I’m not into birth plans. Most women who are, if I’m allowed to be stereotypical for a minute, are the kind that think birth is a beautiful, natural experience that your body is capable of doing without drugs or hospitals. I read a lot of these experiences on the Internet while first doing research on twin births.
“It was the most beautiful and profound experience of my life to have my twins at home. My doctor and I parted ways because he didn’t approve, since they were VBAC (vaginal after caesarean) and mono-mono (where there’s no separation between the babies and you’re carrying them around--cords and all--tangled up like two cats fighting in a burlap sack). But my doula felt that I could do it and coached me in my living room in a birthing tub of warm water. My doctor would’ve wanted me to have an epidural and to deliver the two quickly one after the other, but I was able to nurse my little Gaia for 20 minutes before her sister Flower was ready to descend…”
As you can see, some prefer to deliver twins the natural way. When I say "natural", however, I don’t mean drug free. This woman obviously smoked enough crack before writing her birth plan that her judgment was floating loosely in the sky with diamonds. I’m glad she and her twins enjoyed their one-of-a-kind “birth experience”, but she’s missing the point. PEOPLE DIE HAVING BABIES. Both my dad and Craig’s dad can think back a generation ago, when a hospital birth was still unusual and medical care was comparatively limited. Lots of kids in grade school had stepmothers because their own mothers only made it through three or four home births until their luck or health ran out. Twins were born then, too, but not always safely. Elvis Presley’s twin brother, Jesse, was stillborn before him, and many wonder if The King’s obvious emotional problems were a result of the lifelong heartache many suffer from being an only surviving twin.
Today childbirth is safer for mother and baby because of prenatal care and hospitals. There are a hundred different ways that Gaia, Flower, or their mother could have failed to survive the home birth, some of which are listed in her narrative. Adhesions from the previous C-section could’ve bled out. She could’ve needed a new C-section and not been able to get to a hospital. And yes, babies that share a blood supply (like mine, even though their sacs are separate) are usually encouraged to come out close together because of increased risk of placental detachment. I don’t care if it is fun to give birth in my living room in a Rubbermaid tub of warm water while tiny seahorses swim around me and nibble at my toes. I don’t want to do it. And really, what woman who has been through any kind of birth before wants all that mess and noise IN THEIR OWN LIVING ROOM? I’d never be able to look at a brown spot on the carpet the same way again. Even if the doula-and-pool package comes with a cleanup service, I’d rather give birth in a hospital under the influence of safe and legal drugs.
Although, after the week I’ve had, I’m not sure that delivering with my current OB office leaves me much better off than that poor lady and her living room tub. I’ve been battling a cold for about two weeks, and on Thursday I woke up at 3 am with a sinus infection giving me the worst pain I’ve ever felt. After staring at the clock for five hours until my doctor’s office opened, I called and explained my situation. I’m in my third trimester of a high-risk pregnancy with mono-di twins, ill with a sinus infection, a fever, and maybe bronchitis, and need to be seen by my doctor today. I was told to leave a message (!!!) then, and at 9am and 11am when I called back. At 1 pm I was sick of spending the day crying on the couch because I was in so much pain and my fever was starting to spike, so I called back and demanded to speak immediately to someone who was authorized to schedule me.
“We don’t see you for a sinus infection. Go to your primary care physician,” replied the nurse, clearly annoyed at being made to answer the message.
“Not only is it too late in the day to start the message game at another office, but I have nobody to see but the University Health Service. While the interns there can give me a flu shot or fix a minor sports injury, I’d prefer to see a DOCTOR because…” I countered testily, launching back into a description of my case and my symptoms.
“Well, if you have a fever, you should go to emergency!” As you know, we have Humana Student Health Insurance (Need health care? No, you don’t!) and they wouldn’t take too kindly to an unnecessary ER visit.
“You can’t tell me that I am not sick enough AND too sick to be seen. I’m sorry if you’re busy today, but it’s unacceptable to deny me the care that my case warrants because you’re overbooked…” I try to use big words on the phone with my office in general. Sadly, it seems like they’re used to dealing with people with a lower level of education who are therefore more easily bent to the will of overbearing nursing staff (especially because most of the patients don’t pay their own medical bills, if you know what I mean). In short, I refused to hang up and was given an appointment. The doctor was concerned, called in a safe prescription, and checked that the babies weren’t suffering distress from my week of poor health.
I admit that I'm not entirely proud of the way I handled the situation. Shakespeare nailed it when he said "Hell hath no fury like a woman scorned," only he didn't take into consideration what it's like to be THREE women. When the nurse (a different one than my phone buddy) came in, she remarked kindly over my son and said "He's a keeper!" and I replied "Really? I thought I had to hand over my firstborn in order to get an appointment today."
I've heard horror stories about non-OB doctors misprescribing for pregnant women because they didn't know any better, like Vicodin for pregnancy migraines. I felt that to get the right antibiotic I had to see an OB and I don't like it that I was forced to choose to be ugly or not get what I needed. I’m glad the situation was resolved, but it doesn’t exactly inspire confidence in the team of people slated to get me through the riskiest thing I’ve done so far.
Not that this is my first inkling that I would prefer to not deliver at UK. There’s the story of a friend-of-a-friend who labored to 8 cm in a hallway because they were short staffed and couldn’t prepare her room (or her epidural). Or my friend who battled an infection for a week after her son’s birth because they left her in L&D for too long and she didn’t get adequate recovery care. Also, UK is a teaching hospital. Since the birth of twins happens in the OR and is medically interesting, you might as well wheel the gurney to the three-point line at Rupp Arena and sell tickets. That’s how many people will be attending. Like it or not.
To console me, Dad reminds me that there are advantages to having the twins surrounded by a great cloud of witnesses. Giving birth is icky, but it’s better in my book than being whacked open like a Cinco de Maya piñata that sprays babies instead of candy. I’d rather not have a C-section. I’d also like to leave the hospital in my pre-pregnancy jeans and a belly shirt. We’ll see if that works out. My most vivid fear surrounding a C-section is that the surgeon will punch a few of my organs while he’s clearing me out and I’ll wake up piddling and leaking indiscriminately. According to my dad, it’s comforting to know that with that many witnesses, I’ll at least be a wealthy woman who pees into a bag for the rest of her life.
I think that making out a birth plan is audacious in the assumption that I actually can determine the course of a process that is unpredictable and entirely out of my control. But here goes:
My Birth Plan, In which I list my preferences of the upcoming “birth experience” according to priority.
1. Nobody dies.
2. Nobody has to be in the NICU. Or the ICU, for that matter.
3. I don’t have a C-section.
4. If #3 conflicts with #1 or #2, forget about it.
