Why I’m Skipping a Birth Plan

I have a *lot* of Google Docs, y’all. Spreadsheets for everything– what to pack when we camp in the summer, spring, or fall (three separate lists, obviously); literally every dollar I’ve spent this week; a running inventory of the freezer and fridge, by category and number of servings; u-cut Christmas tree farms organized by driving distance; family health histories; and guest lists for every last thing. I love lists.

I also love data– I’ve got (e)stacks on stacks on stacks of journal articles regarding various birth related topics, from the effectiveness of different pushing methods to the ACOG opinion on delayed cord clamping, from the impact of oral evening primrose oil on labor outcomes in low risk women to the efficacy of membrane sweeping. I like to think that I’m a pretty informed healthcare consumer.

Despite my love of lists and seeing things in black and white spelled out in front of me, despite my desire for a birth free of unnecessary interventions, I’m just not that into birth plans.  I mean, I kind of hate them. Don’t get me wrong– I think it’s great to know what you want from your birth experience, to go into labor with an understanding of your options and for preferences about those options, but I think that knowledge and agency start well before checking into L&D and continue right on through each and every contraction.

During my pregnancy with Winnie, I wrote four birth plans.  Two were before I was 20 weeks pregnant, one was for a birth that I am so glad I did not have to have (that one would have ended with Sascha-sans-uterus), and one was in earnest.  There are a number of boilerplate birth plans available online and in the myriad available pregnancy and birthing books–some of them more gag inducing than others–and not a one felt like it met our needs.  I wrote and rewrote the opening, “WE ARE SRSLY SO EXCITED FOR Y’ALL TO BE DOING MY CERVICAL CHECKS, REALLY!” statement about a thousand times, trying to convey that we were really happy with our choice of where to birth, that we were trusting and flexible, but there was an underlying implication with each plan that—for us—betrayed those basic principles of trust and flexibility.

I know lots of people find comfort and utility in birth plans, but despite initially being quite excited to put together this outline for the big day, despite pouring my whole self into hours of research about each and every possible preference I could have about the experience, it just never felt right.  Putting together a birth plan— or birth preferences or birth wish list or birth storyboard (no thanks!)— felt like sidestepping a conversation with my providers, like I didn’t trust them to respect my agency in the process or that I didn’t trust myself to communicate my preferences and engage as an active player who could make wise decisions.

And so, in a moment of wild abandon, I smacked my Hypnobirthing book closed and declared to Michael, “We’re scrapping the plans!”  He glanced up from the New Yorker and said, “Cool,” but I know he felt super liberated, too.  He held that magazine with a lighter grip, for sure.  It was like the whole issue just went Shouts and Murmurs on him.

It’s not because I wasn’t still committed to everything within that plan— I was and I am.  I still prioritize a healthy baby (like anyone ever prioritizes anything else, but that’s another topic for another day), a vaginal delivery, minimal intervention, and preserving a sense of agency in decisionmaking.  It’s because not having that plan enabled me to feel even more empowered to initiate conversations, participate in my birth process, and communicate my needs with immediate relevance.

After our first trimester worries flew by in my last pregnancy, and my attention turned to the whole “this-baby-needs-an-exit-plan” segment of pregnancy, I fastidiously went through each of the provider questionnaires recommended by natural birthing sites. Would I be allowed to have a hep lock rather than an IV? Sure, unless there was a medical reason for me to need IV fluids. Would I be able to have intermittent fetal monitoring rather than continuous? Sure, unless there was a medical reason for me to need continuous fetal monitoring. Would I be allowed to move from the bed? Sure, unless, you know, I couldn’t get out of bed due to having my lower two-thirds rendered useless for weight bearing by the whole “elective catheter in my spine” thing. Would I have to have an episiotomy? My doctor couldn’t remember the last time she had given an episiotomy, nor her colleagues. Could I labor in the shower? With a birth ball? Moan real loud? Get in touch with my inner llama goddess?  At this point my doctor looked at me and said, “Sweetheart! You can literally labor on your head for all I care, as long as everything is going well and there is no medical indication not to. THAT IS ALL I CARE ABOUT.”

The problem was, there was no way of knowing, for either of us, what that birth would bring. Premature rupture of the membranes? Non-reassuring fetal heart rate? High blood pressure? Probably not, and in my case, I didn’t have a single problem with any of those scary things. But what about the part where I didn’t go into labor, where despite all of our best efforts at shifting and moving and spinning that dang OP baby, her head just wouldn’t engage enough in my pelvis to dilate my cervix (Winnie was still floating way up high AFTER I was fully dilated, which meant I got to hang out with back labor funtimes while letting my babe take her sweet time down the birth canal)? I asked for Pitocin, and I asked for artificial rupture of my membranes, and before either of those things took place, I had a conversation with every person involved in implementing them.  When I checked in, a nurse asked me if I planned on getting an epidural as she took down notes that I was allergic to cats, dust, and codeine, and when I said “I don’t think so” that was the last time we talked about it (until many hours later when I think I maybe pulled a muscle begging Mike and our doula Jillian to please oh please go find an anesthesiologist and FAST). Mike and Jillian, with help from nurses, brought out birth balls and squat bars and rocking chairs as I seemed to need them, and tucked those things away that I wasn’t using. No one needed to consult a packet to find out if I wanted something. I just told them. 

