A New Birth Plan
Written by Anna
With all of the new information we were getting about our son and my pregnancy, it was time to come up with a new birth plan. Quickly after the bulk of my care was transferred to UW, I was informed that I now needed to anticipate a c-section, and, after meeting with a geneticist from Seattle Children’s Hospital, I was told to anticipate having this baby a bit sooner than expected. While I dreaded the idea of a c-section, I was miserable enough being pregnant that the idea of delivering my son sooner rather than later was almost welcomed. While my first two trimesters didn’t include too many unwelcome pregnancy symptoms, my third trimester was rough. I had been diagnosed with gestational diabetes and cholestasis, and our baby was so large that my body began to experience those end of pregnancy aches and pains much sooner than expected.
Why was my son so large? Beckwith-Wiedemann Syndrome is an overgrowth syndrome. He was already showing off his overgrowth with his head, abdomen, weight, and length predicted to be greater than the 99th percentile for his gestational age. He had some internal organs that were larger than average, and we were waiting to see if his tongue would be too (a common occurrence with BWS kiddos). Some other fun (or not-so-fun) facts about BWS? These kids are predisposed to developing tumors- namely Wilms tumor and hepatoblastoma, and have to experience frequent tumor screenings throughout early childhood. Kids with Beckwith can have a difficult time regulating blood sugar after birth, their large tongue can cause breathing and feeding difficulties (which can be exacerbated by an omphalocele), and their limbs can on occasion grow asymmetrically. These were some of the complications we were ready to navigate upon the birth of our child. To some this may seem completely overwhelming, but I had an overwhelming feeling of gratitude. I was grateful that, aside from the tumor risk, this was not a life threatening condition.
The months leading up to our son’s birth were full of prenatal appointments, fetal nonstress testing, and meeting with specialists at the children’s hospital. We were simultaneously eager to meet our son and have his omphalocele repaired, while also dreading having to send our baby to the OR. Zach and I both have STEM and health related degrees, and he was applying to medical school during this time, so we knew enough about everything that could go wrong to give us some anxiety. With a heavy reliance on prayer, we were able to make it through this time still appreciating the joys of anticipating the birth of your first child.
While I found great comfort in reading blogs like this and hearing about others’ NICU stays and medical parenting journeys, I felt that one topic that is not discussed enough is grieving your former birth plan. I had been dreaming of a natural birth experience with minimal medical intervention at our local birthing center. I did not want to deliver in a hospital, and I definitely did not want a c-section. These wants often get thrown out the door the second you get a complicated prenatal diagnosis. While I understood the need to make these changes and was happy to make the best and safest decisions for the delivery of my child, there was still lots of sadness when I had to discuss the change of plans.
One thing that did help was requesting an appointment with a neonatologist to discuss what the delivery would look like. He described minute by minute what would happen to my son immediately after birth, and gave me an overview of what my husband and baby would experience after being transferred down the street to Seattle Childrens. He assured me that as long as the delivery didn’t become an emergency situation, things like delayed cord clamping and skin-to-skin contact with my son could still be a possibility. Upon having this conversation, I began to embrace the new plan and looked forward to the scheduled birth of my son in just over a month.