• 10 AUG 15
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    The Plague of Fear

    fearinpregnancyOur society is undoubtedly plagued by fear. We try to ignore it, pretend it’s not there but it haunts us day and night. Certainly fear can be healthy. It tells us when something is wrong or that something can cause us harm and to avoid that something. However, when does fear become something that hinders our everyday lives or prevents us from being happy or pursuing happiness?

    I had a client tell me a story about how she had mentioned to a co-worker she was having a home birth and her friend told her a barrage of home birth horror stories about babies or moms dying or there being really bad outcomes. “How could you ever do something like that to your baby?” As if she had just told her she was delivering her baby into a vat of acid or razors. Society has somehow been tricked to believe that the only safe place to deliver is in the hospital setting. In reality, the hospital has only been available to everyone the last 100 years and yet, society is thousands possibly millions of years old. How did we survive all those years of birthing without the hospital or the OBGYN?? You guessed it, midwives!! Birth was not feared in our early civilization but celebrated. The ancient sculptures the Aztecs made of women birthing their own children or of paintings of midwives holding and supporting women as they birth support this fact even more. There was no fear and if there was, there was someone there to encourage the mother and bring her safely through her birth, the midwife.

    Aztec labor                                              MideivalBirth
    When someone is afraid or fearful their body goes into two modes: fight or flight. But scientists are beginning to realize that there is a third mode: freeze. Fear can literally cripple someone and prevent them from being able to do anything, including birthing their own baby! These fears can be having a c-section, tearing, pooping herself, not being a good mother, not being able to handle the “pain”, being told she isn’t good enough, baby not breathing right away and the list goes on and on. Below are some things I have noticed in my own practice but have also read about in research. It’s time we put an end to birth fear and return to our roots of celebrating birth!

    Fear Hinders Labor

    Fear makes the female body literally “close up” because the body is meant to relax during birth and if there is fear present, a woman’s body slows or stops labor until mother can get to a “safe” place to have her baby. This is a mechanism that has developed from women birthing in the wild (all mammals have this instinct) as the body knows when it is safe to deliver baby and when it was not and history shows countless stories of women in full labor and then being able to stop labor when a dangerous situation presents itself. For some women, this “dangerous” situation can also be the hospital. The bright lights, loud alarms and unfamiliar environment decrease women’s natural oxytocin levels and hinder the body’s ability to get comfortable and feel “safe”. It’s no wonder Pitocin augmentation and induction rates are so astronomically high! These women report having intense labor and knowing they needed to get to the hospital and as soon as they hit the bright unit’s triage desk, their contractions are gone, even if they are at an advanced dilation. This “closing up” is also discussed in Ina May’s book, Guide to Childbirth when she discusses Sphincter Law. When a woman must transfer from out of hospital birth, she will be one more advanced dilation at home and upon inspection at the hospital is significantly less dilated than she was before. Sphincter law is directly related to fear.

    Others’ Fear Hinders Labor

    So many women are all for home birth but their husbands or family members are not on board. Or the husband/family member says they’re is on board but underneath there is a brewing pot of fear just waiting to boil over! I have seen so many cases of mom’s labor stalling because she can sense the fear of her husband or family member, which inevitably increases her fear. We can sense when someone else is afraid, it’s an instinct that tells us we should probably be afraid as well. And just as our own fear can slow labor down, the fear of someone else makes just as strong an impact. I have often had to talk to clients interviewing for a home birth about the importance of both of them being on board with out of hospital birth because the husband’s lack of support will come out in her labor pattern. I have even seen moms kick family members out of the labor room because their fear and anxiety was palpable and causing significant delays and difficulties in the mom’s labor.

    Negative Thoughts Increase Fear (and Pain)

    Fear is not only a feeling but often expresses itself in thoughts. When someone says something negative to another, that thought bounces around in our head and cripples us with paralyzing fear, causing everything to freeze! Think about it: someone tells you “you can’t do _______ (fill in the blank), or you’re not good enough for ________.” If you don’t have excellent coping mechanisms, positive self-talk and facts to get you through these statements, eventually all you will be able to hear is that one person’s voice bringing you down and playing even more into your fears. Some women don’t even know these thoughts are present until they are in labor and then suddenly a flood of emotions, thoughts, and feelings comes rushing in at our most vulnerable point in life and if not addressed appropriately, dashes us on the rocks of fear. When a women is preoccupied with negative thoughts, she cannot focus on her baby, the contractions or how to keep her pain under control. The most fearful women I have encountered in my career were the ones who reported the most pain and feeling the most out of control. When you let someone else’s thoughts fill your mind, you are no longer in control; they are.