I’m just not going to have a baby, or enter a practice, where someone can only push flat on her back or where episiotomies are routine or where a provider would perform a medical procedure on another person in an non-emergent situation without addressing it first.  I’m a human, and I expect that all of my healthcare providers know that, and that they’re humans, too. I realize that having the option of giving birth in a place where there isn’t overwhelming resistance to evidence-based practices might be a luxury, that I’m lucky to live in a place where evidence-based medicine reigns supreme, where statistics on birth interventions and outcomes are readily available, where medical education is ongoing and superb. But I also think that part of having a good birth isn’t luxury or luck, and it’s certainly not a piece of paper riddled with checkmarks, handed over with a box of cookies and a smile– I think that owning one’s birth depends largely on owning one’s agency, with maintaining a level of participation in each moment of one’s birth, and with building trust rather than opposition to one’s team of providers.

That’s my plan, anyway– to communicate my desires as I find them out, to ask all the questions I want and get answers, too. I plan for Mike to be my partner, to find out alongside him what works and what doesn’t. And if that doesn’t work, I probably have a Google Doc or two that will do in a pinch.

Birth Story, Part III

Read the first part of our birth story here.

Read the second part of our birth story here.

And then I had a baby!

That’s what I felt like, anyway, after months and weeks and days and hours on hours of waiting.  I was fully dilated!  Here comes baby!  I mean, all I had to do was push her out.  That was it!  That’s all!  Just use some sort of some kind of muscle-y thing, some special combination of squinching up my face and calling upon my inner tiger/lion/bear, right?

I’ve admittedly avoided writing this segment of my birth story only because this last phase— the most painful, utterly exhausting, downright gross (and shortest!) phase of labor yet— was my absolute favorite.  I would go through that handful of hours over and over and over again just to have that single moment of hearing sweet Winifred’s voice for the first time.  I hope I can do those hours justice in the retelling.

I was ridiculously excited to labor, particularly in the weeks before my induction.  I viewed the labor process as an endurance feat, an excruciating, overwhelming, ultimately rewarding experience.  I was, and still am, wowed by all that your body can and will do to protect and deliver another human from safe and snug inside of you, into a bright, bustling world.

I always found it funny—and difficult to remember—that pushing was the second of three phases of labor.  Surely it had to be third or fourth or maybe twentieth, what with all the prodromal labor and early labor and active labor and transition phase and whatnot. But no- everything until now had been one, cohesive phase, despite its ups and downs and stops and starts.  It was only now that we moved into stage two.  Looking back, this makes so much sense.  Even though each moment between when I was ready to meet that darn baby already and when ol’ Doctor Fully’s eyes got wide seemed so singular, so distinct, once I reached full dilation all of the hours previous ran into one another and the task before me suddenly came into focus.

Enough with the hippy-dippy pontifications— I was about to push this baby out.  This is the point where I apologize to my family members and friends with more delicate constitutions because it’s about to get rather real up in here, with a whole lot of colorful language and some fairly frank discussion of bodily functions.  So if you’re the kind of person who’d rather skip all of that, here’s the short version: I pushed, it hurt, and I fell in love again with my dearest Winifred Eleanor.

But if you’re not squeamish, here’s how it actually happened:

There we were, at ten centimeters of dilation, fully effaced.  This babe, though, still wasn’t in any hurry to meet the world.  She was hanging back at a -3 station, meaning she hadn’t yet begun to descend into my pelvis.  This wasn’t particularly surprising, since she’d been ‘floating’ during all of my previous exams, not yet engaged in my pelvis at all, but it wasn’t exactly great news, as it meant she had a bit of a trek ahead of her.  The actual great news was that Winifred had corkscrewed herself from the occiput posterior/face up position (which causes back labor and puts the skull in a less desirable position for descent) to occiput anterior/face down— the perfect position for descent.

In all my hippy woo-woo books about natural birth there were about a thousand warnings about how my doctor was going to want to give me a routine episiotomy for kicks, give me an emergency c-section so that he (she, in this case) could go play golf, force me to lay on my back, and generally ignore all of my preferences in favor of the opposite kind of birth that I’d hope for, all with the BUT DON’T YOU WANT A HEALTHY BABY line hanging over my head.  Nope.  Not my doctors, not a single one of them in a practice of seven.  I knew that in my gut before I went in, but of course I hadn’t been able to get a single doctor to say, “Sure, Sascha.  No-way no-how are we going to give you a c-section even if the most wild, crazy, dangerous thing happens to you or your baby!”  They would say, though, that their wish was for me to have a vaginal birth, and that they were going to advise every single thing in their power to make that happen— and, as I’ve stated before, that my voice would be a part of all decisions.  At this point, I had been in labor for 18 hours, in their care for 21, and not once had anyone made me feel like I was rushed— when they broke my water (yes!  AROM! in my hypnobirth!), they told me there was no 24-hr clock to race against; when I had only dilated a centimeter after twelve hours, at the max dose of Pitocin, they told me to get some rest and that they would check back in the morning.  Literally the only time anyone mentioned a c-section to me was well before I was induced, at one of my last OB appointments when my doctor said, “Hey, by the way— there’s this thing called shoulder dystocia, and it’s wild.  If we think it’s happening to you, someone’s going to mention the possibility of a c-section and I’d prefer if the first time you heard those words wasn’t in the heat of the moment.”  And that was that.

So, with all that said— here I am, babe waaaaaaaaaaaay high up in her little cocoon, with a fully dilated cervix.  I was giddy, high on adrenalin, and finally ready to DO SOMETHING.  When the doctor came back in, she had me do a test push while she conducted an internal exam, and I eagerly awaited her instructions.  ”So— what do I need to DO?” I asked, quite possibily squealing, probably panting, with my eyes likely twice their normal size. “Just go ahead and hang out.  Sit up, and kind of bear down a little if you feel a contraction.  You don’t have to push— just tense your abs and hang out.” Wait, what?  My assignment is to sit?  To chill?  To wait?  And no one is freaking out about that except me?

