering woman, and it's coming from a good place. Which I get, and which doesn't change anything about how I feel. She's going to make notes in my chart about my preferences and encouraged me to express them again as soon as I get to the hospital, and offered to set up a meeting with one of the anesthesiologists for me to discuss pain relief options for anticoagulated patients in more detail. And, um, she suggested that I meet with a counselor. You know, the "let's explore your anger" type of counselor. Which I have declined.

So... there's a lot going on here. In a way I think I'm just as protective of my "birth experience" as the fictional Jamie and Jeff, because I've already seen what happens when I have a negative interaction with the medical community. And the stakes are higher this time. What's at risk is not just my ability to sleep and eat and function like a normal, non-sobbing human adult, but my relationship with my new son. He is the very definition of innocent in this whole crappy situation and he deserves the best possible start in life. If this goes badly, and there are a million ways that it can, I honestly don't know how I will be able to get past it and start bonding with our baby. And what can I do in advance to prepare for this, realistically? Nothing. Except maybe practice saying "What's my name, bitch!?" to someone during a chaotic experience in bed, which I have never done... something to look forward to, I guess?