to wish I had whatever it takes NOT to be childbirth phobic?

[emeraldgirl1]

Thinking about this more and more (am 22 wks pregnant) and thinking about it now after reading the thread on here about someone sympathising with a woman about having to have a c section.

I have never, ever been able to understand the desire to have a v-birth. It just doesn't make any sense to me at all why anyone would prefer to do it that way. I have always known, btw, that this is not a reasonable, sensible, logical thought!! I am phobic about childbirth, I think down to the fact that every day on my birthday since I can remember, I would be regaled with the merry tale of how my mum had haemorraghed and almost died giving birth to me.

Add in the fact that not a single female member of my family these past 5 years has managed to have a successful vaginal birth, including 2 truly horrendous emergency C-sections for my sister, and I can easily trace the roots of my phobia!

I put off the decision to try to conceive for many years because I just couldn't even begin to countenance the idea of childbirth.

The problem is such that I am in the process (I hope) of getting agreement for an elective C-section when my baby is due.

But - unexpectedly to myself, because I never thought I'd feel this way - I am starting to feel bad and guilty and almost slightly grubby about it.

Everywhere I go I seem to encounter pregnant women talking calmly about their birth plans, which all seem to involve nothing more than light reflexology and a lavender candle ( I jest, and I know they'll probably be yelling for epidurals when it actually comes to it, but I admire their plans all the same, even if I still can't understand how the hell they can possibly want that!)

I am starting to feel that something is wrong with me/missing in me, that I literally can't even think about what they are planning. :(

I am also coming to terms with the fact that an elective c-section will mean taking the baby out a week before due date and feeling awful about that - shouldn't it 'cook' right up until it is ready?!

FWIW I have never thought of this as the 'easy' option but now I am hearing people talk about major surgery and pulling faces at the talk of a c-section and I just feel pathetic and awful and ashamed and weak.

Never thought I'd be at all bothered by this!!

YANBU

Though I wonder if someone came on AIBU and talked about arachnophobia impacting on their life choices, people would be falling over themselves to suggest having the house hermetically sealed or buying a spider proof sleep-suit, instead of discussing the issue of therapies for the condition. My understanding is that therapy can be very effective - for some women.

As an aside: I do think there's something weird going on culturally in relation to childbirth that at a time when birth has never been safer, and when really effective pain relief is widely available (pain relief which is so effective that it offers the prospect of a largely painless birth), that there seem to be more and more cases of tokophobia.

"Instead, we all have to go down a fairy path of pretending that one way is better than another"

A vaginal birth, successfully completed (in other words, in retrospect) is almost always the best option for a healthy mother and baby - as far as health outcomes go. Obviously making allowances for women with tokophobia (some of whom will be better off having a vaginal birth, some who'll be better off with a c-section), and severe perineal complications, which only occur is a very small percentage of vaginal births. The difficulty comes with trying to factor in the impact of emergency c/s on the outcomes for vaginal birth. Across the board high rates of emergency c/s make planned c/s and planned v/b comparable for many of the most important outcomes. However, healthy women who plan a homebirth or a birth in an MLU have emergency c/s rates FAR below the national average rates, and therefore, on balance it's reasonable to say that planned v/b for women giving birth in these settings, is probably safer (ie, is less likely to result in death or serious injury), and therefore IN CLINICAL terms 'better' than planned c/s. Obviously morally there is parity between c/s and v/b. Birth is not a moral issue. But midwives are health professionals, and so a large part of their concern will be about health outcomes - physical and mental.

shagmund - but will it be better for the mother mentally to have a natural birth in these circumstances? I ask that most genuinely - it's not a rhetorical question. I agree with you that what you say is correct from researching myself and I think that needs to be pointed out to the woman. Of course. But the ultimate decision is up to her.

DH is a dentist and has some patients who are absolutely scared witless about the dentist. He's had to eventually refer them for GAs for extractions. That is not the "best" option in that any GA has an inherent risk and it is accepted that it is medically safer for a dentist to carry out the extraction under a local. It is also more expensive for the patient to get a GA. Rightly or wrongly, that is something that is factored to the NHS process and something that DH has to consider. However, these are patients who are genuinely scared to death and willing to accept the risk of the GA once the pros and cons are discussed with them. Therefore, that is the "best" outcome for that patient. It might not medically be the safest. But it is the best taking in all the factors that need considered.

I see this as a similar situation.

Wow - thank you all so, so much for all the replies! Not only have you all been very nice and not judgey at all but you've offered some terrific advice and help.
RedToothbrush thanks v much for your post, I am going to have to work quite hard on feeling less guilty, I think! Get into training for motherhood!!

montysma your post made me laugh, I love the idea of all the chin-stroking... yes, I wish I'd ended up in that situation myself as I'd have been much happier not even really having to confront my own (perceived) weakness! It seems a real luxury right now to be told, "oh, you really need a CS" rather than me doing battle to get one!!

Good to hear the stories of people saying they felt fine and got back to normal life, as my mother people will be having me convinced I can't so much as lift a spoon for 6 weeks.

Oh, and a half marathon??? I salute you. Not sure I'd do such a thing even if I hadn't just given birth!

However, healthy women who plan a homebirth or a birth in an MLU have emergency c/s rates FAR below the national average rates, and therefore, on balance it's reasonable to say that planned v/b for women giving birth in these settings, is probably safer (ie, is less likely to result in death or serious injury), and therefore IN CLINICAL terms 'better' than planned c/s.

And there was me thinking that mental health issues were also clinical issues with medical diagnosis. Albeit one thats a lot harder to measure or count but still clinical.

'Better' is a word that is far too often banded about. Which of course, you yourself know because you stuck it in inverted commas.

