"Let me take a look at your birth plan." I smile sweetly, but inwardly cringe. With their stack of pillows, exercise ball, and aromatherapy setup, this couple clearly has some preconceived notions about labor and delivery. It's going to be a long night.
Jeff, the father-to-be, eagerly digs through an overstuffed satchel, then triumphantly hands me the pink page, complete with a decorative font and pictures.
"Okay." I adjust my reading glasses. Tawnee & Jeff's Birth Plan: We are looking forward to a fantastic birth experience at Valley Hospital. We understand plans can change, but we would like for our wishes to be honored as much as possible, and that we will be advised regarding all medical procedures so that we can make informed decisions. "Great start, guys. I like that you're open to any changes."
Tawnee fidgets in the bed and furrows her brow. "We're open to changes, of course; that's why we're here. But you will be able to honor most of our wishes, right?"
I smile again. "I'm sure we can, yes. I'll compare your desires to our protocols, and we'll do our very best to stick to your goals."
Back to the birth plan. I quickly scan the page, looking for familiar phrases seen on most written plans, often copied from standard internet sites. Some parents even print out pre-written plans with check boxes. This one has its own personalization, but the key words stand out easily to the trained eye: intermittent monitoring, drinking liquids instead of IV fluids, natural methods of inducing labor, freedom to choose positions, no offering of medications by nurses, etc.
"How's that contraction?" I ask, my peripheral vision having caught the start of it on the monitor screen.
Tawnee breathes in and out slowly, closing her eyes. Jeff leans closer and reaches for her hand. "Shh...she prefers we not refer to them with that word."
I resist the urge to roll my eyes. "What are you calling them?"
"Surges." He stares at her face. "Great job, honey," he cheers as the contraction ends.
"How was that 'surge'?" I repeat with the corrected term.
She smiles up at me. "It was definitely stronger, but I think I can handle it."
"Well, your endorphins will build up as you labor, so you should be able to tolerate stronger and stronger 'surges.' Just remember to relax, breathe, and take one at a time. Natural labor isn't easy, certainly, but you can do it if you remain focused."
"So how soon can I get up out of bed and walk around?" She leans into the pillows Jeff has positioned for her back.
"We'll monitor for twenty minutes to make sure the baby's okay, and then you can walk if your doctor okays it." I lay the birth plan on the counter.
She frowns. "Of course he'll okay it. He totally signed off on our plan in the office."
I clasp my hands together, and choose my words carefully. "It's probably okay, so we'll just make sure the doctor agrees. You may have some expectations of how things are going to go, but the doctor and I have worked with hundreds of laboring women. We have a slightly different perspective."
Jeff sighs. "See, darling? We're in great hands. Just trust the doctor and the nurses. They know what they're doing."
Ah, the voice of reason. This I can work with. "Great. Well, I'll give the doc a call, and you breathe through some more 'surges,' and we'll be on our way to having a lovely birth."
They smile at each other, and I duck out of the room. A quick call to the doctor ensures that the plan will be followed to the letter, and I breathe a sigh of relief as I gather extra towels and blankets. Maybe it won't be such a long night.
"Great news, Tawnee," I start, as I walk back in the room.
Jeff gives me a panicked look as Tawnee moans, rocking back and forth on the bed. "You wanna tell us about that epidural?"
"Um, is there a reason you're asking? This isn't on your plan." I indicate the light pink page still lying on the counter.
"Forget the plan! This hurts!" Tawnee squeezes Jeff's hand until it turns red.
"Well, yes, it does. Do you want to try walking around, or using the shower first?" I offer.
She shakes her head violently. "No. Epidural. Now."
Sigh. Yep - it's gonna be a long night after all.
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