Interesting article for 1st timers?

[squizita]

I found this article after following a link on another thread and browsing her blog.
midwifethinking.com/2013/03/27/feel-the-fear-and-birth-anyway/#comment-40391

As a first-timer I found it quite a reassuring article. I am using natal hypnotherapy, yoga and attending NCT ... but have felt uneasy that sometimes in classes/publications promoting natural birth the natural fear/pain (and understanding that there are risks) is kind of 'glossed over'. And that pain/fear was 'wrong' and would do bad things.
I was getting scared of getting scared IYSWIM!

[PenguinsHatchedAnEgg]

That is interesting!

I did natal hypnotherapy with no.2, but it didn't work for me. I couldn't be that calm, serene person surfing over the waves of the contraction. At the risk of sounding like a woo-idiot, I needed to do battle with my labour, be loud, moo and roar my way through the pain.

I was the same with no.3. A few times I felt labour was 'getting away with me' as it was becoming more intense more quickly than I was used to (though in the end this turned out just to be an overall much quicker labour!) and definitely vocalised fears. Where my birth attendants were great was reassuring me that I could do it, and re-directing any noises that became too much like panicked screams into more productive noises.

[RedToothBrush]

Its an interesting article and ties in with my experiences of childbirth/pregnancy fear and the information I've found out along the way.

I find attitudes to fear and anxiety in the UK quite odd. After reading hundreds of threads on MN on the subject, I do feel there is a massive taboo about the subject and there is a massive cultural and institutional dismissal of women who suffer from more extreme anxiety whilst still pregnant. There are quite a few women who comment on being afraid of raising their fears because they think they will be ignored, laughed at, referred to social services or otherwise deemed a bad mother before the child is even born.

It seems only logical that because they are unable to express or tackle these fears properly in a meaningful way before going into labour, then its naturally going to compound the problem. But instead we are told that the rise of fear is down to the media portrayal of childbirth. I can't help but think thats bollocks. The issue is regardless of how childbirth is represented, if women don't feel able to talk about that and their individual fears properly and without judgment, then they are going to be unprepared and scared.

I feel that women generally need to be reassured and encouraged to talk to someone. Every time I see the comment "well everyone gets a little scared" on here, I want to scream at my computer because its such a dismissive phrase which doesn't help a lot of women and may deter them from getting the support they need.

I have had a very positive experience so far with a hospital that seems to be doing a lot of this already. I've had it explained to me as "fear and anxiety covers a massive spectrum with women at various points along that line" which I find a very good way of describing it, without making you feel like some kind of freak. Some find it a breeze but others really struggle with it and need the extra support. The range of normality is huge, yet we expect everyone to be within a certain narrow window. It doesn't make you less of a woman. Just different.

I actually like the points at the end of that article, which focus not on positive thinking so things don't go wrong, but more on mindfulness and acknowledging that things can go wrong, but preparing yourself for bad situations can be a good way to enable you to cope. I do feel that one of the problems with the pro-natural birth lobby has been this focus on positive thinking being the solution, but I think this is potentially dangerous in setting up some women for 'failure' rather than what they need which is 'coping'.

Certainly, though I am personally going down the ELCS route, the route I've been encouraged to take to cope with my fears, is very similar to that described and I'm finding it useful so far. Breaking down fear into smaller chunks and discussing it without judgment, has helped me build trust in those caring for me, which I didn't think I would be able to do. So I think it applies to everyone, regardless of how you give birth.

The one thing I would stress to anyone, is that if you are feeling fearful or anxious to the point where it is dominating your thoughts, causing you considerable stress or giving you repeated nightmares is to speak to someone and try and get some help. There are places and people that can offer you support that you need, and you are anything but a failure for trying to address your problems in a positive manner.

[Hazchem]

I love the midwife thinkign blog because ti think it's well evidenced as well as well written. She is after all a pHd and a midwife.
This piece from the mule is good to. The article is almost the start of the Positive birth movement which rather then just think positive and it will be ok is about making things positive by knowledge and empowerment if that's HBAC or an ELEC.
My positive birth meeting this month focused on birth planning and we all agreed that what was most useful for us was the planning around the what if. Not the I'd like but researching and looking into the just in case bit. so for me part of my birth plan talked about what should happen if I had to have GA to have a cesearen. Rather then the discussion being about fear I knew that if that was the case, OH would come with me and then skin to skin the baby until I was in recover. In some ways while i didn't want that at lest i felt I had some empowered decision making about it.

