The Best Laid (Birth) Plans

Or, my most prized possession

The calm before the storm. Photo courtesy Teresa Vittorioso-Fortin.

“Oh, you’re going to be one of those patients.”

I’m sitting at the end of the exam table, and the nurse practitioner looks up at me from her rolling chair. She’s just had a look at my cervix, which appears to be behaving itself for the time being. I, however, am clearly not.

“One of what patients?” I say. All I did was ask how to be sure our birth plan is referenced when I check in to the hospital on labor day. Don’t all patients have a birth plan?

She explains to me how doctors get a little uppity when patients come in and tell them how it’s going to be done. Anything can happen, after all, and they’ve attended hundreds of births. Doctors don’t like patients who think they know more than the professionals.

She doesn’t want me to be one of those patients.

“Well, I just…” I stammer, clear my throat. “I can be flexible. I know unexpected things happen. I just want the doctor on call to know what my plan is.”

She beams her reluctant, condescending smile up over my knees. “Sure,” she says with a sigh. “Fill it out and give it to me. We’ll be sure it’s in your file.”

Pregnancy has been pretty uneventful on the outside. My numbers have been good, ultrasounds have been normal, and there’s no gestational diabetes (thank goodness, because my diet has consisted entirely of carbohydrates since the pukey days at the very beginning). I’ve read every page of What to Expect When You’re Expecting, and also The Girlfriend’s Guide to Pregnancy. I check my pregnancy app every Wednesday to see what kind of fruit is taking up space inside my womb. I hold my husband’s hand up to my belly when the baby rolls around. I’m having anxiety dreams about breastfeeding: the baby eventually turns into our dog, Macie, and all of a sudden I’m Red Riding Hood and oh what sharp teeth you have, baby! So, basic pregnancy stuff.

But on the inside, I’m a ball of emotion wound so tight, I can’t tell where excitement ends and nervousness begins. I just want to get this part over with already. Meet the baby, settle in, move to to the next phase of life, and get out of this holding pattern we’ve been in for nearly a year.

First, though, I have to actually give birth. And I have some ideas for how I want it to go.

Back at home, my husband and I sit together and fill out the ten-page document we printed out from the internet.

What do I want? That part is easy. Natural birth. No medication. Skin-to-skin. Breastfeeding support. All the natural things you can think of. If a woman would have done it a thousand years ago, that’s what I want.

Some prompting questions follow: What will we bring as snacks to have during the birth? Where will dad stand? Will he cut the cord? Will we be bringing a videographer?

“Wait, a—” I start.

At the same time my husband says, “A videographer?”

We look at each other and explode in laughter. “I don’t need anyone else seeing that,” I say as I check the No box.

We finish the form, which forces us us to think through the things that might happen during a birth and ignore the ones that don’t align with my plan.

Of course, some of those things end up happening. Two weeks before my due date, my water breaks but doesn’t really break but definitely breaks a little. I go to the hospital, where they give me the choice to go home and wait for labor to start (and risk infection) or stay in the hospital. I stay in the hospital, where after a few hours they start pressuring me to start induction medication. I eventually consent, and it is terrible, and within a few more hours I’m begging for the epidural I swore I’d never get. It doesn’t work (but it does knock one of my legs out of commission for the next 18 hours), and they have to place it again a couple hours later.

I sleep and wake up, and they check my cervix for the hundredth time, and eventually it’s time to push. The doctor is apparently busy; it’s just me, the nurse, and my husband in the room. My husband, who was definitely planning to dab at my forehead with a wash cloth and leave the bodily fluids to the professionals. But he grabs a (dead) leg and watches as his first child makes her way out into the world at 11:52 AM.

12 years later, we both remember the day with immense clarity. No videographer required.

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For the next baby, we hire a doula. We were unhappy with just about every facet of our hospital experience the first time around and hoped that having an advocate would help this time around.

“Will anybody else be in the room?” she asks at one of our meetings. “Family members, photographers, anyone?”

My husband and I laugh once more. “Nope,” I say. “Just the two of us. And you!”

The contractions start at 3:30 AM, and by the time we meet the doula at the hospital, I’m 8 cm dilated. At 8:13, baby #2 arrives. Natural births are apparently unusual at this hospital (which is no surprise considering my first experience), and it seems the entire teaching and learning staff watches as she navigates her way into the world. I wonder how vivid their memory is of this event.

I remember my doula standing at my shoulder, coaching me through my contractions. I remember refusing to let them break my water. (It broke on the second push.) I remember them taking her and helping her breathe. And I remember turning to my husband at the end and saying, “I’m never fucking doing that again.”

In 2020, I do it again.

After #2 was born, I always said if I were ever to have another baby, I’d do it at home. But by the time I get pregnant, many years have passed and it isn’t hard to convince me that it would be good to have medical staff and equipment on call.

We change practices, choose a hospital that has both doctors and midwives, and hire a doula.

And then the world shuts down.

We hear tales of people giving birth wearing masks, without their partners or their doulas, alone in a room with a practitioner and a prayer. All the local hospitals are changing their rules daily. The unpredictability is intolerable.

We find a midwife and decide to have the baby at home.

The contractions, once again, start in the morning. It’s Easter, and I grip the countertop with white fingertips while the kids open their baskets, showing me the socks and the candy and the coins. I bake some banana bread. My husband fills the tub.

The doula comes. Two midwives come. No one checks my cervix. My water breaks at 2:30, and I go into the tub.

“Do you want me to take some pictures?” the doula says.

I nod. “Sure,” I say, pointing her to where my phone is. Aside from checking the baby’s heart rate a few times, nobody bothers me. I move with my body’s desires and lose myself into the meditation music playing on the speaker. The doula takes a few pictures. After a while one of the midwives says, “She’s pushing.” The baby is born in the water at 3:29.

Later, as I go through the photos from his birth day, I come across a 23-minute video. There I am in the birthing tub, head hanging over the side, eyes closed, wearing a sports bra and nothing else. I run the slider back and forth and realize—this is it. This is the birth of my son.

Three years later, I still won’t have watched the whole thing. I won’t have done anything much with the video, though while writing this piece I’ll think I should at least back it up somewhere. Because, while I never felt like I needed a video of me giving birth, this video has become one of my most prized possessions—evidence, to me and nobody else, that I’ve done the hardest thing in the world.