Help me reduce my baby-birthing anxiety
October 18, 2005 12:17 PM   Subscribe

Help me reduce my anxiety about labor & delivery of my first child (due date = less than a week).... I'm having recurrent nightmares: Repeat airplane crash scenarios. Nightmares of my husband getting killed on the way home from work. Of having a stranger assault me at home, BTK style. And it doesn't help that we had to put our wonderful dog to sleep last week.

Is this anxiety normal? Granted, I've probably read too many books about childbirth (I'm an INTJ and like to be prepared) and watched too much Discovery Health. Also -- I'm planning to go natural, because I have a back-surgery scar that may preclude an epidural. I figure it would be better to plan for the alternative rather than expect an epidural as a matter of course. Part of me also thinks that nothing could be as bad as my herniated disc was (screaming level), and I want to see if I can do this unmedicated.

Am I trying to control something that is uncontrollable?
posted by mdiskin to Human Relations (18 answers total) 4 users marked this as a favorite
 
Well, I'm not sure if your question is more how to address the symptoms of your anxiety, or about the labor and delivery specifically, but since I can't help with the first, I'll address the second.

It (either the labor or the pain) is controllable to the extent that you've prepared adequately. I sense that you probably have, so I don't think I need to list the various pain-alleviating methods that may work for you. But be aware that things change quickly during labor, either the level of pain you're feeling, or if the current method is working, or even the status of the baby. So be prepared to change your response if you need to.

Sometimes you will feel out of control during an unmedicated labor, and your response will be to panic, so you need someone to keep you focused. I assume you've chosen someone to help you (the preparations I referred to above). But it is very possible to have a relatively controlled and happy delivery. I've experienced both an unmedicated and an epidural delivery, and though the epidural delivery was more enjoyable (and controlled, if you want) during the labor, the unmedicated was notable in the instant release of pain and flood of endorphins the moment the baby came out. I felt nothing afterwards, not all the poking and prodding which I'm sure would've otherwise been considered painful.

In reference to your immediate anxiety, I would recommend a prenatal massage, which probably would be both emotionally and physically beneficial for you.

Good luck!
posted by artifarce at 12:36 PM on October 18, 2005


I think some level of anxiety before childbirth is normal-- not that I've been through it myself, but I saw it in my wife when our son was born last year. She kept reminding herself that MILLIONS of women have done this before, and many do it every day without even the benefit of modern medical care and pain relief.

Regarding the "natural" method, it's fine for you to want to go that route, but I'm not sure if "I want to see if I can do this" is the best reason. It isn't a competition, and whether you do or don't get an epidural doesn't mean you are any more or less capable as a mother or woman than if you do. I'm just waying that so you don' t feel "let down" if you do get an epidural.

Best of luck.
posted by GregW at 12:37 PM on October 18, 2005


Response by poster: I should clarify that I'm not *at all* against epidurals or medicated labor -- just that I can't count on it for myself. I have supportive midwives (and docs) for anything I want, and my husband is also going to be there to help me figure out what to do. Part of my minor issue with epidurals is that it means you then labor on your back and don't have gravity assisting you. Or so I hear.
posted by mdiskin at 12:47 PM on October 18, 2005


yes, and it sounds like your hormones are doing a number on you, which isn't helping.

Remember, for every horror story you've heard, there are plenty more routine, or even happy birth stories. Among my acquaintances, most of the deliveries went perfectly fine. Natural childbirth hurts, and anyone who tells you otherwise is probably trying to sell you something. But pain can be minimized with good emotional support and plenty of non-invasive techniques.

Do you have a doula? I didn't use one, but everyone I know who has say the special attention and care one of these assistants provide is worth every penny. If money is an issue, you may be able to hire a student doula, who will probably charge less. The service usually includes regular visits before and after the birth to help you with whatever challenges you're facing (including anxiety), and support throughout labor and delivery.

Also, it's really okay to have anesthesia if you need it. You can have pain meds without an epidural.

