I have been preparing and planning for an unassisted birth since I realized how traumatized I was by my first child's birth. It was that trauma that also brought me to the awareness that medical attendants at a birth are not neccessary all of the time. When it came to unassisted birth, I think of it as something I'm going to do, but when not pregnant it like saying someday I'll hike Mt. Everest.
But now I'm pregnant. I found out yesterday. Which illicits from me a hushed "yay" because I'm happy, its what I wanted but now the prospect of an unassisted birth is real. Its really being planned. But, between not knowing I was pregnant and knowing now, honestly nothing is different. Other than the fact that before it was all hypothetical and now its real.
For so long now, I've thought about what will be different with this birth and how to prevent being coerced and bullied by others during labor and birth. But all that time, no concrete plans could be made. There were plans made for what to do once we learned about being pregnant, but none of those things could occur until that positive proof was there.
Of the things we have agreed on, this is what we now our course will be for this pregnancy:
1. A reduced prenatal schedule. Even though we plan the birth to be without a midwife in attendance, we plan to see a midwife for infrequent pregnancy visits. The average prenatal schedule in the United States is 14, if I recall correctly (from "Expecting Trouble" by Thomas Strong, MD). The fewest number of visits for European countries (with lower maternal and infant mortality rates) is 5 with many countries only scheduling 9 for pregnant women. I plan to follow a schedule more similar to Luxembourg than the United States. Now that I'm pregnant, I need to figure out when and how often they are occuring.
2. Routine 20 week ultrasound. My husband and I have agreed to the routine 20 week ultrasound which is the anatomy check for fetuses but is better known by parents as the time to find out the baby's gender. We went around on that issue but have determined that at or around the 20 week mark, we will have the anatomy ultrasound and find out the gender of the baby. If its a girl, she'll be named Carolyn Belle. If its a boy, he will be Joey (Joseph) David.
3. Private Childbirth Education Classes. My husband is supportive of the idea of having this next baby at home without a midwife present but he is still nervous at his ability to handle that situation. Because of that he has requested that he and I take childbirth education classes that address the specific preparations for an unassisted birth, especially detecting and handling abonormal situations and complications. The typical childbirth education class does not contain information detailed and accurate enough. Instead childbirth education classes are often orienations to hospital policy and how to cooperate with medical professionals. We have found a childbirth educator who will be preparing and teaching us those classes, starting after my husband finishes his qualifying exams as a PhD candidate and after my thesis is submitted.
4. Not disclosing an exact "Due Date." Because EDDs (Estimated Due Dates) are often treated more like deadlines for the birth of babies and in the age of a 40% induction rate taking place often just days after the 40 week deadline, we are only telling people that this child will likely be born between Mother's Day and Father's Day of 2009. We do that to prevent some of the well-meaning but annoying comments about going "overdue" or from having to disclose definite plans to people who are not likely to understand the rationale of our actions.
5. Praying and relying on the power of the priesthood and personal revelation. My husband's and my faith is such that we beleive that God will guide our decisions for what is best for this pregnancy. While I beleive that unassisted birth is the ideal birth for me, I also know that everyday situations that arise in pregnancy and birth may not be ideal. Based on the best of knowledge and understanding that we can gain from seeking out accurate information and education and the guidance of the Lord's Spirit, we believe that if it not right in our circumstance for an unassisted birth, then we will make alternate plans for more emergent situations and seeking out medical assistance.
6. Having a water pool available. Warm water pools in labor and birth are called the "natural epidural" for its ability to soothe and relax some of the intensity of labor. We plan to have one available. Nothing fancy here, just a $35 inflatable 22" in high kiddie pool with cartoon fish on the side. There's a clever device that can attach a garden hose to an indoor faucet that will bring warm water from the kitchen to the living room. And there's always heating large pots of water on the stove.
7. Practicing Hypnobirthing and Hypnobabies. With Willem's birth, I prepared using Hypnobirthing. I found it to be very useful to coping with contractions and some hours of back labor. Since then I've learned about Hypnobabies and their greater selection of scripts for pregnancy and birth. I'll invest in some of those for this coming birth.
8. Being selective in who we tell about our plans. We hope that it will not become common knowledge for people to know we are planning an unassisted birth. They are also the people who are a) not likely to read this blog and b) are very indoctrinated with modern birthing practices to think that anything out of hospital is unsafe.
Beyond those plans, there are somethings we don't know or haven't decided yet.
One is what are we going to do with Willem while I'm laboring. I want him at home with me for nursing and cuddling and being present for the birth of his sibling, but my husband will need another support person who can help attend a toddler and a laboring woman. A doula comes to mind as a qualified person to do that, but I have continued fears about being negatively influenced by having another person present while I'm trying to birth. Since unassisted birthing is so far out of the norm in our society, I fear it would be difficult to find a doula supportive and encouraging of me and our plans.
I also don't know what I'm going to do about the early ultrasound. It is typically for a transvaginal ultrasound to be performed between 9 and 10 weeks gestation. This is when any differences in due dates from the last menstrual period might be detected. I had anticipated to refuse that ultrasound but there is some concern in my mind that my dates may be off. Conceivably, I could be a month further along than I think I am because possibly there was bleeding that I mistook to be a period. I will continue thinking on that one...
I need to figure out the prenatal visit schedule and figure out when I want to notify the midwife. Its a good thing there is time for that...