I like birth plans but I wish I could tell all first-time Moms who come in with long, intricately specific birth plans to save them
for their second birth. Second labors are usually easier, faster and more
suited to a birth plan than a first. This is, of course, a generalization but
one that is pretty consistent. Second babies are easier to deliver than first
babies. Why? Lots of reasons: Our uteruses get smarter and figure out how to do
the job. All the muscles, tissues and bones have already stretched out making
it easier for the baby to descend. The trail has already been blazed and is
easier to travel than one you have to create from scratch.
Moms of first babies are birth-virgins. They've never
done it before. They don't know yet if their anatomy and their babies are
compatible for a vaginal birth. Most of the time they are. She doesn't know yet
how long it will take for her uterus to contract enough to dilate her cervix
and push that kiddo out. There's a lot of literature that says the average first
labor is 12 hours but if I've said it once ... babies never read that
literature. Some take longer than others. A lot longer.
There's always some debate as to when labor actually
starts. The official word is labor starts when strong, regular contractions
cause cervical change. It's not always possible to determine that exact moment.
Lots of moms have strong, regular contractions for hours (days, weeks by some
stories) that don't cause significant change. Try telling them they're not in
labor. Most moms will argue, "I don't care what you say, labor started at
3:00 this morning." I'm going with Mom's story. My first took 30 hours—no
matter how the obstetrician timed it. I went with my birth plan for the first
25. Once I finally tried some stuff that was "off plan," labor
progressed rapidly and my daughter was born 5 hours later. The point is, first
labors take a long time. A lot of thought and planning for exactly how you want
your labor to go is a good idea, but keep in mind that as the hours drag out
and progress is slower than you hoped for, birth plans frequently have to
Second labors, however, are perfect for birth plans.
If you've already successfully delivered a baby vaginally, you most likely will
again. Your labor will be shorter (usually) and it's way easier to deal with
contractions when your cervix is dilating quickly and the finish line is in
Let me get specific here. One of the most common items
on a birth plan is "no pain medication or epidural under any
circumstances." OK, that's not so tough with a second labor that's likely
to be over fairly quickly (anywhere from 1-12 hours). That's a tougher target
to hit when you've been contracting forever, have run out of coping mechanisms
and are still only 3 centimeters dilated.
Another popular item: "No pitocin to augment
labor under any circumstances." With a second labor, there's frequently no
need. They're way more efficient and don't tend to need much encouragement to
keep the ball rolling. Item: Want to labor in the tub? Perfect! This works
beautifully with firsts too but second labors are so much smoother that
frequently, a little time in the tub is all the pain management needed before
complete dilation. Heck, I've had seconds go so fast in the tub the water didn't
have time to cool down. Item: Want to wait until you feel the urge before you
push? No problem. If you've followed your birth plan request for no pain
management, you probably don't have an epidural. Believe me, once you have that
urge to push, no one's going to stop you. You won't have to wait for it either.
Once the baby is on her way through the birth canal, your urge to push will be
so strong, it's irresistable. Remember those two long hours of pushing with the
first? Thing of the past. Seconds pop right out. I've delivered seconds myself
when they came so quickly, they shot out like cannon balls. I was grateful
there was a wall behind me for support. Doctor? Midwife? No time. Just snap on
the gloves and catch. That hardly ever happens with a first.
Some birth planning with the first is an important
part of preparing for labor along with prenatal classes and a healthy dose of reading.
Just please, remember that you're a birth-virgin and plan for flexibility.
We're going to do everything in our power to help you achieve the birth of your
dreams. We're all for birth plans but those of us who've been doing this for a
while are more realistic than some first time parents. We know that plans
sometimes have to change. It's an important first step in parenting. You'll
raise the child you deliver, not the one you planned on. They might, or might
not, be the same child. Most of the time, the child you birth is far and away
better than anyone you've ever dreamed of. Best laid plans...
Got a question for Jeanne? E-mail it firstname.lastname@example.org it may be answered
in a future blog post.
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educational purposes only. It is not intended to replace medical advice from
your physician. Before initiating any exercise program, diet or treatment
provided by Fit Pregnancy, you should seek medical advice from your