Finally, it sounds like you've only read the scary birthing books. More empowering stuff includes the books of Sheila Kitzinger and Birthing from Within.
posted by whatnot at 12:48 PM on October 18, 2005


Are you trying to control the uncontrollable? Oh, sure, but everyone does. After Claire was born I wrote a lengthy Note To Self, the gist of which was "Let's not do that again," but in accordance with cliche my second daughter is due in about three weeks.

Are you hiring a doula? I highly recommend the practice; she can help you with alternative pain management techniques (toning, water labour, changing positions, visualization) and with assessing your medical options. Doula-attended births have, on average, far lower rates of epidural, episiotomy and c-section, and mothers report more favourable experiences.

Things my doula said that really, really helped: "It's not the pain of damage, it's the pain of work." "If it's getting too hard, change the situation." "You can do this."

Epidural is not your only drug option. The opiates don't mask the pain but they do have a powerful dissociative effect - it still hurts, but you don't care. Fentanyl worked brilliantly for me in transition. I slept between contractions. Bliss. I was B strep positive so I already had an IV, so they didn't even have to stick me again. I've heard nitrous oxide has very similar effects, though it's not commonly available in the US.

All up I'd say my broken ankle and two wicked migraines were worse, so your herniated disc probably was too. It's no picnic - Claire's was an easy birth and still felt like a car wreck - but you probably won't die, and neither will the baby. You may very well swear and shout vile imprecations at your loved ones and cry and poop on the bed, but again, everyone does. Afterwards you get to tell your gruesome birth story at parties. The childless people cringe and the parents laugh. We are a people of simple pleasures.
posted by rdc at 12:49 PM on October 18, 2005


my "yes" above was in answer to your question "Am I trying to control something that is uncontrollable?" btw. Best of luck!
posted by whatnot at 12:50 PM on October 18, 2005


Some freaky anxiety like this is pretty normal--I mean, you're about to be handed a baby, for which you are responsible...it's pretty heavy. Your hormones will make hash of your common sense. You're probably having some insane dreams lately, too?

I've done medicated and unmedicated births and if I were to go for the trifecta, I'd aim for drug-free. It was a great recovery process, much easier than my medicated birth. And while I remember the pain and shrieking vividly, it's almost as though I saw a very realistic movie about a crazy woman who screamed a lot, then had a baby. I'm a little detached from it, a year and a half down the road. So I think you're right on the money there, though I do hope you've discussed alternatives to an epidural, in case you do need pain management at some point.

I do not know if reading my birth story would help you at all, seeing as it involves some fast driving and the aforementioned screaming, but if you think it might, my blog link is in my profile--look in the June 2004 archives. At the very least it might get you to the point where you can look forward to having a hell of a story to tell (because even the most routine births are a hell of a story, if you ask me).
posted by padraigin at 2:38 PM on October 18, 2005


Response by poster: Thanks for the answers, everyone. I have Birthing from Within -- my neighbor gave me all her empowering-birth books to read. So I'm trying to feel empowered and know my options. I felt fine about all this up until last week -- then started having all these Worst Case Scenario nightmares.

Is it too late to find a doula? I'm due in just a few days.
posted by mdiskin at 3:08 PM on October 18, 2005


Have you taken breathing classes to prepare? If not, do so as soon as possible. If yes, start using them to calm yourself. You're experiencing the first of many parent-related-anxiety attacks as your mind gets used to the immensity of the endeavor you're about to experience (not just giving birth but taking on the responsibility for another life!)

BTW, my wife and I were planning to go for an unmedicated birth, and after about an hour of suffering, we went for the epidural and it helped SO MUCH that we wondered why in the world we were planning to go without. And the stories she'd heard about how deadened you would feel after the epidural were not true at all. I was talking with the anesthesiologist about it afterwards and she kind of shrugged her shoulders about why people consider this particular pain medication issue differently from other pain situations - few people decide to go without anesthetic for getting teeth pulled, for instance!

Good luck to you! Let us know how it went!
posted by jasper411 at 3:15 PM on October 18, 2005


I also have a physical issue with getting an epidural to "take." For my first birth I had one that didn't work at all -- I learned the hard way that it was indeed possible for me to survive an "epidural-free" birthing experience. And it was an experience: incredible, painful, primal ... and in the end, in retrospect, amazing. I was humbled by how my body took over and did what it did on its own. I was also humbled to learn how lucky I was -- that I have long pre-labor but very short labor, that I could push a baby out in 5 or 10 pushes. I know that's not the case with everyone, but it turned out to be that way for me.