[squizita]

Interestingly I just had a yoga class. She did a few really tough poses and talked in very practical terms about how "this helps some women with the pain before you go to hospital/the MW arrives", "childbirth is hard work for everyone...", "this is a great pose if you need to resk during a long labour but don't want to lie flat"... encouraging and clearly pro-natural-birth, but not glossing over the fact it hurts and is tough.

...I found it a lot more reassuring than ante-natal classes where they won't use the word "pain" and suggest that by doing the class everything will go perfectly! Which I have had and TBH I might be cynical but I felt it was almost "if it goes badly you've done it wrong".

[Hazchem]

My mum said to me anyone who says they aren't scared about giving birth is lying. She has had two babies one at home. Has helped at maybe 30 or 40 births, organized home birth conferences, she knows birth inside and out so it maybe be feel ok about not feel brave all the time. I think being honest and realistic is so important.

Birth is hardwork. this time round I'm focusing on squatting. I can hold a deep squat for about 3 minutes and pick everything up by deep squatting so probably do 40 or 50 a day. I even deep squatted and then stood while lifting our bed frame!
On the day I'll probably be like, no I want to lie on my side

[squizita]

Hazchem the only bit of that Mule article which really got my back up was "My fear and negative expectations became, as they do for many, a self-fulfilling prophecy."

Again: 1st time mums have this mythical choice:
-act like you won't need drugs and it will all go to plan (it might not, and you can blame the hospital etc' and be utterly traumatised for years like some women i know)
or
-If you ever dare consider birth can not go to plan, it will be your fault for thinking that.
Unfortunately I have seen this 'choice' peddled out lots of times. :(

[Hazchem]

it's tricky. I know for me my worse case scenario was going to hospital which was where I ended up :)

I think sometimes natural birth advocate ( of which I am one) forget that preparation isn't all there is. Rather to have a "good" birth part of it is how emotionally prepared you are and that aspect is much harder to teach and explore particularly when we are so focused on risks, outcomes. I don't mean that a "good birth" is a natural one more one where how you feel about yourself is good.

It's why I think birth plans that explore the scary and icky side of things really help. For example at one point during pregnancy I was looking at pain relief options available at home birth. Lack of pain relief is one of the biggest reasons for transfer. So I was exploring pethadine. I'd intially thought Ok I'll get them to bring that so I don't have to transfer but then I read about sleepy babies and difficulties breastfeeding and thought "if it gets to the point that I actually really want some more pain relief then its ok for me to go to hospital and have an epidural.

My mum also said that when labour starts you have to put your expectations in a suitcase and leave it at the door.

[squizita]

Hazchem Yup have been told similar. My old ma told me while it's nice having a natural birth "there's no shame in an epidural, you get a baby not a bloody medal." she only had one because of blood pressure and forceps delivery of twins, she adds...

It is all about information. Having an inkling of what choices I might have to make makes me feel more secure! So if even though I'm active, the pain's unbearable, I'll ask for painkillers. If baby sticks even though I'm not on my back, I know the difference between vontuse and the 2 types of forceps and so does my DH...
Doesn't mean anything will or won't happen.

[Thurlow]

^1st time mums have this mythical choice:
-act like you won't need drugs and it will all go to plan (it might not, and you can blame the hospital etc' and be utterly traumatised for years like some women i know)
or
-If you ever dare consider birth can not go to plan, it will be your fault for thinking that.
Unfortunately I have seen this 'choice' peddled out lots of times^

I know what you mean, that's very well put. I was told on another thread that birth and breast-feeding being difficult was a self-fulfilling prophecy I know it is a minority of women/posters out there, but the ones who hint towards the concept that you only struggled because you expected it to be bad can sometimes be very vocal.

There is a lot in birth which is sadly outside your ability to control, and no amount of positive thinking in the world will help in a few situations.

Fwiw, I think you have a great attitude to it. Hypnobirthing and yoga sound wonderful (and I would do them if I wasn't so keen on an elcs 2nd time around ) and hopefully they will help women to manage their labour without pain relief. But I think it's a very good idea to have an idea in your head as well what you want to do should things not go quite to your initial plan.

[JaneParker]

They don't call it "labour" for nothing - it is very hard work. Luckily all birth classes I went to and books including the NCT always made it very clear there are many types of births and lots of options.

[PenguinsHatchedAnEgg]

You know, I hate that phrase (nothing against you Jane). Labour and hard work are, to me, a totally different kettle of fish to birth labour. It's not just about working hard. It is about luck, and positioning, and how manageable it is. That phrase always implies a degree of judgement to me - because hard working is seen as intrinsically good.

