Gang Aft Agley

“No plan survives contact with the enemy.” Helmuth von Moltke – German military strategist

If you’re like me, you’re walking into this birthing thing without fixating much on the “birthing experience.” Granted, this is because I am a guy and I will not be passing a small ham out of my pee hole, but that is neither here nor there. People have been having babies for, what, 10,000 years or so? I mean, you can literally have a baby entirely by accident, without even knowing that you’re pregnant until “splash” you literally take your kid to the pool when all you’re trying to do is enjoy your morning coffee. No planning, no preparation, you don’t even have to miss tonight’s episode of Game of Thrones, and you’ve got a screaming crying bundle of joy to boot. Congrats, mom! Nowhere in that equation was there a suitcase full of tennis balls, “adult” coloring books, bath salts, massage oils, and certainly not a page-long birthing plan. Plan?

Here’s the plan: 1) get wife pregnant. 2) wife has baby.* 3) whiskey on the rocks from your “World’s Best Dad” flask. 4) Wash, rinse, repeat if desired.

*Preferably in a hospital, but just about anywhere will do.

My wife is the polar opposite to me in this regard. She began her planning as soon as we started trying to conceive. Seriously, she consumed every shred of written information on the subject of babies that she could get her hands on, and googled the rest. She was a nonstop learning machine, and I am so very glad that she did enough learning for the both of us. She composed a nice, short, succinct birthing plan for her OB, discussed it with me (at one point actually including me in on the process…), shared it with her hordes of online forum mates, and settled in for what was certainly going to be an amazing experience.

And of course I’m all like “what do we need a plan for? We did our part (with the help of some tools and a team of medical professionals). What more do we need to plan for, other than what route we are going to take to the hospital?”

Now, I’m not in a position to wax all eloquently on how spiritually amazing the birthing experience can be. I’m not trying to discount the amount of time and preparation that some expectant mothers put into their birthing plans, either. I’m just a big advocate for doing whatever is necessary to ensure that both baby and mom are able to come home safe and healthy. Having a heathy baby trumps everything.

The idea of a long birthing plan just seemed so pretentious to me, like birthing-plan moms are just focusing on how enriched and enlightened they will be if all of these steps are followed accordingly, and anything less will just be a tremendous disappointment leaving them feeling robbed.

But here’s the rub: the moments leading up to full-on labor and delivery, the labor and delivery process itself, and the moments immediately following the birth of your little crusty bundle of meconium are absolutely chock-full of decisions that have to be made. These are decisions that actually carry some medical significance, and should not always be left for the doc to decide (especially if that doc has dinner plans or a tee-time).

And you, if you are the dad or significant other or birthing coach, might be the one tasked with making these decisions. It really helps to play it all out in your mind before go-time finds you fatigued and delirious.

At the very least, you should ask your wife’s OB, and the maternity/birthing department where you plan to have that baby, for a summary of what will follow the actual birth. Likely, it will consist of some minor interventions, like some antibiotic eye ointment and a vitamin K shot, and will be followed soon after with your baby’s first Hep B vaccine. They will sometimes even include the inane details, like when they will commence wiping the afterbirth off your baby and snipping the umbilical cord. They can delay these things for a bit if, for example, you both want to wait for the cord to stop pulsing before cutting it (and removing all chances of the baby climbing back up into the womb, un-cooking itself, and resetting everything back to zero, which is totally irrational but I still wonder “what if”), or want to hold baby against your skin for a moment before they whisk it away.

Beyond getting a feel for how it’s all going to go down, the big things you should consider beforehand are pain management and labor interventions, in addition to the aforementioned post-birth treatments. Pain management decisions should be made before labor progresses too far along, ideally before mom even goes into labor. The deeper mom advances into labor, the fewer her pain killing options will be.

Pain management is pretty key, even if your wife is charging headlong into the birthing room all gung-ho with her war-face on, daring the pain to take its best shot. Eventually, after two or fifteen hours, the war-face will fade into more of an uncertain “did I shart” face, and she may start to reconsider her stance on pain killers. In this case, the doctor will be the one to advise you on what is safe for her to take at that particular juncture, and you will be limited to what that hospital keeps on hand for pain management. Seems like an easy decision to make, right? Well, yeah, technically it’s really easy at this point, since the doctor and hospital have already made that decision for you by giving you maybe one option. Easy peasy.

If, however, you know that she isn’t one to handle the pain very well, then you should familiarize yourself with the most common pain management techniques and interventions used at the hospitals in your area. Know ahead of time what the medical effects of each medication are on mom, and what they could possibly do to baby. If she makes the decision early on in labor, then you may have more than one choice for pain management.

And if you decide against pain management because of the potential health risks to baby, then be prepared to be the guy that has to put your foot down and tell your screaming wife to “suck it up, sweetie! It’s for the good of the baby! Remember? We said no pain killers!”

I’m dead certain that my wife is going to include some very informative charts and slides in her post on this subject, so I am not going to delve into the specifics of each medication.

Now on to labor interventions. Mom may want to let things progress along a natural path, or mom may be totally cool with allowing the doctors and nurses to help urge things along by breaking mom’s water for her, or with medications that trigger uterine contractions, like Pitocin. I am not recommending one thing over another (to each his own), but on this subject I am more granola. People really have been having babies for eons, and they’ve been doing it without Pitocin for a really, really long time. If the doctor doesn’t push Pitocin, despite how often he or she looks at the clock and insists that it’s necessary,  mom is not going to not have the baby. You can quote me directly on this. I am not a doctor, but I’ll bet my lunch money that pregnancy still ends in a baby, with or without Pitocin.

That being said, there are times when the use of Pitocin may be recommended. For more on how Pitocin works, check out my wife’s post (coming soon, if not already posted when you read this). And if you have a great doctor that is willing to talk this stuff through with you, make sure to discuss these labor interventions so that you get a good feel for what will be best for mom and baby.

Now brace yourself.

I wrote all of that to basically say this: all of your planning means jack squat once the ball gets rolling. Your OB’s last concern is the plan you shared minutes before labor. When things really get moving, that doctor may get focused and revert back to autopilot mode, recommending interventions that mom thought she didn’t want. You are going to need to be strong and resolute when deciding between the doctor’s recommendations and what you covered in the birth plan, especially if mom is at a point where guttural moans and swear words are all that she can muster.

This is really where the rubber meets the asphalt. This is the time in which you play your part as the birthing partner and ensure that mom is treated well and her wishes are respected. This is when you really need to be up to speed on that ridiculous birthing plan.

Whether or not you busted out those tennis balls or massage oils or ran through some labor yoga with your wife, or if you opted to induce labor and get hopped up on painkillers, when it is all over you will have everything that matters right there in front of you. It may be screaming and covered in some nasty sludge, but that is the little miracle you planned for, regardless of how sideways went the plans.

Congratulations, moms and dads.

A side note: I may treat this with some brevity in the blog, but debates rage on about which interventions are beneficial and which are unnecessary. I strongly recommend looking into scholarly articles written on the subject of hospital interventions, rather than poring through your buddies’ Facebook memes on the absolute horrors of vaccinations and pharmaceutical companies. Bottom line up front: hospitals aren’t in the business of doing a bunch of unnecessary stuff that could result in a costly legal backlash. Don’t give in to the hype and fear of evil medicine. We’ve all actually come a long way. The vitamin K shot in particular… it’s almost entirely harmless, but foregoing this one results in a dramatic increase in the risk of fatal bleeding disorders in baby. Why would you skip this step and take this risk?
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