With the second baby, I went into it thinking, "well, the epidural's not going to work, so why bother." But then I talked to a friend who was an anesthesiologist, and he said that really the problem was operator error, and that this time I should request/demand that the chief of anesthesiology perform the procedure. So in the end, that's what I did -- after talking it over with my OB, etc. The epidural *did* work a bit the second time, but mostly just for the period of early labor through transition. By the time it came to deliver the baby, it had worn off completely and I felt everything. But I knew I could do it, and that it would go fast -- and it did.

The difference between the first time and the second time was that since I had no pre-emptive pain relief with the first one, I felt like I'd been hit by a truck, and it took me so long to recover. With my second baby, getting an epidural that worked for me from 3 cm to 8 or 9 made ALL the difference. I was up walking around minutes after delivery, I felt back to myself within days instead of weeks.

I think the message, for me, at least, was that being proactive about managing my pain relief was key. Both times I ended up experiencing the full physical sensation of giving birth (and it's true, it hurts), but my recovery time was cut in half with the administration of timely pain relief.
posted by youarejustalittleant at 5:03 PM on October 18, 2005


Yep, you're trying to control the uncontrollable. But childbirth is a great welcoming into a life that will, from the moment the baby is born, be basically out of your control. The sooner you learn that, the better.

I too had frequent, horrible visions of my husband dying in a plane crash or a car crash, an earthquake and us being crushed, a car crash en route to the hospital. I think it's just your anxiety..esp. about being possibly left alone to do this on your own. Veeery scary.

I would admit that it's okay to have these thoughts, also acknowledge your hormones are simply out of control, and move on.

By the way, the more planning you do for your birth, the worse you will be when if it doesn't go according to plan. I wanted a labor brought on by nature, labor at home for a while, and push it out without an epidural...but I knew it probably wouldn't work out that way. In the end, I was induced, lay there for 15 hours in pain and only dialated 5 cm., got an epidural and every other drug in the book and finally, crying with gratitude, after 32 hours, had a c-section. And in the end, it didn't matter. Just tell yourself that...it doesn't matter how you get there. It's the end result. And you'll be much happier going with the flow of something you really, honestly CANNOT control at all.
posted by aacheson at 5:33 PM on October 18, 2005


And yes, you're flat on your back when you have an epidural. You can't move your legs. But usually they wean you off it as you go into transition so you can sit up a bit and push when you need to. But if you have an epidural there will be no squatting or sitting in a tub or anything like that.
posted by aacheson at 5:34 PM on October 18, 2005


Hi,
It's normal to be anxious about your impending labor, delivery and life changes. And it may be normal to have these nightmares. You're under a lot of stress and your hormones are fluctuating. Hormones carry signals to the brain and you may be experiencing repeated uptake of some of those signals. This is often more common in women who are used to being in control.

However, what is not normal -- but very common (up to 30% of women) -- is for those hormones to continue in this pattern. It can be before or after birth. So you should talk to your GP, OB/midwife (and doula, if appropriate). Do make sure your medical team is aware of this situation. Ask if they can monitor you -- check you after you give birth, a week after, and six weeks after, if not more. You may want to ask if you can debrief with someone a week or two after your labour. Studies show that this can do a lot to offset challenges in the post-partum period.

I am not suggesting that you are abnormal or that you should think there is something "wrong" with you. I just wanted you to know that sometimes these patterns continue and that there are many resources available to help you. So, if you let your doctor know about what's going on, they can make sure you have supports in place. That way, if these intrusive thoughts continue, you'll be able to manage them and focus on your new role as a parent.

In the meantime, have you found some parent & tot groups drop-in groups you can go to? This will be really helpful in going forward. I've got an 8-month-old and still really value the group -- for debriefing everything from labour to introducing solids.