It turns out this was awesome, effective medicine— the practice of laboring down or passive fetal descent shortens pushing time, reduces fatigue, and results in fewer decelerations.  And passive fetal descent, for me, was just… hanging out.

I thought for a few minutes that maybe they had forgotten about me— or worse, given up.  But every so often a doctor would come in, ask me how I was, and then just leave.  No fiddling with the Pitocin, no internal exam. Just a quick check-in and then back out.  My epidural was turned off once I was fully dilated, and I was feeling plenty, but I couldn’t have cared less.  Bring on the baby!

Hours passed, and finally Dr. M, who had been with me throughout my 20+ hours of labor thus far, was headed home.  Dr. R. was taking over, and I was pumped.  Dr. R had been my GYN prior to my first pregnancy (when I switched docs because she was on vacation and I had those first weeks jitters).  She was brazen, dry, hilarious, and a total badass.  The perfect push coach.

It had been nearly four hours since my last exam, so she checked me again to determine any change in station.  Sure enough, Winnie had wiggled down to a zero station, with her head in the middle of my pelvis.  Eager to get this show on the road and meet my baby already, I asked again, “So, can I do anything to help from a zero to a +3?”  I expected her to suggest the birth ball or changing positions in bed or some sort of pelvic rocking.  ”Yeah,” she responded. “Push.”

Oh.  That.

Look, I knew this stage was coming and I was crazy, over the moon excited for it.  But I hadn’t the slightest idea what it meant to push.  Sure, yeah, push— just, what is that again?  The thing where I squish up my face and scream a lot?

I must have watched a couple dozen birth videos, the last dozen or so just of the pushing stage, to get myself ready for this.  I had learned a few things about myself, like that I will cry like an actual baby during any and all birth videos, but I hadn’t actually learned HOW to push.  What muscles are those?  And are you sure I have them?

So she coached me, and I practice pushed, and felt like I was expending a lot of energy and accomplishing exactly nothing.  I wasn’t quite ready to begin in earnest, so she gave me a minute to hang out and wait for a stronger urge to actually push.

As soon as Dr. R left the room, it hit me.  It had been over a day since I’d had anything to eat, but I knew that feeling.  I needed to take the biggest poop of my life.

I knew going into this, of course, that the urge to push might feel like the urge to have a bowel movement— that stuff is all quite close down there, especially with quarters being so cramped those last nine months.  But I was certain that this wasn’t the same.  No, even though every sign pointed to TIME TO PUSH, I was reading all of those signs as TIME TO POOP. NOW.

I told four doctors of this need, convinced someone just needed to get me to the bathroom, bring me a bedpan, just SOMETHING YOU GUYS I AM TELLING YOU I WILL PUSH AFTER YOU LET ME POOP.  Dr. R came back in the room, and I explained my predicament to her.  She nodded calmy, and said, “Okay.”  Finally.  Someone who listened. “Then poop,” she finished.

Even to begin with, I’m not an overly modest person.  I knew I was going to lose whatever modesty I did have as soon as I went into labor, and I certainly didn’t have any qualms about leaving the door of my absolutely sweltering room open during my roughest contractions in order to catch a breeze.  But even I— she who will write the word poop several times on her family blog— wasn’t about to just, you know, right in front of two doctors, my husband, a nurse, and my kind doula.

But of course, I didn’t need to— I needed to push out my baby, the sensation of which just so happened to correspond quite closely with the most intimate of bodily functions.  And finally, that clicked in my brain.  I asked for the squat bar (which, by the way, despite being CERTAIN that I wanted to push squatting, I forgot to even ask to have them bring over to the bed, because squatting was the last thing I wanted to do once I started pushing.)

I pushed.  I pushed, and I pushed, and I groaned, and I used every fiber in my body to do something that I wasn’t sure was working but oh boy, was it ever taking it right out of me.  The uncomfortably warm room had leapt right on into unbearably hot territory, so I ended up shoving giant bags of ice under my arms and on top of my head to keep cool.  I was running a slight fever, but Dr. R wasn’t concerned, since Winnie’s heartrate was stellar, and it was about a thousand degrees in the room.  I pushed with each contraction for a count of ten, with the whole team cheering me on, and then crashed out for 30 seconds of sleep before gearing up to do it all over again.

I must have pushed for the better part of an hour thinking nothing was happening, that all of my effort was futile.  I threw myself back from my sitting position and declared that I was doing NOTHING and that if this kept on, I wouldn’t be able to do it anymore.  So there.  Looking back, there’s no way I would have possibly abandoned pushing, but there is something about an exhaustion so deep, so consuming, that pushes you to say those things as a matter of protection— all I need to do is say this, and then I’ll feel better, and I won’t actually have to quit.

Dr. R knew this, of course (see mention above of badassery), and she looked at me with a glint in her eye and practically guffawed. “I absolutely love it when women say that,” she said, “because it means they’re almost there.  Now get angry and meet your baby.”

And I did.  I pushed every bit of me that had every existed, every good and bad decision, every feeling, every thing I had ever done or left undone.  I used the time between contractions to scream at the room, “It is absolute crap that only women have to go through this.”  And then it got a little essentialist and gender normative in there for a minute, but hey— it worked for me, and my doctor called me a goddess, which doesn’t happen every day.  At least not to me.

