To ask how do I best manage my anxieties over pregnancy and giving birth??

[Absofrigginlootly]

I have no idea if I'm committing some huge MN etiquette faux-pas by doing this so really really sorry if i am. But I have posted a thread under 'relationships' asking about how best to manage my anxieties about giving birth and something going wrong and also about dealing with my difficult DM and MIL whilst in the midst of struggling thru this anxiety.

Thread link:
www.mumsnet.com/Talk/relationships/2176878-To-ask-for-advice-on-dealing-with-my-anxieties-about-my-pregnancy-and-birth-and-also-dealing-with-difficult-DM-and-MIL-and-new-baby?msgid=49354961

I have receive some really excellent advice regarding my mum/mil and am VERY grateful to those people who have taken the time to reply.

I would however, like a bit more practical advice on the birth side of things, as this is what iam most struggling with at present.

I saw a thread on here the other day about an OP who was wanting to refuse all vaginal examinations. She got some really excellent advice regarding how best to manage her situation and her anxieties.... I was kind of hoping for similar sort of advice, as I'm not really sure where best to go from here.

If anyone would read the other thread and comment/advise I would be extremely grateful. Perhaps if there are any MW or Drs (obs and Gynae) out there who could advise??? Or anyone who has been through a similar situation?

Thank you

What are you anxieties specifically.

Yes sorry! that might be helpful for you!

Some extracts from my post which may explain things....

Anyway, I've been feeling pretty anxious during this pregnancy and spend some days in such a state that I can't leave the house. Some days are much better. I spoke to the MW the other day and said it felt like I was developing an anxiety disorder. She just gave me a leaflet for a local counsellor.

I guess where I'm at right now is feeling so apprehensive about the future....worrying about giving birth and something going wrong (to the point I can't sleep sometimes and wake up in tears), having no one for support other than DH

With regards to my anxieties around the pregnancy....I am toying with the idea of a doula...someone to act as a 'mother figure/old experienced woman' I'm my life. Our nct teacher is a doula who offers a package of pre and post natal care and birth support. DH is slightly unconvinced thou as think she is a bit of a hippy! He said he'd go along with whatever I want though.

I'm also thinking of phoning my MW back and asking for a meeting to be arranged with the delivery suite manager, to discuss my anxieties around the birth. Trouble is, I'm a nurse in the NHS so I am acutely aware of how stretched things can be when you're short staffed etc (some days I used to go home and wonder how none of my major-surgical patients had died that day!)....so I feel some of my anxieties are coming from a genuine place. Others are of course a reaction to the stress and grief we've been through in the last few years, this baby is just SO precious to us.

Thank you to those of you who said I am normal to be feeling like this. It helps to read that. My MW and consultant etc are almost a bit like "you're out of the first trimester, what are you worrying about now?!"

Would definitely like to hear more from people that have had similar anxieties about pregnancy and birth after fertility problems or loss, as this is the main thing I am struggling with right now.....how did you cope? What did you do? What support did you arrange? Do you think me trying to arrange a meeting with the delivery suite manager and MW to discuss my concerns would be valuable??

It helps to have a birth plan. Even though, births never go according to plan, it at least gets you thinking about it and understanding what your options are. It's best to have them written down on a sheet while you're thinking clearly.

Me, personally, having an epidural helped tremendously. The birth was very relaxing since I wasn't in pain. Got to chat with DH while eating cherry popsicles until I had to push.

Also, remember, there's no "right" way to give birth. At the end of the day, if you have a baby, you did good. So don't put pressure on yourself.

Could you volunteer on the delivery ward if the hospital you work in has a delivery unit and do cleaning or stock ect. Seeing the ward a few times may make it less scary.

hypnobirthing - beyond all the lentil weaving talk the relaxation techniques and breathing techniques are great.

imo although they bang on about intervention a bit I really feel that when I was heading for intervention I was able to stay calm.

another thing that helped me (and this isn't for everyone ) I watched tons of birth programmes - babes in the wood about a mw lead centre, loads of american ones and a homebirth one - just as I am the way I am I found understanding birth as a whole including the interventions and terminology and the process etc really helped me as I knew what was happening at why at every stage.

plus my fiance was totally clued up and understood exactly what I wanted and understood what I needed - so a doula would be fab.

oh and a tens machine was invaluable.

