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As I get closer to BabyGirl’s birth, I can’t help but think about Paulo’s birth and how very, very different this one is going to be. For starters, I was in labor with P for 47hrs – which not only isn’t likely for a second baby, but there’s just no way the hospital I’ll be delivering at has any kind of patience for that. And more importantly, neither does my neurologist. Bringing us to the second big difference – this birth won’t be anywhere near “natural.” Not even gonna try. And in the mom-blogging community, this is so rarely talked about… here I am, blathering on so another high risk mom-to-be might not feel like she’s the only one.

With Paulo, I wanted the “blog standard” sort of modern-natural birth (because let’s face it, there’s nothing totally * natural* about having a birth soundtrack and the possibility of a csection if it doesn’t work. Cave women did not have iPods or OBs standing by). A home birth wasn’t an option due to my epilepsy, so I “planned” a medication free hospital birth with a doula and a midwife. (Note: my mom is a former OB nurse. I use the term “plan” loosely, this was my ideal – my PLAN was “give birth.”) I talked things over with my neurologist who was wary – she didn’t say no, but she did say that a long labor should prompt me to her an epidural so I could sleep – lack of sleep being my biggest seizure trigger, combined with the stress of labor…

I ignored this to my peril. I didn’t have trouble coping with the *pain* of the contractions, so hour after hour I stuck to my guns that I didn’t want to be in the hospital. I was comfortable laboring at home and being someone who has been a professional patient (which I literally am this pregnancy – I’m in a research study so I am actually getting paid for having epilepsy), I loathe hospitals with every fiber of my being. By hour 36, it was clear that my “plan” and the reality of my brain chemistry did not mesh. I had a seizure, followed by an epidural, followed by many more hours of labor and a vacuum birth.

I have no regrets about Paulo’s birth, but if I tried for a “natural” birth again, it would be insanity – doing the same thing and expecting a different result. Now that I’ve had a seizure in labor, we can add “labor” to my list of seizure triggers and create a new plan to avoid that. So, there’s no doula. There’s no midwife. The epidural needle will be ready and waiting for me the second I walk in the door.

And this is where I feel like the movement towards “natural” birth does a lot of women a disservice and the echo chamber of mom-blogging reinforces that. A part of me feels like I’m *expected* to at least want a natural birth. At first I did feel disappointed that trying for one was off the table. But… My pregnancies aren’t natural, why would my births be?

Having a healthy pregnancy with epilepsy means I’m very, very closely monitored. In addition to my OB appointments – and I do see an OB, not a midwife (this was true the first time as well – I had half my prenatal appointments with an OB due to my risk level) – I have very regular neurologist visits. I had to start adjusting my medication an entire *year* before I even wanted to conceive. I don’t have the option of a birth center, I’ll be there in the fluorescent lit rubbing alcohol scented joy land wearing that oh so attractive gown. My fetus is checked not only for your typical abnormalities, but for specific defects that may result from my medications. (She’s fine.) My blood is taken so often to check my medication levels that you could come and prick the inside of my elbow in my sleep and I doubt I would notice. Why on earth would I expect that I could have a low-intervention birth after a high-intervention pregnancy?

And so, a different plan it is. My OB did give me the option of delivering with a midwife and/or trying to go med-free… but also agreed it would be much safer for me and baby to just accept the epidural early in case I need to sleep. So, we’re working out the details on what “early” means and the ideal plan is for a low-stress, uncomplicated, medicated hospital birth.

And this is what’s best for us. Natural birth is *not* for every one. It’s an amazing thing and many, many women can do it. All women should know their birth options and what they have access to with their own risk level – including low-risk women for whom a home birth is safe. Please don’t read me as being *against* natural birth. What I’m advocating is SAFE birth. For me, a hundred years ago, Paulo would have at the very least been a horrible forceps delivery. I would have had more seizures and who knows what after that. Maybe I would have been ok, maybe I would have suffered permanent damage, maybe I would have literally died from exhaustion. What is for certain is that without modern obstetrics, neither one of us would have been *healthy.*

I’m so very, very glad that I live in a place and time where BabyGirl and I will be pretty much guaranteed (barring the unforeseen disasters that could happen to anyone) a safe birth, despite my seizures. I am so incredibly grateful for my excellent prenatal care and I’m truly getting excited to step into that horrible gown, get the monitors strapped on, and meet this baby in a cold, fluorescent lit hospital room. The first time around, I wanted to have the birth “experience” that gets talked about so much – the spiritual experience of bringing life into the world like all of the mothers before me. This time around… I’m content to change the parameters so the “experience” of BabyGirl’s birth is as calm as possible in an environment where we will both be safe and cared for, given that there are some added wild cards in our own “Things That Could Go Wrong” pile. I hope for both of us that the various precautions are unnecessary and everything goes off without a hitch, but I feel so much more confident knowing that even if it doesn’t, we’ll be taken care of. I’m very much looking forward to seeing how it goes and hopefully having a much lower stress birth than the previous one!