Before I knew it, everything was on fire, and I pushed through that fire and the most amazing thing happened.  The room changed, and everyone seemed on the verge of tears and euphoria, and I reached down and felt my baby’s sweet, soft, squishy head of hair, and like that— one push, two pushes— she was here.

She screamed a hearty scream and within seconds she was on my chest, in my arms, snuggled right in, and we were a family.

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Within the half hour, she nursed, we cried, and all of us were ready for a nap.  We waited for my blood pressure to come back up to normal (I maybe tried to leap from the bed a little too soon and maybe almost passed out a couple of times), I got a good look at that impressive placenta Winnie had gotten so friendly with over the last few months (Seriously, excellent work, placenta.  Hope you don’t mind that we told Winnie we sent you to a farm upstate when we actually tossed you out like yesterday’s news.  Nice knowing you!) and we headed upstairs to recovery.

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It was the best day of my life.

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Welcome, Winifred Eleanor! + Birth Story, Part I

First things first:

On Saturday, June 8th, at 11:04 am, in the warmest room at Beth Israel Hospital, we welcomed our daughter, Winifred Eleanor Guinn Anderson, with her wide eyes and mess of silken hair, into our arms.  She weighed 8 pounds, 10.5 oz, measured 21 inches long, and had the softest skin and most wonderful smell I’ve ever smelled.  She snuggled on Mama instantly, and was nursing within a half an hour.

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If I were to write about every moment of the week of prodromal labor leading up to the birth, my birth story would give Homer a run for his money.  Instead, suffice it to say that I contracted for hours on hours- but the contractions would be regular but not painful, or painful but not regular, or regular and painful but not frequent enough, and at some point they would fade or something else would signal that these were not, in fact, THOSE contractions, and I would cry or sleep or throw myself into some nesting project and hope that it would all begin, in earnest, soon.

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Nope, still not twins, but thanks for your input, lady at Target.

Based largely on this review of randomized controlled trials, as well as conversations with our providers throughout the pregnancy and the fact that my cervical changes and other signs deemed me a good candidate for successful induction, we decided to begin induction at 41 weeks.  The evidence demonstrated, to us and to our providers, that expectant management past 41 weeks carried a small (really, very, very small) risk and didn’t appear to improve our ability to avoid a C-section.  I feared induction more than almost anything else during the pregnancy, but felt confident in the literature and my doctors.  Further, my doctors didn’t pressure me in the slightest to induce— we calmly discussed my situation in light of the evidence, as well as their experiences, and they reiterated many times that I had the option to choose whatever date I liked to schedule induction (as the scheduling needed to be done for logistical reasons) so long as my 40 week biophysical profile was reassuring.  It was, and above all else, I felt in my gut that this was the right thing to do.

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The first of many, many walks, during which it appears I’m trying to jiggle the baby out.

In the days leading up to labor, I tried every gentle, natural method to get things moving that we could: I ate multiple whole pineapples daily, gobbled licorice by the handful, went for five-hour walks, and engaged in a few other activities I’d rather not mention in a space that my grandmother may read.  We didn’t go for castor oil, evening primrose oil, or blue cohosh or any of the other more intense herbal induction methods because in my mind, those were induction methods just the same as the one I feared— and they were in some cases correlated more highly with pregnancy complications that would undermine my desire for a vaginal delivery.  I know that those methods have helped many, many women, but I knew that they just weren’t for me this time around.

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In which I unsuccessfully attempt to hide, on our last walk at Brooklyn Bridge Park.

I took time each day to quietly observe Winifred’s movements to determine her position.  She remained occiput posterior throughout the week before she was born, and I was convinced that her position was preventing further descent, as an OP presentation makes it more difficult for the head to fit neatly within the pelvis.  When I wasn’t walking or chopping up another pineapple, I was glued to Spinning Babies, trying all manner of inversions and hip circles, along with Walcher’s and abdominal lifts when I was contracting.  I knew that most OP babies turn in labor, and I also knew of plenty of mamas who delivered their babies OP with no problems at all, but I wanted to do everything I could to help make Winnie’s trip to meet the world easier and, well, sooner.

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This what an inversion looks, in case you were wondering.  It’s super flattering.

Try as we might, this little one was snug and cozy in mama’s growing belly and it turned out she needed more than a little coaxing to come and join us.  In the wee hours of the morning of Friday, June 7th, I lept out of bed to meet Mike— and bacon, eggs, and coffee— in the kitchen, where we puttered around making sure all was in order while trying not to wake my mom.  We watched the sun rise from our kitchen window, double (triple and quadruple) checked our list one last time, and slipped out the door to head to the hospital.

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Mike diligently reviewing the dogeared pages of Penny Simkin’s The Birth Partner.

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My little nest in the corner of the waiting room.

We arrived two hours before our scheduled induction, and spent a few hours in the waiting room watching terrible morning shows abuzz with news of the Cronut while I scarfed granola bars like each would be my last (24 hours of hard work on an empty stomach is no joke!).  Finally, a nurse lead us back to a labor room with a view of the Chrysler Building and the torrential rains of Tropical Storm Andrea.  Soon enough, my IV was in and, after a chat with the attending physician, the Pitocin drip began. We texted our wonderful doula Jillian, and she made her way in from Brooklyn to meet us.  One way or another, after months of waiting, we were going to meet our sweet bean.

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Our last photo as a family of two.  

