After feeling debilitating, nearly indescribable pain one Saturday, I found out, at 10 weeks pregnant, that I had a massive ovarian tumor and was experiencing an ovarian torsion, which was brutal. Thankfully, my ovary stopped twisting on its own that night (after nine hours of agonizing pain), which meant I could avoid immediate surgery. But surgery would have to happen at some point. The entire color of my pregnancy changed hue after that night.
I was no longer able to freely move around the way I’d been able to before. I was also no longer able to imagine much of a specific birth plan. I also didn’t know if the tumor was malignant or not, which threw a significant amount of fear into the mix of my pregnancy. Before all this, I had hoped I would sail through an unmedicated, vaginal delivery the same way my own mom had for me, but no one could give me a definitive answer on whether I should even attempt a vaginal delivery at all. Tumors as large as mine was just aren’t seen in pregnancy regularly enough for anyone to feel certain, but an OB/GYN and a gynecologic oncologist both said it would probably be safe to try. There was one thing and one thing only that I was strict about: If I had to have an emergency C-section, I wanted the tumor taken out at the same time.
There was one thing and one thing only that I was strict about: If I had to have an emergency C-section, I wanted the tumor taken out at the same time
My birth plan, as much as I could make one, was mostly filled with ideas, suggestions, and things I could control. Dimmed lighting—check. My own music—check. Essential oils—check. When it came down to the things some people tend to get more dogmatic about, I refused to allow myself to step into rigidity. Even before my pregnancy became high-risk, my birth plan was always an idea, not a plan. I understood that the birth itself would be a wild card. Now, 10 weeks in, I knew I was dealing with something exceptional and I also knew that we don’t ever truly grasp what we need or want until we are actually in a situation. I wrote down my opinions on medication types and the kinds I would be most comfortable with if medication were needed. I also wrote down what I wanted to happen for me and the baby after the birth. But there was one thing and one thing only that I was strict about: If I had to have an emergency C-section, I wanted the tumor taken out at the same time.
This was something I’d discussed with every OB/GYN who worked at the hospital where I gave birth. We all agreed that this would make the most sense. After all, the tumor needed to come out ASAP, and leaving it in after my baby’s birth would create a huge risk of torsion again due to the sudden space in my abdomen. If I delivered vaginally, I would have to be on bed rest for a month to reduce the risk of torsion and then proceed to surgery. If I delivered via C-section, however, we could remove the mass then and there and have the results of the biopsy within a week.
When I finally went into labor (10 days after my daughter’s due date), I braced myself. I hadn’t scheduled a C-section, and it was clear to me that no one really knew what to expect out of a vaginal birth attempt. My doula met me at the hospital around 2:30 in the morning and, together, we focused on mastering the elements we could control. We did dim the lights, play the music I’d selected, and utilize essential oils. She massaged me and used her soothing voice to encourage me throughout. She dutifully took notes of the process as it unfolded, and I can’t understate the relaxing energy she brought to the experience. However, the physical reality of my birth was something we could not control.
Despite knowing all that I did about my situation, I didn’t expect for the tumor to interfere with delivery as much as it did. My baby’s posterior position was perhaps related to the soccer-ball-sized mass getting in her way. She struggled to move through my birth canal. When she finally was getting close to crowning, she got stuck. We could have tried forceps or a vacuum, but without knowing for sure whether the tumor was playing a role in the stuck-ness, and to what degree if so, those interventions would be more dangerous than usual. As she began showing signs of serious distress, it was time to make the call for an emergency C-section.
We had to wait 45 minutes for everyone on call to arrive to the tiny rural hospital where I delivered. During that time, the epidural I’d received at the end of my laboring was removed and I was left to feel every bit of a sustained ring of fire while writhing around on the operating table. My daughter wound up being so physically lodged that the surgeon had to manually push her back into my abdomen so that she could be delivered through my incision. The mass was in the way of everything so much that it had to be pulled out and repositioned to the side before she could come out.
Many of the things I’d requested in my birth plan for the immediate after-birth chapter weren’t possible. We couldn’t give her ample skin-to-skin time with me because she was born in distress and had to be hooked up to oxygen and heart-rate monitors urgently. I wanted her to have a delayed bath, but that doesn’t top the list of priorities when dealing with a newborn who may or may not make it. She was rushed to a NICU two hours away, and I didn’t get to hold her until two days after she was born.
When we don’t get what we’d hoped for, when we feel traumatized by what we did get, we can and should process that and push for self-advocacy. But the cliché that the only thing that matters is an alive baby doesn’t offend me. In the end, that slice of gratitude for an alive baby—something so many mamas do not get to have—is what gave me strength
Everything about my birth unfolded in less-than-ideal ways. In the end, I clung hard to my gratitude that we both made it out alive, but I eventually had to deal with the trauma of the birth itself. Reflecting back on it now, nearly five years later, I think my birth plan was perfectly appropriate for my situation. It pragmatically addressed the wild card situation I’d been handed while offering me some autonomy over the little things. Because I was accepting from the start of the fact that I couldn’t be fully in control, I didn’t have to contend with shocking disappointment over expectations that weren’t met.
Birth plans aren’t meant to be unwavering instructions. They are meant to be a set of hopes and goals; they are meant to be a loose guide. And they should be reflective of each individual mama and her situation. We can and should aspire for the most peaceful and comfortable birth experiences possible. When we don’t get what we’d hoped for, when we feel traumatized by what we did get, we can and should process that and push for self-advocacy. But the cliché that the only thing that matters is an alive baby doesn’t offend me. In the end, that slice of gratitude for an alive baby—something so many mamas do not get to have—is what gave me strength.