I think that preterm labor teaches you one huge thing: nothing is as important as getting the baby (or babies) here safely, be that by following your birth plan or not. With Nicholas and Sophia, I was really hung up on the "plan". We spent quite a few hours going over what we wanted, didnt want, etc, and I put together a nice little form thanks to an online software. Like all the books said, I carried it with me and planned on making several copies to give to L&D, etc. I'd even asked Dr B if he would look over it and sign off on it, which he agreed to do, after explaining that we should be prepared for emergencies where the plan wouldnt safely be able to be adhered to. But I was still loss-dumb so I couldnt even imagine that possibility. I mean, yesssss, I'd probably go into PTL (which I thought would be that beautiful 36 week mark) but otherwise, my pregnancy had been perfect, "textbook" was the word that often was thrown around, so what was to worry about!
And then I delivered Nicholas and birthplan be damned. Now, in retrospect, his labor was perfect, beautiful, natural, and at home. He gave me the birthplan we had thought of prior to knowing we were carrying twins and decided we wouldnt attempt a home birth. When I talk to him, I still thank him for such an experience. With Sophia, the last thing on my mind was a "plan"; I just wanted to carry her to that line-in-the-sand of 24w. That was my only "birth plan".
When we got pregnant with Alexander, I wasnt even thinking of a plan. We kept it simple: natural birth. That was it. No drugs and vaginal. Who cares about music and dim lights when you are just trying desperately to save your baby? I decided I could deal with the people and the hospital nonsense if it meant that we could save Alexander's little life. When I went into the hospital at 16w3d, I mentally dropped the plan in the wastebasket; I'd never even bothered to write one down let alone print one out. From that day on, the plan was simply "get another day".
We decided from the start with Bobby and Maya's pregnancy that we still wanted a natural birth, but we made no mention of a plan. The only plan was to try and stay pregnant, no matter the cost. Cerclage- no problem. Bedrest- no problem. Hospital Bedrest- no problem. Constant Monitoring- no problem. After losing our children, what was inconvenience? As the pregnancy wore on in the hospital, the nurses and I joked that the Universe "owed" us a natural birth after the hand we'd been dealt. When Maya turned from transverse to vertex, we cheered and told her to stay that way for the 36 week vaginal birth that was touted as our big goal. (Not a plan, mind you, a goal... See how the verbiage changes...)
When the doctors explained that a c-section would be THE way to go prior to 28w and their suggestion prior to 32w for the safety of the babies, again, we said 'no problem' because, in light of risks, there is no greater one than the health of the babies. At the time, the reasons why they wanted the c-section washed over me. I didnt want a cesarean. I didnt want a drugged out birth. I wanted to be able to hold my infants on my chest after a lovely quasi-full term delivery and nurse them. But more than that, I needed to know that everything possible had been done to keep Bobby and Maya safe, and that became the plan. Birth them safely, no matter what.
When I went into labor at 27w5d and our nurse gently explained that it couldnt be stopped and that we were delivering that Thursday evening, I knew that there wasnt going to be a vaginal birth. Knowing how much we wanted that, I appreciate that Dr M agreed to try if I dilated to 10 right away, judging that the babies would be small enough that *possibly* they wouldnt get hurt in labor if I was completely open. But I also knew that she, like we, werent willing to take any chances (she told me later that she knew Dr B would "kill her" if she let anything happen to the babies or us). She had told me when she came in that she believed 100% that a c-section would be the safest option to get the babies here quickly and as healthy as possible. And I trusted her. I knew that Dr B would say the same thing. And, at some point, you know that these people who have been with you every step of the way, who have mourned your losses and celebrated your triumphs and milestones, want nothing more than to give your babies the best chance possible. I knew that the second I heard that Dr M was in the parking garage, when the on-call doctor told me that he wouldnt do the section because she had driven back to the hospital. Any doctor who will cancel an event with their own child to come back for mine has more than just a paycheck in mind.
As the nurse who had admitted us and had been with the babies from the start of their hospital journey followed me from antepartum and held me during the spinal/epi told me that she wouldnt leave, I knew that we had yet another person who cared just as much for these babies as they could. That they werent just "another section delivery" but that they were Bobby and Maya. Whenever a question came up, she rattled off my medical history, what the babies had done that day and weeks before, what drugs I'd taken and when. I didnt feel like a clipboard or a patient; I felt like a friend who had a friend who cared so deeply for them that they knew the ins and outs of their life. Because she did. For those 50 days, she had taken in everything about me and the twins.
The plan was simple: birth safely. And while abdominal surgery wasnt what I'd hoped for, and while I loved my Bradley classes & books, and while I will always, always, ALWAYS advocate for natural pregnancies and births, the primary plan has to be safety for the baby/babies. It just has to be. Everything else is just a preference.
When I've been asked if I regret the cesarean, I can honestly say no. How could I? My babies are doing wonderfully. Was the c-section partially responsible? We will never know. Would a vaginal birth have given us the same outcome? Maybe. If they were doing poorly, would I blame the c-section? I'd like to think not, but I dont know. But I know that I cant waste the precious energy I have lamenting a birth experience that gave me two beautiful, safe, healthy babies. Not when I know so painfully what the other side could have been.
I feel fortunate that I was able to experience 5 very unique deliveries for 5 special babies. Nicholas gave us our natural home birth; Sophia gave us hard labor; Alexander gave us peaceful breech labor; Bobby was born with his bag intact via cesarean; Maya was born into this world when her breech legs kicked out of her water bag right as the cesarean started (and before her brother was removed). These are memories that I have of each of the children and I am glad they are all different so that it is something they have just for themselves.
If we are ever graced with another pregnancy, I hope to attempt a VBAC, but it will just be my preference and what we prepare for mentally and physically. But our primary goal will still be a healthy pregnancy and safe delivery, no matter the method. I think that thought is what saved me from the regret of not having the birth that I wanted and allowed me to see that the only thing I really wanted was safety for Bobby and Maya, a safety I couldnt give their siblings. The cerclage brought us a lot of safety and we choose to see the cesarean as an extension of that.