Birth Story, Part II

The Scary Stuff

For all the close calls and near misses that we’ve had in this pregnancy, not one single less-than-stellar thing that’s happened so far has been something I anticipated or feared ahead of time.  Don’t get me wrong, I have PLENTY of fears, but I never for a second was afraid of placenta accreta, or getting the flu while away from my husband, or falling off a curb in my 35th week.  Dealing with each little stumbling block— and to be clear, we’ve been very, very lucky this pregnancy, as mom and baby are both healthy and whole— has been an exercise in who we are and how we cope.  The day after I fell, I was all sunshine and rainbows until I walked into the bathroom to get dressed to go home (and eat after 36 hours, hooray!) and I burst into tears, finally admitting to myself that I had been scared beyond belief by the fall and the subsequent contractions, that I had been afraid for my baby, and simultaneously felt guilty that a tiny part of me actually just couldn’t wait to meet her.

There were good parts, too, of course— we discovered that our hospital team is truly fantastic, that Michael and I work well together in that environment and that we’re on the same page even when in a stressful situation, that Michael’s actually been reading the Birth Partner and not just slipping the New Yorker in behind the cover, that I won’t start eating him if I can’t have food for 36 hours.  We learned that our hospital team shares our birth philosophy, that they will explain absolutely everything along the way, and that they will ask first thing if I plan to have an epidural, and when I saw, no, I don’t think so, they won’t raise their eyebrows and tell me it’s going to be worse than I think it is.

At our first childbirth class, our instructor asked us to share what we were most afraid of.  It wasn’t that I didn’t have any fears, of course— I had plenty of fears about the pregnancy— but I had been so focused on preparing for the birth that I hadn’t stopped to think about what I was supposed to be afraid of, only what I was supposed to know and do.  ”I…. I… um… I haven’t figured out what to be scared of yet,” I stammered.  And it was true!  In the subsequent weeks, I grappled with a number of fears, most notably induction, now looking like a real possibility as the days past my EDD tick by— but none of them has overwhelmed my intense desire, bordering on an almost reckless giddiness, to just DO THIS.

I can’t wait.  I can’t wait to meet my daughter.  I can’t wait to see her father with his daughter in his arms for the first time.  I can’t wait to be her mother.  I can’t wait to watch my body do crazy and really, truly, actual-meaning-of-the-word awesome things.  I can’t wait to hit a wall of difficulty and come out on the other side, with my family.  I know the scary stuff hasn’t even begun, that I’m looking at a lifetime of gasps and worries, but I just can’t get over how much love we’re going to get and give over the years to come.

On a side note, do you think they’ll let me play The Final Countdown in the delivery room?

Books on books on books

I have a problem.  A major, abiding problem with reading books.  If you’re in the market for a few dozen books on pregnancy, childbirth, and infant care, have I got a list for you:

On Pregnancy

After a few weeks, I figured out that my body doesn’t actually need any books to tell it how to grow a healthy baby— it is perfectly capable of doing that on its own.  Find a book, or series of books, that speak to you in a tone you enjoy, whose organization makes sense to you, that offer a number of perspectives, and that have been updated in the last few years, and you’re set.  Your body can do all the rest.  At some point the Baby Center emails about what fruit or vegetable your fetus is will start to make you mad/make zero sense, and you won’t care if you’ve read about pelvic floor pain or not when you try to roll over in the night— you’ll mostly just want a list of creative expletives.  There’s a million dollar idea for you, pregnancy book people: “Creative Cusses for the Expectant Mother”.

I found that pregnancy books will, on the whole, assume a few things about you:

  • That you are straight
  • That you have a partner, and that he is your husband
  • That your husband is kind of an idiot, who loves you very much, doesn’t understand feelings/how babies are born, and wants to have sex with you all the time or is really freaked out by having sex with you
  • That you have a doctor who will tell you nothing/everything
  • That you are not already scared enough, so it is the book’s responsibility to scare the peewadden out of you (not that hard, since you’re pregnant, and as you learned in Chapter 54, you might have to go to the bathroom more, hehehe, haha, omg, having a baby is so grooossss!)

I don’t have any books about nutrition for mother and baby below, primarily because I had access to a lot of wonderful resources in non-book, real-live-person form, and secondarily because much of what is written about nutrition in trade books is, in my total layman’s opinion, at best misleading and at worst flat out wrong.  Don’t get me started about the varied and erroneous statements made about cheese and dairy in nearly every book I read. Eat to replenish what your baby needs from your body to grow and avoid pathogens.  Talk to your healthcare provider.

YOU: Having a Baby: The Owner’s Manual to a Happy and Healthy Pregnancy

This is my favorite book about pregnancy, though I wouldn’t recommend it as a comprehensive go-to resource.  I just loved the way the book was organized and found that it made learning about pregnancy fun- a way to geek out about what was happening in my body (epigenetics, anyone?). It’s basically a comic book about having a baby.

The Pregnancy Book (Dr. Sears)
Perhaps the most outdated of this group, but I felt it was quite comprehensive and helpful.  I disagree with Dr. Sears on a number of issues, but I appreciate that he included, for the most part, a variety of perspectives and information on competing viewpoints.  He advocates empowering women to make choices in childbirth without undermining the importance of trust between a woman and her care provider— and this was a balance I found lacking in nearly every other book I read. Heteronormative and at times patronizing to women, but that’s sort of the norm for many of these books, and it’s not so pronounced here as in others.