whatever you choose is fine the main thing is you get through it - and since most go on to have another baby it can't be on average so bad can it! don't focus on the horror stories or on how you think you should give birth but on keeping calm and going with it - a majority of the time your body knows what to do - it realeases the right hormones to set labour of, in contracts and relaxes and dilates and gives you the urge to push, your baby positions itself and if not the hospital has experienced and diligent staff that know when to intervene to get the best outcome - sometimes this can be traumatic and being able to stay calm through this would stand you in good stead - but most are lucky and it is a good experience (if painful and hard work ) with a healthy nbaby at the end of it. it can go wrong yes but focusing on that does not help you and it is unlikely to happen.

hope it all goes well for you xx

Doula.

Midwives are fab, but often don't have time to sit and really listen to a woman antenatally. That is what you pay a doula to do, she will also help you make decisions which are right for you about your birth plan, eg pain management, place of birth and on the day, will focus on your emotional wellbeing and that of your husband. Lots of evidence that women who have a doula have more chance of a straightforward birth, although I've known women planning a C-section who have used a doula to help them through it.

Also look at some of the self-hypnosis preparation for labour and birth, that might also help.

With the pain don't be a martyr if you need it have it.

If you want a doula it's nothing to do with your husband, and I mean that in the nicest of ways. It you who is going through labour and delivery.

Write a birth plan, pack your hospital bag early.

It is a scary time, being pregnant and knowing that the baby you have growing inside you is going to be your responsibility for the next 18+ years is a terrifying time with the anxiety with that.

Doula is a great idea. Daisy Birthing is brilliant too if it's in your area.

Hypnobirthing invaluable-try to find an actual midwife who does it though. First time round we did it with a counsellor/therapist and although it was good, it didn't compare to the refresher we had this time with a midwife who has actually attended many births.
Having one midwife (I have a one 2 one-see if they are available in your area or independent if financially viable) this time who sees me often, has the time to talk and get to know me and who will be there when I give birth
Planning a home birth relieved so many anxieties for me-although I appreciate this isn't for everyone. First time my DD had other plans but we will have to see what happens this time (due in 5 weeks!) x x

My Mum was the expert at terrible birth stories: scared me witless! All I can say is ignore, ignore , & ignore some more.
Look around you. Look at who has children. They were OK. They survived. They were fine. All went well.
All will go well for you too, you'll be fine -x-

I had a very anxious pg following rmc. For me, having an elcs was what I needed to regain some kind of control, but that's not for everyone. Take any counselling that's on offer, it will help. Pg can bring up all sorts of unresolved emotiona

Ps with pain relief just start off and see where it takes you - go up the pain relief tree - start off with breathing, massage, tens, paracetamol , warm baths or showers or birthing pool if that is possible (eg not always poss in an induction ), do relaxation and tens, maybe cocodamol then think about gas and air or pethadine or head straight to epidural if you're not coping - at each stage you can give yourself more options of where to go next - if you go to some choices others become not possible eg a some stage birthing pools are not an option and after a certain point epidural might not be an option - so go in knowing your options and why and when choices are available, what they entail and their effect on you can help, you can have control and make sure your birth partner doula and/or Dh know what you want and why and are confident to discuss the the mw or dr if you aren't in the right place to do so, they can help the mw know what you need - my fiancé was great at telling me what was going on and listening to what I wanted and conveying that to the mw.

You need to contact the unit you are giving birth in & see if they have a midwife that counsels women who are anxious or fearful of birth. We have one in our unit who has time to sit & speak with women. It's usually a senior sister or experienced midwife, they can show you round the unit, help you make a birth plan & help you feel more prepared & in control. You can also access a supervisor of midwives, look on the nmc website for guidance. I think a doula or someone objective would be a good idea so they can support you without being overly emotionally involved. The idea of volunteering is not a good one, too much happens on a busy labour ward & more than likely you will end up feeling worse.
Good Luck.

Thank you all for your helpful replies.

One of my problems is trying to find the right balance between informing myself of birthing options...and reading things which then just set my worries/anxieties off...and makes me think that ignorance is bliss. It's a fine line to tread.... and I'm not sure I'm striking the right balance.

I'm not worried about giving birth from a pain point of view...I'll deal with that as best I can. It's not me I'm worried about, it's the baby. It's the thought of being left alone, something going wrong, no one noticing, that sort of thing....

