Crohn's Disease & Pregnancy: My Birth Plan

I’ve written about "My Journey to Motherhood", the "Emotional Parallels" I’ve found between Crohn’s Disease and Infertility, and the "Stigma" I’ve experienced with both conditions. I wrote about parts of my pregnancy including "Safe Foods", "Carrying my Daughter", "Planning", and "Preparing to be a Mother" (parts one and two), and most recently, about my journey to "Self Love" during my pregnancy. I’ve written about all of these facets of being pregnant while having Crohn’s Disease, and the way it has impacted my life, my thinking, my pregnancy, and my mental health. Today I want to talk about how all of those pieces impacted creating a birth plan for labor and delivery, all while considering the unique needs of my body with Crohn’s Disease.

As a Crohn’s Disease patient, I’ve often referred to myself as a “Professional Patient,” and my pregnancy was a great time to more or less show this off. Outside of my regular check-ups and monitoring appointments for baby girl, I did end up twice in OB Triage (a special “Emergency Room” at my hospital for pregnant patients), and the nurses were more than surprised that I could easily provide my medical history, medication list, allergies, and a concise explanation of what landed us in the unit for monitoring on that occasion.

My birth plan

I thought a lot about this as I put together my birth plan, which is traditionally a loosely structured print out listing the mom/parents preferences during labor and delivery in order to communicate with the nurses and doctors working on your case. Given that I knew I didn’t want to have to express some of my physical or medical needs, medication list or medical history while also experiencing contractions and delivering my daughter, I took this birth plan as an opportunity to really get right down to business. I combined the “to include” sections of a couple of recommended Birth Plan templates, and then I added in a few sections based on having IBD.

Planning and preparing for labor and delivery

My plan was three pages, typed, and included a LOT of information in an easily readable way. It started by listing my personal information, along with my OB, GI and Doula’s names and phone numbers as well, in case anyone not in the room needed to be reached during my labor. Next, it listed my medical conditions with Crohn’s as the first item on the list, my blood type in case postpartum hemorrhaging was increased due to IBD and I needed a blood transfusion, my current medications, and my medication allergies. It also contained detailed information about my surgical power port, the medical device implanted in my chest. It then went on to detail my obstetric history, labor and delivery preferences like normal, including information/instructions about a cesarean contingency. My postpartum care instructions included information about not being able to take NSAIDS due to Crohn’s, my scheduled Remicade infusion after delivery, and my understanding of how/when to request stool softeners or laxatives if needed rather than being given them automatically.

As a very Type A, organized patient, I completed this plan by 34 weeks pregnant, which many people including my doula and my OB told me was super early to have it done. I was a little worried about my Crohn’s disease flaring, or going into labor early, or not having enough energy in the last weeks of pregnancy to think coherently. Spoiler alert - it was a good thing I did because my water broke when I was just 35 weeks, 4 days pregnant and my daughter was delivered 14 hours later. Had the plan not previously been completed, printed, copied, and stored in my hospital bag, it basically never would’ve existed, and this would’ve driven up my new mama/Crohn’s disease patient anxiety about 1000x.

I felt secure with this birth plan

When I arrived at the hospital in labor, I handed a copy of the plan to the nurses in the triage room. I handed another copy to the OB doctor that was on shift during my overnight labor, and a third copy for the nurses once I was admitted on the labor and delivery floor. I had my own copy, and my doula had a copy too. Call this overboard, but I felt content, safe and grateful that everyone working with me knew about my body, my medical history, my medical allergies, and the things required on both my part and theirs to bring my baby into this world without her or I entering any type of crisis.

In my next post, I’ll talk more about how this birth plan was used during labor & delivery, and the things I was hyper-alert to/aware of when it came to my Crohn’s disease.