    So what are some ways to reduce fear in our lives? It surrounds us every day so it is important to have excellent coping mechanisms available to battle fear at the root!

    Get the Facts

    This is so important! When someone tells you something that increases your fear, make sure they’re right! Or even better, go find quality research that supports the truth and remind yourself of those facts when someone wants to rain on your parade. There are many quality research articles which prove time and time again that out of hospital birth is safe for healthy low risk women and some even go so far as to point out that out of hospital birth is safer than hospital birth for healthy low risk women. Some citations of these articles are below. Now realize that no matter how many articles you throw at someone, you may not be able to change their mind. That’s fine. I’ve decided not to be in the business of changing a stubborn persons mind and it has relieved me of some significant stress, you should try it too! 😉

    Citations:

    Cheyney, M., Bovbjerg, M., Everson, C., Gordon, W., Hannibal, D., & Vedam, S. (2014). Outcomes of care for 16,924 planned home births in the United States: The Midwives Alliance of North America statistics -project, 2004-2009. Journal of Midwifery & Women’s Health, 59(1), 17-27

    Nutter, E., Meyer, S., Shaw-Battista, J., & Marowitz, A. (2014). Waterbirth: An integrative analysis of peer-reviewed literature. Journal of Midwifery & Women’s Health, 59(3), 286-319.

    Positive Self-Talk

    I get a lot of rolling eyes when I talk to my clients about this one but I have seen it work miracles!! Positive self-talk literally puts fear right in its place or really out of your place! How can you be fearful when you are reminding yourself that you are courageous, you are strong, you are beautiful, you were made to do this, you are capable and on and on! You can’t. The next time you hear someone’s nasty comments or words flitting in the back of your mind, turn it right back out the door with a statement exactly opposite of it, I know you will see a world of difference!

    Meditation

    Now, this looks different for each person but I think it goes right along with the positive self-talk. Meditation can be yoga, praying, reading the Bible, quiet time, or anything that removes you briefly from all the negativity and fear the world has to offer. Basically, you are filling your mind with positive thoughts while relaxing your body and relieving it from all the stress fear causes. I actually read a statement recently that said that one day of worry (a subcategory of fear) is equivalent to working a 40 hour work week. Can you say holy cow?! What damage fear does to our bodies and our babies! Research has shown that increased cortisol levels associated with excessive stress and fear can cause significant problems for your baby and even affect them as adults. Now don’t go getting fearful about having too much fear, that’s not the point! The point is we need to rest and we need to fill our body with positivity. So take some time to medicate on those positive thoughts and shut the world out, even if it’s just 10 minutes.

    Take Responsibility                                                        

    The only person who can make you fearful is you. The top three suggestions lead to this one major point and that is that you must take responsibility for your actions or reactions. If you choose to have an out of hospital birth, you must take responsibility for any and all outcomes. If you have a hospital birth, you must take responsibility for any and all outcomes. You are in control of the place you birth, no one else can (and they shouldn’t) tell you what to do or how to do it. Now this does not mean bad outcomes caused by irresponsible providers. This means that you must be ok that an OR is right around the corner in the hospital, that the epidural rate is 95%, the c-section rate is 25% and you will likely be tied to the bed on continuous monitoring for majority of your labor. This also means you must be ok that an OR is more than 5 minutes away at your home or a freestanding birth center, that we don’t have many medical interventions (continuous fetal monitoring, forceps or vacuum) and that you cannot get pain meds. There are risks and benefits to both and the decision on where you birth must be yours. Take responsibility to end unhealthy fear now. There are things to be afraid of but when you have hired a highly competent team to care for you, your birth is not one of them!

    And if all else fails and someone is still trying to ruin your birth with their ugly stories, tell them to stop. Boundaries are healthy and in a society where we often overstep boundaries and see nothing wrong with it, it’s time we start becoming healthy again and telling people no. That of course is another blog for another day!

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