Friday, January 22, 2010

Respecting Fear?

I had a meaningful exchange with a relatively new friend a few days ago that has really made me think about why I tend to become so anxious about childbirth. Because despite my enthusiasm for natural childbirth and my excitement about the event, I do tend to become anxious. It occurred to me that, though this may sound dramatic, I have a slight case of post traumatic stress disorder connected to my first birth experience. (I'm sure many women do.) Perhaps it's part of the reason I tend to cringe when I'm in a crowd of women singing the praises of epidurals. I don't just think, "No thanks, not for me." I literally feel a slight "fight or flight" impulse go through me.

I will openly acknowledge that the difficulties which I faced in my first labor and recovery were not entirely caused by the epidural. I had poor obstetric care and received very poor care from the hospital staff. I also had such little knowledge that I didn't understand enough of what was going on, and so my anxiety and fear in the situation was increased. Still, receiving my epidural was the catalyst for the many events which led to my hour of delirium and the many weeks to follow of pain, failed nursing, and increased stress (on top of the typical stress of having a newborn).

The exchange I mentioned before was with a new person in my neighborhood, a beautiful and delightful woman whom I've only known a few months. She asked how I was, and when I answered that I was "okay" (I need to stop using the word "okay", by the way), she said, "Really? Are you really okay?"

I then shared, as generically as I could that I tend to become very anxious when I'm expecting a baby, not because of the labor pain, but because I have a lot of preparation to do for labor and, being a mother of 3, I have little time to do it. She empathized that she often found insufficient time for important parts of her life (she is a mother of 2), and then she asked if I like to go unmedicated. I shared with her that I do and that I enjoy it, but also that I'd had some difficult labors and some surprising and scary deliveries. Then I gave her my reader's digest version of each labor, and she passionately empathized.

"You've had some rocky experiences, and those fears are very real and should be respected," she said when I was done.

I, sensing that she somehow understand better than many what I was talking about, asked if she knew a lot about childbirth (beyond what she would inevitably know from being a mother of two). She answered, "I'm a trained doula." (Aha!)

I gently asked, "Do you mind me asking, do you prefer unmedicated birth or do you choose an epidural?"

She responded, "I choose an epidural, but that is because I have a strong fear connected to pain in..." and then she trailed off. I could tell that she had a very real fear that affected her birth choices. And yet I could tell that she was perfectly at peace with her births and that her epidurals were not a problem for her. I respected that. As I've said, I don't think there is only one way to birth a baby, and her experience was an illustration of that.

The conversation ended well, and I had a new-found appreciation for her, not because I think epidurals are great, but because I'd met someone who I felt truly respected both sides of the issue without feelings of contention. I don't know what the root of her fear is, but I admire the fact that she, approaching childbirth with more knowledge than most women, was making a conscious, informed, self-aware decision about her labors.

I thought a lot about her use of the word "respect" in referring to my fears. I'm not 100% comfortable with it, because I don't want my personal fears to hinder or disrupt my ability to birth peacefully and comfortably. But there was something very compassionate in the use of that word. And perhaps right now, as I approach my final birth experience, I'm just very hungry for that kind of compassion. :) No I can't complain that I've had to have cesareans with all (or any) of the my births, and no, I've never lost a child in birth (thank goodness!!). But the pain and poor health associated with the epidural was real. The guilt and disappointment of having a mostly painless and very positive labor with my 2nd birth, and yet realizing that my efforts had not saved him from complications was also real. And the terrifying image of my 2nd son, pale and floppy after his rocky birth, are still real.

And yet, this fear, while I want to acknowledge it and "respect" that it has affected me, doesn't have to take away my peace. I feel my daughter's movements and feel in my heart that she is unencumbered by her cord. I see the possibility that she may arrive earlier than her siblings (which I wouldn't mind), and I know that, even if she does pass mechonium before birth, it doesn't have to be a threat to her. I know that I'm in good care, and I've doubled my confidence by discussing my birth preferences very plainly with my midwives and having our birth plan in my file. I have one of the most wonderful (and handsomest) birth coaches alive. I know that I'm going to the providers and the hospital with the best reputation in the area for natural, low intervention childbirth.

I know that it will be okay. God has blessed our previous births in one way or another, especially those of my sons, and He'll bless this one in different ways.

How do all of these musings become an advocate for natural childbirth, because I do want to openly advocate it to those who are interested in it or desire it? Well, I'd say, look at your feelings. Why are you reading this (other than that you might be a very nice person who I've invited to read it)? Perhaps you are uncomfortable with the popular attitude that there is only one obviously "sane" choice for birthing: Hospital birth with an epidural. If so, I'm glad to hear it. There are other ways to bring a baby into the world. You do not have to feel sheepish about your interest in it. It doesn't mean that you think that you're smarter or stronger than other women, and it doesn't mean that they are uninformed weaklings either. It just means that you're paying attention to your own feelings.

What I think an interest in natural childbirth says is that you might feel a slight loss or void if didn't explore other options. Perhaps you are someone who doesn't just want to "get (childbirth) over with" or who wants to really feel confident that, should you choose an epidural, it's a truly safe option for birthing and will not keep you from being able to fully participate in the birth. If you feel this way, I consider you kindred. :) I felt the same way, and I've met too many women like myself who, when face the anxiety of the unknown in their first birth, didn't prepare for natural birth and left themselves with no other option than an epidural. Many of them later felt as though they'd given away a precious experience.

So, where I'd like to go with this post is to extend the invitation to explore your options. Read about the different choices you have. Look up Hypnobirthing, Bradley birth, epidurals, OB's, CNM's, etc. Consider your health and your personality. (If you are high-risk, natural childbirth is not necessarily lost to you - you'd just need more intervention than others might). Take seriously the possible risks of epidural. (This is important, because regardless of your personality, you cannot choose your biology, the size or position of your baby, or the anesthesiologist). In other words, educate yourself and keep an open mind. And don't feel embarrassed or sheepish about your interests. No one need take offense if your choices are different from theirs.

In closing, what are my fears? Well, if you haven't read about my previous births, I'll tell you plainly that danger to my babies, having no control in a labor, and terrible postpartum pain are my deepest fears in connection to childbirth. And if I'm going to respect those fears, the best choice for me is natural childbirth.

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