These two were perfectly fine:

Mayo Clinic Guide to a Healthy Pregnancy

You and Your Baby Pregnancy: The Ultimate Week-by-Week Pregnancy Guide

On Birthing

Here’s where some reading can come in handy— or did for me, anyway.  While being pregnant had a pretty predictable pace and required very little effort on its own (except for such wild tasks as “standing up out of bed” and “putting on pants” and “walking up one flight of stairs”), birth was going to be A Thing. Plus, to me, birth was and is fascinating— there’s so much going on, so much your body just DOES, and so much you get to be an active participant in.

UPDATE: I had a baby, and I’m not going to lie— I was glad I read all of the books I did!  Some things were more helpful than others, sure, but the security I gained from what little bits of knowledge I gleaned helped me to better work with my team of heathcare providers, my husband, and my doula.  I’ve modified some of what I wrote below post-actually-having-a-baby. Specifically, two books not mentioned here were tremendously helpful.

The Birth Partner

Hands down the best book-helper for birth there is.  The best part is that, if you’re having the baby, you don’t even have to read it!  You can, of course, and the information is fantastic, but this is really a comprehensive resource for your partner— who can be your spouse, your mom, your doula, your friend, whomever you choose to be by your side for your birth.  Penny Simpkin outlines nearly everything you could need to know about birth, illustrates positions to help you cope, to help labor progress, to help you push, and gives specific advice to your birth partner to help aid you through you birth.  Knowing that Mike had read this book, that our childbirth education classes were based on this book, and that our doula dug this book (she brought over copies of the positions in the book before she knew we had read it— which Mike recognized, thus earning him major birth bonus points) gave me such a feeling of confidence in my little birth team.

The Big Book of Birth

The author of the Big Book of Birth, Erica Lyon, is the Director of Education for the entity that hosted our childbirth classes, and I found her approach to align really well with ours: she promotes minimal intervention but notes that intervention can be lifesaving, stresses the need for a trusting relationship with your provider, and gives you the opportunity to advocate for yourself and your desires (even if they include an epidural!  even if they don’t!) throughout the process.  Plus, it’s not all that big— a pretty quick read compared to the others!

Mindful Birthing: Training the Mind, Body, and Heart for Childbirth and Beyond

This, along with Hypnobirthing, is going went in my hospital bag, and will be  was dogeared and worn out by the time Bean makes made her appearance.  Chock-full of concrete exercises to help both partners deal with whatever happens in the birthing process, I feel like Mindful Birthing, unlike some other books on this list, doesn’t set you up for failure or disappointment if your ‘perfect birth’ invariably goes awry— it teaches you to cope and roll with the punches.  That flexibility gives everyone involved a better sense of control, and, I think, ultimately leads to healthier outcomes emotionally.  The pain management techniques contained within were also more digestible and realistic to me.  Post-birth: I do wish I would have practiced some of the exercises contained in the book more— I think it would have helped me to stay more focused.  There is a ton of narrative in the book that isn’t really necessary, but if you use your ol’ skim and scan skills, the content can really help with pain management and maintaining a sense of agency.

The Healing Power of the Breath: Simple Techniques to Reduce Stress and Anxiety, Enhance Concentration, and Balance Your Emotions

This isn’t a birthing book at all- in fact, it’s something I used prior to getting pregnant to treat anxiety and panic attacks.  The techniques promoted, though, are exceptionally effective at reducing anxiety and helping one feel in control, while actually reducing physical manifestations of stress.  I plan to use many of the breathing exercises during labor. Post-birth: Seriously awesome.  I probably used the breathing exercises from this book more than anything, especially once those contractions (pitocin!) got going.  They were also helpful for working through early nursing struggles and my late onset postpartum depression. 

HypnoBirthing: The Mongan Method

Skip the first few chapters on how women used to birth strapped down on tables, totally knocked out, without agency or awareness because really?  Do you really need someone to tell you for the four hundred and thirty fourth time how bad birth used to be?  SO BAD, y’all.  I get it.  I’m an informed woman who trusts my body.  Now treat me like the informed woman who trusts my body that you say I am, Natural Childbirth Books.  FOR THE LOVE.

Beyond those brief chapters, this book is a goldmine.  I love the breathing, relaxation and visualization exercises, as well as the physical exercises and information on birthing.  I place a tremendous amount of weight on the power of language in my day to day life, and I appreciate the alternate vocabulary used in Hypnobirthing to eradicate negativity from the birthing process.  I don’t think I’ll use exclusively Hypnobirthing techniques in my birth experience, but this has been the most powerful and helpful resource about birth that I’ve read so far.   Post-birth: A sleeper hit! I dug into Hypnobirthing much deeper in my last few weeks, and Mike and I started practicing the visualizations every night.  I do wish we would have started that earlier— I’m even considering a Hypnobirthing class for our next baby.  The birth breathing in particular was great for pushing.

The Birth Book: Everything You Need to Know to Have a Safe and Satisfying Birth  (Sears)

The Sears family clearly advocates for minimal intervention, but again, aren’t so rabidly anti-intervention that they eschew smart choices. Trust with one’s care provider is reinforced throughout, and it gives women the tools to pursue the kind of birth they hope to have— without promising that anyone will end up with the exact birth they plan.  They review a number of birthing techniques without pushing one over the other.  But oh my god, if I have to hear about how Martha Sears has painfree two hour labors one more time, I’m going to light this book on fire— and then buy another one. Postbirth: After reading fifty ka-thousand books, the only thing I remember from this book were the birth stories.  In my last few weeks, I gorged myself on birth stories, walking through every imaginable iteration of childbirth— the good, the bad, and the ugly— in an effort to have some control over the uncontrollable.  If, like me, you need to live vicariously through dozens of other women to feel ready for a birth unlike any other, go for it!

