September 29 – October 5 : 15 Weeks 0 Days – 15 Weeks 6 Days.
Up until this week, I haven’t had the wherewithal to think much about my birth preferences. When I was going through the first trimester, I remember having thoughts like, This is baby had better stick, because I could absolutely not start this process again from scratch, and, We’re going to have to adopt our second child, because I can’t do this again. My nausea has faded so slowly that I didn’t even notice my days getting easier, but I’m not having thoughts like that any more so I must be feeling significantly better. The only times I seem to get nauseous now are when I get hungry and when I overexert, so as long as I adequately snack and laze, I’m golden. Now I can see why people like being pregnant so much.
In the first trimester, I did enough investigation to figure out I wanted to get prenatal care and give birth at a hospital with a low-intervention philosophy, and settled on Saint Luke’s. I also knew I wanted to try for a natural birth. But that was about it. This week I started to explore my options for birth.
Doula or Do not (la)?
My doula friend, Heather Charmatz, has been incredibly helpful in giving me advice and recommending books during my pregnancy, so I was already feeling good about doulas. I want to give birth with as few medical interventions as possible. Hiring a doula increases a woman’s chances of doing so, both via the doula assisting with non-medical comfort measures and advocating for the mother in an intimidating medical setting. I reached out to friends on Facebook asking for thoughts on birth with or without a doula. There was unanimous consent among both the mamas that had had a doula (or doulas) and the ones that hadn’t: definitely hire a doula.
I searched online for suggestions for questions to ask doulas, and made a shortlist of the ones that were most important to me:
- What is your training? Are you certified?
- Can you tell me about your experience as a doula? Do you have any stories you can share?
- Can you give me a snapshot of the care you provide before, during, and after birth?
- Do you have experience attending births at my hospital? Do you get along with the staff there?
- How will my husband be involved?
- How do you feel about the use of pain medication and other interventions?
- What is your fee? What does it cover?
- If you don’t attend the birth do you have a refund policy?
- Do you have anyone else due near the time I’m due?
- Do you offer any other special services? (e.g. massage, photography, aromatherapy?)
- Do you have references we could talk to?
So far, Richard and I went to a Meet Local Doulas night at Saint Luke’s (the San Francisco Doula Group does a few of these around the city every month) and we also interviewed Heather and her doula partner, Joy. The Meet Local Doulas night helped us establish expectations about a doula’s scope of practice, how much they cost in the Bay Area, and what their packages typically include. We didn’t see ourselves working with any of the doulas at the Meet Local Doulas night, but Heather and Joy were great! Instead of making an automatic decision between a good choice and a bad choice (well, not bad—just not a the right fit for us), I wanted to be able to make a thought-out decision between two good choices. Based on some online research and recommendations from friends and other doulas, Richard and I have one more doula interview lined up in a couple weeks. Then we’ll make our final choice!
How Do I Know My Birth Preferences with No Previous Experience?
Heather lent me a great book called Natural Hospital Birth by Cynthia Gabriel. Even though I’m only halfway through, I’d recommend it to anyone planning a hospital birth. The book outlines some exercises that get the reader to think back to experiences planning big ritual events (like a wedding) and participating in endurance events (like a marathon), which helped me make some concrete decisions about what I want for my birth.
My number one advice for people planning a wedding is, “Get a wedding planner!” That’s what I would have done differently. I enjoyed and took pride in planning my own wedding with the help of friends and family, but on the big day, rather than relishing in the experience of being the bride I felt like I was also playing the wedding planner. As my lips parted from my new husband’s after our first kiss, one of my hands lovingly caressed the back of his neck, while the other discretely gestured to music person to start playing our exit song. When I give birth, I want to have my birth plan written up with plan A’s, B’s, C’s, and have someone else there to coordinate and orchestrate, so I can just focus on bringing my baby into the world. This is where I see a doula fitting in. Richard could be play this role too, but as much as it’s my day to experience becoming a mother, it’s his day to experience becoming a father. Also, when discussing doulas, Richard brought up a past experiences to illustrate his apprehension about supporting me through pain.
When Richard and I were vacation to Cabo San Lucas. I got stung by a horrid little jellyfish—I think it was a Portuguese man o’ war. In excruciating pain, I insisted that Richard try to suck the venom out with his mouth. In a much more rational state than me, he refused repeatedly. I was horrified to see the blue venom under my skin slowly being absorbed into my body. After enough relentless and desperate pleading, Richard caved and tried to suck the venom out. In less than a second, his whole mouth was in stinging pain from contact with the venom. Whoops. Needless to say, Richard fully supports having a third party present at all times to protect him from the ill-advised demands of a laboring wife.