The trouble with what you say about other phobias is this; I can honesty think of no other phobia that is so closely related to self worth and esteem as tokophobia. And the social structures that surround it mean that:
a) there is a taboo meaning people feel unable to talk about it freely
b) there is so much judgement/pressure being displayed by professional organisations and lobby groups that makes unbiased/influenced research hard to (see a)
c) there isn't much political will to fund research (What if it proves that the problem is being massively under reported and more women have a good case for a cs. Or worst still that one of the reason behind requests for ELCS and tokophobia is poor healthcare and this leads to more compensation claims for negligence. Or that it proves the need for more funding in maternity in general).

Put simply, its 'better' to try and pretend the problem isn't there and to try and say its women who are wimps and its all the media's fault.

Institutionalised beliefs are a massive problem in helping women feel OK about their birth experience. You can kind of forgive the uneducated and ignorant woman at the school gates who makes a thoughtless and ignorant comment to a degree.

But the midwifes, consultants and policy makers? Na. They are the real issue in making women with a genuine medical and health need feel shit about this.

Shinyblackgrape, I'm definitely not Paula Radcliff, but I am a keen runner. I didnt run through the pregnancy as I didnt want to do anything too risky as it was twins and also, you get that horrible heavy feeling down below really early on, so it would have been hellish.

It wasnt that heroic, as I somehow seemed to have retained a fair bit of cardio fitness. I did a few jogs from about 7weeks post, to see how it felt and was fine. So just went ahead with the 1/2 marathon as it was a race I did every year. I wouldnt have done it if I thought my innards were about to land on the pavement! But the wound seemed well healed and I wasnt in any pain whatsoever.
I'm sure the docs and health visitors would have slapped me, but they didn know!

If they will let you have an elective C-Section, go for it. It is major abdominal surgery but very safe and my female consultant told me in her opinion it is actually safer for the baby, it is the mother for whom there is a slight risk. This might explain that survey years ago which said a majority of female obstetricians would choose an elective C-Section over vaginal birth...for the baby's sake.

I have two children - the first was induced because of being big for dates and I managed to make it pretty painfree even on UK NHS by insisting on an epidural at the earliest possible stage in my birthplan. So it is possible to do this provided you make it very clear upfront that you are not a natural birth type. Beware midwives trying to turn you into one and claiming the anaethetist is not available or you are too far gone etc.

The sequence went Tens machine - Gas and air briefly - Epidural - epidural topped up for forceps delivery after ventouse failed.

Like you, I put off childbirth for years despite being happily married as I feared having a severely handicapped child like my sister. I had also found all TV depictions of childbirth extremely harrowing and degrading and always said I would medicalise to remove pain as much as possible.

Like I said you can get a vaginal birth painfree even when it goes wrong(like I did) if you use an epidural - it will still however be potentially traumatic as mine was in many ways.
So much so the second time around I made a case for an elective C-section - baby was seen to be big again and I got one and it was a lovely experience doing it by appointment and the baby arriving minutes later.
The only afterpain was minimal and involved soreness with the scar when first moving around but I was never at any time in pain constantly and they gave me good drugs including morphine in the post-op period.

So the only downside to C-Section really if you can overlook the unnecessary surgery argument - is the recovery but i.m.e. it is more inconvenient than painful if all goes well and there is no infection etc etc . I made sure I had extra support at home in the first couple of weeks but would have needed it anyway with a toddler alongside a newborn. In fact I think the episiotomy scar during vaginal birth was harder to recover from because of where it was located than the C-Section one if I am honest.

So I am pleased I did it both ways - rather than listen to all the horror stories of either method, it might be best to take control in your own case by discussing how your birth can be managed in accordance with your wishes. Given your phobia, if they cannot guarantee that an anaesthetist will be available to do a vaginal delivery epidural - then maybe protect yourself by opting for the elective C-Section. If however you are told there is always an epidural available to women who want/need it, you may feel abale to leave your plans more open.

Do not listen to any criticism from either side of the camp - do what is best for you because at the end of the day it matters not how the baby comes into the world, just that the baby gets here safely for all to enjoy and cherish.

Best Wishes.

SBG - c/s is one response to tokophobia.

Expert counselling is another.

Some women who've chosen to have a v/b after great soul searching and a lot of work in counselling have found it a hugely empowering and positive life changing experience. And yet people seem so unwilling to suggest this may be a viable option - to try counselling.

Again - as an analogy, if someone was phobic about sexual intercourse but was desperate to conceive, it would be very odd if everyone piled onto the thread and immediately encouraged the OP to go for IVF.

UKAT - planned c/s may well be safer than a planned vb in the obstetric units female obstetricians work in as these units usually have extremely high rates of births which end in emergency surgery. The balance of risks and benefits for mothers and babies looks very different if you focus on the much better outcomes achieved by midwife led units. You'd also want to take into account that while planned c/s is very safe for the first baby, it puts subsequent pregnancies at much greater risk of serious placental problems. Not such an issue for a 36 year old doctor who is very likely to have a small family, but more of a problem for a much younger woman (who has a massive lower risk of emergency c/s if she tries for a vaginal birth) who may want a larger family. In other words, it's very hard to talk sensibly about risk without taking a range of factors into account.

To be fair - I don't think everyone is. I've suggested hypnobirthing and others have suggested looking in to epidurals etc.

I think mainly what everyone has said though is that, at the end of the day, it is the OP's decision and the key thing is to make that an informed decision based on the pros and cons of each option. Once the OP has done that, she shouldn't feel "guilty".

I still am of the view though that the whole thing needs to be looked at in the round and the OP's mental health is just as important as her physical health So, what is absolutely "best" physically may not be the best option when all things are taken together.

People get no medals for childbirth. And you will have a lovely baby

xxx