Husband-Coached Childbirth (Fifth Edition): The Bradley Method of Natural Childbirth

The Bradley Method has crazy high numbers for intervention-free births among its adherents, but I couldn’t get past the inherent heteronormativity and paternalistic tone of Dr. Bradley himself.  I’m certain a good number of Bradley practitioners would agree with me, but I had to just toss this book to Mike and ask him to fill me in on any good stuff.  Recent editing has softened some of the “Listen up, ladies” rhetoric and certainly having an active, supportive birth partner is important, but I’m not sure this was the right resource for us.

Ina May’s Guide to Childbirth

My body is awesome— it’s growing a whole baby entirely on its own as I go about my business, and I have every faith that it has a darn good idea of how to get this baby out into the world, too.  Ina May’s Guide to Childbirth reiterates this, and points to numerous birth stories to illustrate how awesome a woman’s body can be.  I didn’t find, though, that this was a guide to childbirth for me— I don’t find myself reaching for this book for information or helpful tools because I didn’t find it particularly helpful in those areas.  Sure, I enjoyed (most of) the birth stories, but I don’t feel that the book creates enough space for those of us who want to have minimal intervention but aren’t planning to give birth on a communal Tennessee farm with eleventy-nine women attending. I felt like it was a litany of ways the medical establishment is ‘doing it wrong’ without any real assistance for a woman trying to navigate within those establishments.  And that’s perfectly fine if you’re not trying to navigate within those parameters, but I was, and I needed the via media of childbirth books.  This is not that.

The Actual ‘We’re Going to Need to Raise This Bean’ Baby Books

The Baby Book, Revised Edition: Everything You Need to Know About Your Baby from Birth to Age Two (Sears)

Lots of solid information, tempered with the personal recommendations of the Sears’ clan.  The information about going back to work after giving birth, though, is a tad guilt-trippy.  To be taken with a few grains of salt (after, of course, the ankle swelling goes down).

The Baby Sleep Book: The Complete Guide to a Good Night’s Rest for the Whole Family (Sears)

We love many of the attachment parent principles, but I’m also determined to raise a child who can soothe herself back to sleep by the time she’s reached, say, 25.  While this book contains some great information on infant and toddler sleep patterns, it’s pretty heavily tilted toward the cosleeping/attachment parenting bent.

The Happiest Baby on the Block

Full confession- we actually only watched the video and have yet to read the book.  Still, it looks like a solid start to soothing very young babies.  Also, this.  Postbirth: we used this a lot, but just google the 5 S’s and do what you’ve gotta do to get that baby to nap.  I remain unconvinced that this is anything more than an attempt to distract parents from the fact that babies just cry, and you just need to feed/change/snuggle them when they do, and then they still sometimes cry.  Here, make a funny noise and turn your baby into a burrito!  Problem solved!

The Nursing Mother’s Companion

I’m limited in my ability to assess how useful this book is, but it’s certainly answered all of my breastfeeding questions thus far, and I anticipate using it lots in the coming months. Postbirth: THIS WAS/IS THE BEST.  I still use it, 15 months later.  I used it in the hospital right after Winnie was born, I used it after she came home, I used it at 2 weeks and 6 weeks and 8 weeks and 4 months when I started pumping and 6 months when she started food and again and again and again.  I love it so much.  Also, the Womanly Art of Breastfeeding is good, too, but this one.  It’s broken down by phases of nursing, with a ‘survival guide’ for each one— a summary of everything you need to know.  It doesn’t make nursing scary, but it does give any struggles you have due weight.  And while I know breastfeeding is ‘natural’, it’s not always intuitive, or if it is, that intuition doesn’t guarantee ease.  

Eat, Sleep, Poop: A Common Sense Guide to Your Baby’s First Year

I LOVE THIS BOOK.  I’m ridiculously paranoid, clearly research too much for my own good, and this is the book that calms me down and balances my neuroses.  Dr. Cohen presents an overview of information on a given topic, followed by his own common sense recommendation.  The tone is non-judgmental and without agenda.  In places he’s probably a little more relaxed than I plan on being, but it’s a great balance for my worrying nature.  Dr. Cohen mentions how much of an idiot his wife thinks he is an uncomfortable number of times, but I wouldn’t let their particular marital relations overshadow a perfectly competent book.  Postbirth: Great until about the 6-9 month stage.  Short, easy.  A nice read when you’re up at 3 am nursing.

The Preemie Primer: A Complete Guide for Parents of Premature Babies—from Birth through the Toddler Years and Beyond

I’m least qualified to offer my opinion on this book, as I only picked it up when Mike and I thought we might be having an early C-section for medical reasons (that later resolved).  Much of the information was interesting and enlightening, but the tone was frightening, and the author is clearly still struggling with the trauma of her premature labor experience.  Helpful, I’m sure, for parents of premies, but perhaps not for those at high risk of preterm labor or overly cautious people like me who just want to be prepared.

How to Rock Your Baby: And Other Timeless Tips for Modern Moms 

Adorbs.  Learn how to sew a teething bunny and rock your baby from people like Rachel Maddow’s mom (and who wouldn’t want to raise a tiny Rachel Maddow?).

Next up on the reading list:

The Thinking Woman’s Guide to a Better BirthSkipped this one.

Your Self-Confident Baby: How to Encourage Your Child’s Natural Abilities — From the Very StartI disagreed with a good portion of the newborn guidance, but do love this for the 3 month+ stages.  Janet Lansbury does a great job of positioning Magda Gerber’s work in contemporary context.

