Fear of pre

[LeaveMyVagAlone]

My first baby is due in just over a month and I'm terrified of everything relating to the birth.
In particular vag exams, having to have any kind of instrumental birth or episiotomy, or being forced by midwives into any legs open position as I feel v uneasy with people looking at my bits in any medical context (am fine with naked spas, life modelling etc). I'm also terrified that any birth injury will mean more exams, as well as the loss of my sex life and the indignity of incontinence.

I've only had one successful smear test, 3 were failures due to either panicking and not being able to open legs/relax fanny/both. struggling with legs anyway due to spd.

I've also had herpes, and fear passing it to the baby, as I'd be reliant on an exam to check for sores. Ugh.

Am aware that I sound fucking mental - I've been treated for depression on and off for 15+ years, and fear a traumatic birth will set me back into the suicidal mess I was in 2 years ago, with obvious negative effects on my baby and husband. Despite being off my usual helping of anti depressants I've generally coped ok with pregnancy up til now, and don't feel depressed so much as convinced that I'll become very mentally unwell in the months after pregnancy. We have moved house, and I don't know anyone locally.

Does anyone have any experience of refusing exams, inductions, instrummental delivery, or episiotomy? I genuinely fear for my mental health if I'm forced into this.

(I have no money for indeindependent midwives, and lack the attention span for hypnotherapy, and am a bit sceptical anyway)

[PotteringAlong]

Have you considered asking for a c-section?

I did refuse internal exams towards the end with my second labour (no reason other than I was very certain I didn't want them!), although I had happily had one when I went into hospital and no one did anything without my consent.

[LeaveMyVagAlone]

C section seems like the obvious answer, and would probably work better to keep my panicky flaps under control...but is subject to getting a sympathetic midwife/consultant. Hopefully they'll be not keen to deal with a flappy lunatic.

Good news on exams too :-)

[RedToothBrush]

1. You do not sound 'fucking mental'. You sound like you are suffering from severe anxiety over giving birth. This is a recognised medical issue. From what you have said, you tick a lot of the boxes for women who typically request an ELCS for legitimate mental health reasons. It is more common than you realise. Sadly a lot of the language you may come across does not reflect this, and usually ELCS done for mental health reasons are still classified as 'maternal request' which is categorically flawed.
   
   
2. This is all recognised by the current NICE guidelines for C-Section. They were revised specifically for women in similar situations. Unfortunately not every hospital in the country currently agrees with the guidelines and some are being deliberately obstructive. However the guidelines do give you a very good case to answer should you have problems.
   
   
3. A CS is not always the solution though. Because the guidelines are now being used as a template for women in similar circumstances without exploring alternatives. If you are getting good care, they should explore your fears properly and see if there may be alternative ways of dealing with them. Everyone who has fears of this nature is very different and whilst there are common trends, anxiety and fear is a very personal and unique thing, but this is not always recognised. Often simply building a relationship with the hospital staff caring for you and building trust can make a vb be an option that you might consider despite how you currently feel. It can be surprising how much your mindset can change with staff experienced with similar cases.
   
   
4. You should be aware of some of the physical realities of a CS. In particular the fact that it requires you to be exposed at some points and you will need to have a catheter.
   
   
5. You should pursue this as peri-natal mental health issue. Its best to flag it up as soon as possible as it can be difficult to access appropriate services or support. A sizeable number of Trusts do not have dedicated peri-natal services which is outrageous and services vary enormously from one to the next. If you can find a local Trust which does have services this would benefit you enormously, regardless of whether you have an ELCS or VB. There was recently a report on the state of peri-natal mental health services in the NHS which concluded it was costing the NHS billions and could be improved by a comparatively smaller cost.
   
   I had an ELCS for my first baby, for not too dissimilar reasons. My personal experience was very positive, in part because I found a hospital who recognised and had experience with the issue prior to getting pregnant. However I am aware that my experience is not entirely typical, and a lot of women struggle to get adequate care, because there is a real lack of understanding and support within the NHS for this medical condition to the point of harmful ignorance in the worst examples (Again I stress the point that this is a medical issue not just women being demanding in any way as its something that so many women fail to understand themselves and therefore don't seek out the help they have a legitimate right and need for). It means it really does mean that women have to take the initiative in many cases and need to educate themselves about the subject rather than relying on HCP to inform them or advocate on their behalf. Don't be afraid of challenging midwives/consultants if you feel they are being dismissive of you.
   
   Ultimately its not about 'getting an ELCS'. Its about getting the right support for anxiety in pregnancy and childbirth, and this is the angle it should be approached from by you and your health givers alike.
   
   Good luck, I hope you can find a way to tackle this in a way that deals with your personal issues.

[Ihatechoosingausername]

I've had some mild freak-outs during smear tests, and I couldn't have a membrane sweep done this Monday just gone because I was so tense (I'm 7 days overdue). I've been advised to have gas and air for this next sweep later on today. How are you with painkillers and anti-anxiety medication? I took etizolam to get over my fear of smear tests and colposcopys. I'm hoping the gas and air will work today.

[LeaveMyVagAlone]

Thanks for the detailed reply! I think the limited exposure thing would be ok, as I'd be expecting a catheter.

I think we have perinatal mental health services, and I'm seeing someone from the local mental health team but think they only offer CBT, which I've found pretty crap in the past. Hopefully they'll refer me on, advice from midwife so far has been to wait to see if the antenatal classes make me feel any calmer. So far, it's a no.

I did consider going back on antidepressants, but there's probably not enough time for one to become truly effective, and I don't think I'm really depressed so much as v v anxious.


Last smear test required valium (not prescribed) and vodka (ditto), and was still pretty bad.

Hope your sweep goes well, you're a braver person than me!

[batmanandrobin]

with pregnancy i was quite relaxed however the last few weeks i became a mess. everything made me nervous and anxious and the thought of someone being near, looking in or touching me was horrific.

my story took a spin out of control however, as i developed pre eclampsia and suddenly i was forced into making decisions that i didn't think i would be making pre due date (whether i should be immediately induced, or wait weekend, or ELCS).

i don't know if it was the sudden danger to my baby, however i managed stay calmer than i had thought of myself. i waited weekend and went into labour naturally with waters breaking in the night. my contractions were slow so i had a pesseri to help me along- what i thought would be my worst nightmare. i only had one examination (at 4cm) and then asked to have no more.. eventually my groaning changed and turns out baby was on way through canal!

i wanted a water birth but pre eclampsia meant i had to he monitored so i gave birth on all fours with a baggy nighty so i felt dignity was maximised.

i have fought with eating disorders and mental health issues my whole life, however am pleased to say my weight is controlled after birth.

i completely understand everyone's situation is different, and perhaps my fears were different to those you have, i just thought id offer a post that gives the message that..

you're not alone, you won't be judged, but you also don't have to go down the ELCS route. if you did have a VB there are ways to make it dignified and you being relaxed and in control. i had excellent support from DH and my mother which helped greatly. try not to let birth bring you down- it is a leap into the unknown, but it will strengthen you eternally.

best wishes and keep us updated on appointments and the support you receive xx

[RedToothBrush]

I didn't have cbt, as I didn't have a lot of faith in it. They just gave me extra support in the end which was basically just extra appointments to talk about what was bothering me, and for me to get to know staff/the hospital. It worked a lot better than I thought it would.

[LeaveMyVagAlone]

Thanks everyone, you've all been helpfuhel. I'll update this next week post appointment