[Hazchem]

I think it's more of a system prophecy then an individual one if that makes sense. So I think as a whole we see birth as a negative and medical event therefore we have designed systems around that. As an individual it's both hard to buck the system or make changes to it. I guess I'd like much more emphasis on the non medical/emergency side of it.

How else do you phrase it Penguins? Effort. Birth requires effort? That is maybe more positive and I think covers a range of birth as ELECs require effort from mum too a different kind to say a frank breach but still effort none the less.

[PenguinsHatchedAnEgg]

Sorry, I maybe didn't phrase myself very well. And am probably overly attuned to the nuance of language (am a bit of a nerd). I don't mind people saying "labour is bloody hard work" or anything like that. It's the "it's not called labour for nothing" phrase that I dislike. To me it kind of implies that the amount of effort you put in is the key thing about a labour. Almost that working hard is what it takes for it to go well. Whereas of course it is far more complex.

[DearDinah]

Thanks for posting this, I've been doing natal hypnotherapy & lazy daisy & have found them both really helpful, I still get an uneasiness & like you say am scared of getting scared, as have the thinking that it's the fear that's going to cause pain. I have the fear & I can't help it!

[Hazchem]

Oh I see what you mean Penguins. yes I wish there was a way to say the preparation and hard work before and during labour can have a impact on how birth goes but it is not the only factor. BEcause I think our efforts and hard work do impact on what happens in labour but I am aware that it's not all good planning and wishful thinking.

DarDinah My NCT teacher said no one dies of pain, which sounds sort of extreme but it means even though it might hurt a lot you will get to the other side. 3 years down the tract i can;t even remember how a contraction feels. I remember working through them but not how it felt.

[PenguinsHatchedAnEgg]

Yes, exactly. Preparation gives you the best odds of things going how you want. But preparation doesn't mean that they will go the way you want, so things going 'wrong' doesn't mean you didn't try hard enough. Same with 'effort' or 'hard work'.

[squizita]

said no one dies of pain

No, but extreme pain can lead to lifelong trauma in some women (I know of one who was really affected by it). Such levels of shock/trauma would be routinely given CBT etc' if they happened due to an injury and accident... but because almost half the population gives birth (and there is a strong pro-natural movement, for good reason, now) attitudes to pain can be unhelpful from some advisers at NCT and similar - and by GPs and HV afterwards. We've all heard of the women given 2 paracetamol by the nurses after painful stitches and terrible afterpains - and how insulting many find that.

I have one NCT teacher who refuses to say the word 'pain' and calls it 'intense feelings' even when it's post birth (e.g. stitches).
One has said the words "Don't try to be a hero, if you need an epidural go for it".

[Hazchem]

That's true and I take seriously the impact that birth can have on women and try as much as possible to prompt access to services designed to help women recover from trauma. Sometimes the pain however is not the traumatic event it is the treatment.

And the pain quote was meant a bit haphazardly to say it's ok if it hurts. You haven't failed if you haven't managed to breathe through the surge. That the pain is actually there if you are feeling it and you are allowed to feel it.

[squizita]

Worth mentioning the friend is not in the UK but in a European country where they just don't do pain relief - it's seen as very bad form indeed except for C sections (as far as I know even G&A forbidden!!). I dare say in the UK when it all got too much she would have had more access to relief.

[RedToothBrush]

I was surprised by my dutch friend's experience of childbirth. She choose to go to hospital and didn't see to have any problems with that choice. But the system there still meant that her midwife accompanied her and went to the hospital with her so she had that benefit.

She then asked me about how many days the HV would stay with me. It turned out that they have someone assigned to them for a certain number of days (depending on how their birth had gone) to help them adjust and learn to care for the baby, to fend off visitors and allow them to get a certain amount of rest.

Its changed my perceptions of the Dutch system. Whilst it might not be good at certain aspects of care, it seems to also put ours to total shame in other aspects which may enable a woman to cope better with the experience as a whole.

[squizita]

YES! Holland.

Red The problem is it's not a choice. It was utterly traumatic for her even after the birth: having the wrong type of HCP (think nightmare judgemental HV type thing) joined to you by the hip for several days lecturing (bearing in mind how in the UK their short visits can be distressing) ... it didn't help at all and in fact contributed to PND and the issues around the birth. For more private people having people stay with during the hormone crash can be awful, and many women feel silenced or judged - brainwashed not to complain.

[squizita]

...not at all saying all their postnatal staff are like that. But in this case the patient was belittled and shamed for what we would recognise as birth trauma, because her response to natural birth was 'wrong' (morally) in the eyes of the woman she spent that time with.