Birthing from Within: An Extra-Ordinary Guide to Childbirth PreparationSkipped this one because I already had enough crafting on the horizon without needing to craft my feelings on birth (I’m kidding, of course— I just didn’t feel like I could commit!).

The Mommy Plan, Restoring Your Post-pregnancy Body Naturally, Using Women’s Traditional WisdomI still read portions of this outloud [particularly the bit in the voice of an anthropomorphized placenta] for friends after a couple of drinks, just for laughs.  Not my jam, but good for giggles.

I wish I would have read these:

Active Birth: The New Approach to Giving Birth Naturally

Childbirth Without Fear

But I still had one heck of a baby without them!

 

She’s Lost Control (Pregnancy Remix)

Hey, remember when I used to be cool(er) and listen to music with words?

Those were the good old days.

/rhetorical device.

Everything about Mike’s and my relationship from the moment we met felt very much within our control, in a really delightful way.  There hadn’t been any obstacles to our dating, to our engagement, or to our marriage.  Sure, there was work to be done, conversations to be had, misunderstandings and disagreements to resolve, but everything at every moment felt right, and we felt as though we could and would do whatever we put our minds to.

When we found out we were pregnant for the first time last March, we didn’t immediately feel entirely out of control.  We had decided to take a ‘we’ll see what happens’ approach to our first year of marriage, and the news was exciting and new, but not unexpected.  We were thrilled and a little overwhelmed, but completely unaware of how little control we had.

In a few months, when we lost that pregnancy, we knew exactly how little control we had, and we quickly learned how very much we had to lean on in the absence of control: one another, our family, our friends, and our faith.  I don’t think we were aware that we— or I should probably say, I— had been desperately and thoughtlessly clinging to the idea that we had precise control over every aspect of our lives, and certainly those things that were most important to us.

Then followed a few months that in reality flew by but in our minds dragged on and on.  I tried every single possible way to regain the control I felt I had lost in the months prior.  I wanted to control the narrative of my loss, to control the ease with which we would begin again, to control the very functions of my body through detailed recordkeeping and data gathering.   And each month I was reminded that I just couldn’t, just didn’t— that all the effort in the world wouldn’t magically effect change.

In August, we decided to take a break from temperature-taking and charts and schedules.  We went on vacation, I drank some beers and ate a moon pie for lunch on my birthday, we went swimming and bowling and I learned that I was really, really afraid of bees.    I took a pregnancy test out of habit, and then promptly forgot to check it.  The next morning, I realized I had left it out overnight, made a grossed out face, and started to toss it in the wastebasket— at which point I noticed a second, positive line.  I took four more just to be sure, and we jumped around and giggled for a solid half hour.

The worrying took over soon after, making each day of my first trimester (compounded by intense, crippling nausea) feel like a thousand years.  Worrying is its own means of control, a way to feel as though you are doing something when you absolutely can’t do anything.  If I could worry and stew every waking moment, then surely nothing would slip by me, no little sign of distress or impending doom.  Worrying was my way of knocking on wood every moment of every day.

Once my second trimester started, I still worried, but a little less every day.  I found myself exclaiming to Mike, “I think this is really going to happen!” including at highly inappropriate times, like during our anatomy ultrasound when I turned to the technician and said, “I think we’re actually going to have a baby!”

After that ultrasound, during which our wiggly bean felt rather modest about showing off all four chambers of her heart, they scheduled a follow up to get a better look, and mentioned that there might be something a little off with the uterine lining, though it was probably nothing.  For the first time maybe ever, but certainly in the last four months, I didn’t worry about it.

We went back four weeks later and bean showed off all four of those chambers like a champ, but that strange little area near the placenta hadn’t gotten any less strange.  It could be nothing, our doctor assured us, but it also could be something, and she wanted us to know that that something could have a significant impact on our birth- up to and including an early c-section and a hysterectomy.  I trusted her implicitly, and the odds were in our favor— the condition she suspected is most often found in women who have had multiple c-sections, and my chances were statistically minimal—but I couldn’t shake the feeling that she had seen something— another something in a long line of somethings that I had zero control over.  Come back in four weeks, she said, and we would have a better idea of how to proceed.

Within hours, it was back to constant worry, to a state of flux that felt, on the one hand, totally unjustified, and on the other hand, like an inadequate reaction to the looming possibilities.

I couldn’t do any exercises, take any vitamins, or read any books to make myself NOT have a particular condition, and while it was infuriating, it was also exceptionally comforting to realize the kind of trust I had placed in my doctors, and to find that trust held true in the face of my fear.  Because I’m a nut job, I had my birth plan written at 20 weeks, the first line of which reiterated that our primary goal was to leave the hospital with a healthy mom and baby, and pledged flexibility to meet that end.  Far early than I had expected, I found that- in spite of my inner monologue- that was still true, and I was capable of flexibility and trust.

Yesterday my doctor called with the results of the follow up ultrasound: a delightfully unremarkable scan, normal on all counts.  So normal, in fact, that the technician was confused as to why on earth the doctor would want her to record so many images.  I was boring my doctor to tears, and I couldn’t have been happier.  We’ll go for another follow up, just to be sure, but all signs point to ‘Calm down and trust your body, Sascha,’ which I’ll be working to do over the next 25 years or so.

It’s only 40 weeks, and we’re facing at least a few decades of feeling roundly trampled by a lack of control.  I can’t help but feel grateful that we’ve been dragged through a little mud over the last year, because we’re better for it, more prepared to be totally unprepared for what lies before us.