Thank you pippin8 that's a really really useful suggestion, do these MWs have a name? (like specialist nurse practitioners do etc)

iggi999 I can completely understand that perspective! the thought has occurred to me too....but I ideally want to try for a natural delivery as I've had several Gynae ops already and would prefer to avoid being 'messed about with' any more than is necessary. (Currently watching a friend go thru a terrible time with ashermans syndrome as a result of a surgical procedure)

Too neurotic for a home birth thou btw....definitely want to be in my local obstetric lead unit with Drs on call, anaesthetists, theatres and nicu/scbu right there!

Lots of you mention your 'preferences' or 'options'........
In terms of trying to guide my reading and birth plan/preferences, what areas/issues do you think I need to make sure I have an opinion on....??

I'm thinking:

1. Pain relief options
2. Relaxation techniques
3. Delayed cord clamping
4. Managed or natural 3rd stage delivery
5. Vit k injections

I can't think of anything else...I'm sure I've missed something big and obvious! Experienced mums please help!!

From the birth plan aspect I think you need your pain relief options, if you are looking at relaxation techniques do you want use of the birthing pool -my mw made sure I got use of it as she knew it was in my birth plan - and yes to the last three.

Obviously you may go off plan but knowing what you want at the outset is good.

As for your anxieties from a "what if it intervention is needed" I think you need to manage your anxieties as best as you can in the lead up by learning relaxation techniques and making sure your birth partner is clued up as far as the birth process is concerned, helping you with relaxation techniques (eg in my hypnobirthing classes there was also massage that my fiancé was shown that are good for during labour), birthing positions and what you want in a cascade of intervention (eg if I get gp again I would be happy to try venteuse but not forceps - if the option of forceps or emcs I think I would go for emcs - but again you can't plan for some stuff that happens and again being calm would be good for you and the baby if it went to intervention.

You can only plan so much - I wanted natural delivery of the placenta but after. 4 days of labour they felt that there was a risk of bleeding as my uterus had been on the go for so long - by that point I really couldn't have cared less and was fine with that and was just glad I never had to go to theatre :)

Oh and pack lots of non fizzy energy drinks - I couldn't eat after the first day of labour (prob hormone related IMO ) so the energy drinks really got me through the pushing which was hard due to ds' position.

And if you have no pain relief and they think you may tear or need episiotomy then ask for local anaesthetic in advance (as otherwise it bleeds out through the tear/cut and is no use - I genuinely didn't feel the tear due to the local anaesthetic and they had taken the gas and air off me as I needed to concentrate (not that I got a lot beforehand as the prev mw had hooked it up wrong - they sorted it for the stitches and that bit was fine too due to the g&a)

If focus on 1 and 2 of your list and then as intervention says what do you want if things don't go as planned. 3-5 of your list are relatively less important. Things to think about if things go as planned.

I was anxious throughout my pregnancy. Knew a few people where things didn't go well so was kind of anticipating the worst. I was a then a bit flummoxed when I had a baby to look after! So I would also say think about the first few weeks too.

Thank you for the guidance. I think I'll take the plunge and start with the 3 pregnancy books I have at home which have chapters on birth and pain relief.....and avoid the sections on 'if something goes wrong' as I don't think I could handle reading that right now!

Have taken your advice pippin8 and contacted one of the MW supervisors at my local birthing unit. She was lovely and very understanding of my situ. I have booked an hour long appointment for me and DH with her colleague for next week. She said we can start by going thru what my worries are specifically and go from there. She also said it's really common for health professonals to be extra anxious because they "know too much" about behind the scenes stuff...which made me feel a bit less of a nutcase!

I have also told our nct teacher that we're very interested in hiring her as our doula. She is very experienced (over 20 years!) of being a doula, knows the local birthing unit and staff very well and said she can teach me relaxation techniques and hypobirthing etc...as well as offering me support pre and post birth (as I can't really rely on DM or MIL for that sort of support...see my other thread).

Any other suggestions?
For those of you who used TENS - did you find it useful? Where did you buy/hire one from?

I hired mine from Boots. I didn't find it helpful but I was induced. I have heard other people loved theirs.

Me and friend pg at same time went halves on one £20 each - both found it fab and it has done the rounds of our friends as we lend it out.