Second to the man o’ war, my next most painful experience was running a marathon, for which I was sorely under-trained. My running shoes went missing the morning of the race, and I was running in an old pair that were half a size too small and slowly turning my toe nails purple. The funny, encouraging signs people held or posted along the course were wonderful, because they gave me enough of a mental distraction to let my willpower recharge slightly. However, in the last six miles, I just could not run any more and slowed down to a walk. My outer hip muscles immediately went into a spasm that wouldn’t let up unless I started running again. I was determined to finish, and I realized that whether walking or running I was going to be in pain, so laboriously, clumsily, and dejectedly, I started running again. Shortly thereafter I came to an aid station that had more than the standard water, Gatorade, and gel packs—they had RealFruit gummy candies. People emotionally eat for a reason—it works! In the short term anyway, and the short term was all I needed. That handful of corn syrup and gelatin that I savored over the next mile was all that kept me from collapsing into a pile of tears on the side of the road and calling a cab. After I ran across the finish line, I grabbed some more RealFruit gummies and continued jogging over to the massage tent to get that spasm worked out of my glutes. My take-away: I’m going to want some little treats and joys for the most challenging parts of labor to give me the emotional boost to keep going. No need for a massage as a reward at the end though, the baby will be enough!
Should I Dwell in Distraction or Awareness?
Upon the recommendation of many friends, I bought the Hypnobabies Home Study course, and have been enjoying it. The hypnosis recordings I’ve listened to have included visualizations that have helped me connect with the baby—something that’s been hard for me since I can’t yet feel the baby moving and don’t have much of a bump. The course also includes a 30 minute track of positive pregnancy affirmations, which is so up my alley. I mentioned to the doulas I interviewed that I was thinking of using hypnosis techniques, and they advised that some women like hypnosis because it distracts them from the experience of giving birth, some women don’t because they want to be completely present to the experience.
This may be committing yoga blasphemy, but I think that distraction may work by better for me than complete presence and awareness in this case. When I was at the height of my nausea, although it was hard to drag myself out of the house to teach yoga, teaching made me feel better because I was focusing on others’ bodies rather than dwelling on the discomfort of my own. After I got stung by the jellyfish in Cabo San Lucas, Richard and I somehow made it back to our hotel room where he read a book to me. It distracted me enough from the pain that I could sleep the afternoon away until the pain had softened. On my marathon, the only things that kept me going were the yummy and humorous ones that distracted me from the sensation of running. Using distraction can still be meditative—just as we may use the breath as a drishti (focal point) for our meditation, we may similarly use any of these other distractions as a drishti.
I teach yoga and meditation to people who suffer from chronic pain, and one of the most important techniques we master is to halt the pain-tension-pain cycle. When we feel pain, we automatically tense up. That increased tension creates more pain, which causes us to tense up even more, and the cycle continues. If, at that first sensation of pain we can soften instead of hardening, we stay at that base level of pain instead of initiating an ever-escalating cycle. I think little distractions like inspiring or funny affirmations, hypnotic visualizations, or gummy worms will help me do just that.
How Attached Should I Get to My Birth Plan?
Most people have told me not to get too attached to my birth plan because birth is unpredictable, and if it doesn’t go my way I’ll feel like a failure. Natural Hospital Birth gives some alternative advice that I loved. Get attached to your birth plan, the author encourages. Just as with any other goal, the clearer, more insistent, and more determined you are about it, the more likely it is to happen. “Don’t get attached to your birth plan,” is essentially saying that it’s better to never try at all than to try and fail. That’s no way to live! The book acknowledges that the risk in becoming attached to your birth plan is that you may feel disappointment if your birth doesn’t happen exactly the way you wrote it down. The author’s response is a little punch of tough love: disappointment is a part of life. Anyone who is used to setting the types of lofty goals that are worth achieving knows that some of them don’t pan out. That’s disappointing, and feeling disappointment is okay. It doesn’t mean we’re failures, it doesn’t mean we stop setting goals, it’s just a part of the process and of life. Besides, as long as nobody’s stopping by postpartum to rub the discrepancies between my birth plan and what actually happened in my face, certainly any disappointment will be overshadowed by the immense joy of holding a happy, healthy baby in my arms.