With Mayo Clinic certified nurse-midwife Mary Murry, R.N., C.N.M.

In my last blog I encouraged everyone to have a birth plan. Now you're thinking "Fine Mary, I had a plan and nothing happened as I planned. What do I do now?"

Many things can happen that make your birth plan nothing more than a piece of paper. You might come in with active labor and find out your baby is breech and a Cesarean delivery is required. You might find that you have a medical condition or pregnancy complication that requires labor induction when induction was never mentioned in your plan.

It is possible that you wanted low lights and quiet during labor and instead it is the busiest night of the year in labor and delivery and all the loud people are on and someone keeps turning on your room lights! The birth plan may state that a medication-free childbirth is desired. I have known some women that felt they were almost pressured into having an epidural when they really could have gone the distance with more active support and encouragement.

There are also those women who planned for an epidural but were told they were too far along for one and would have to go without anything. A woman can feel disappointed, frustrated, even very angry when their birth plan seems to be ignored or made light of. These feelings can be intensified when we feel that no one explained why things went the way they did, why things didn't go as we had planned. If this happens to you, I think the most important thing you can do is communicate your feelings to the appropriate people. Do it as soon as possible. It might not be immediately.

You may find that it is only several weeks after the birth that you are able to process all that happened. Letters can be written to hospitals, unit managers or supervisors. If your health care provider contributed to your feelings, you should try to express this to them. Everyone needs feedback. Healthcare providers can be unaware of the impact actions or attitudes can have on a woman and family during labor and birth.

Some women feel guilty because they did not do what they had planned. We can't always meet our expectations about how we will deal with labor and birth. As much as we would like to, we can't predict how we will deal with this one of a kind experience.

Try to remember that your birth plan was a plan printed on paper for a unique and unpredictable event. Don't let it cloud the miracle of your child's birth day.

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