Finally, natural childbirth can be wonderful. But if you really feel you need the epidural and it's possible to have one, don't beat yourself up over it. Every woman experiences labour in a different way, even though the level of pain may be the same for each. For me, I couldn't have anticipated a four-day labour with no sleep -- this affects your experience of the pain. I know a few women who ended up having epidurals and other procedures and who still think they did something "wrong". So go in with a plan to have a natural birth, but keep in mind that you can't really control the process or stick to a set plan. Be flexible and debrief with your doctor afterwards.
posted by acoutu at 5:44 PM on October 18, 2005


Speaking as a father, let me echo the comments of aacheson. My son is now two years old, and we have another child on the way.

You have officially seen the last of this "control" concept you regard so lovingly. Children are wonderful, terrible, joyous and terrifying - and rarely, if ever, under control.

A significant part of parenting is learning how to manage constant irrational fear that something might happen to your child - or to you, taking a parent from your child. Most parents feel that way, when they care to admit it. Some of it may be hormones, but I think it's mainly a fear of losing or wounding the amazing treasure that has come into your life.
posted by mikewas at 5:58 PM on October 18, 2005


Some hospitals offer something called a "walking" epidural, or more accurately a low-dose epidural, that does allow you to labor in positions other than flat on the back. But the "walking" part is a misnomer. It's more like a "roll back and forth, with a bit of effort" epidural.

I had a low-dose epidural at Lucile Packard/Stanford Medical Center when delivering my first child and it was positively divine. I could feel all the pressure of the contractions, and none of the pain. I knew when it was time to push, without having to be told by the nurse. However, like all epidurals it came with continuous fetal monitoring, which some people aren't into. And a catheter, which was more trouble than it was worth--the pressure of the baby's head on my urethra made for some wicked swelling. But, again--Vicodin to the rescue later on.

Also, I had the typical drug hangover, which I did not love at all. A lack of drug hangover was my reward for having an accidentally drug-free labor with my second child.

And I adore acoutu's post.
posted by padraigin at 7:11 PM on October 18, 2005


As I was saying at dinner tonight, when discussing the fact that my wife is pregnant (just confirmed this today - I'm gonna be a daddy!!!), I have a suspicion that there are two mind-altering hormone effects on pregnant women:

1) make them afraid so that they are extra-careful about everything

2) make them insane so that anything dangerous stays the hell away from them

:)
posted by Kickstart70 at 8:08 PM on October 18, 2005 [1 favorite]


Of course anixety is normal! Life as you know it now is going to change dramatically from "before-baby" to "after-baby" and it's not going to be the same again. And no, you can't control any of it; you're already in for it - sort of like when you get on a rollercoaster and it's cranking up that first hill; once it hits up near the top there's no going back or exiting the ride. I found it was best to not even think about it much, except for the driving urge to GET THIS BABY OUT, I AM DONE BEING PREGNANT, LET'S GO RIGHT NOW SNAP SNAP that I got in my last week or two of pregnancy with both my boys. I think that's Nature trying to override the fear of labor pain with the desire to produce that baby by any method possible. Heh.

Know what your options are, then pick a course, but be flexible if/when things change. I wanted a unmedicated birth with my first; after over 30 hours of labor I had an epidural. For my second I wanted a homebirth, and I ended up in the hospital for monitoring (at which point I said screw it, give me the epidural again). Both times I made the best choice and I don't look back at it. I have seen women plan out a "perfect birth" and get very sad if it doesn't work out that way. And you don't know what it's like 'til you're there and doing it yourself, and your story is going to be unique because everyone's is.

I did get pissed while in labor that "no one told me what it's *really* like!" but it is pretty hard to convey, I guess. I can tell you that I experienced labor amnesia. I remember I was in pain, but I don't remember the pain itself. I've been told by other mothers they went through something similar. I think that's another of Nature's tricks - if you can forget it, you can be suckered into doing this reproducing thing again and again.

Good luck! and yeah, I don't know if you can find a last-minute doula, but I bet that'd be a big help for you. Even another woman that's had kids that you trust might work in a pinch. Just so you know you're not dealing with it alone with no one else there with you to understand. Also, "Part of me also thinks that nothing could be as bad as my herniated disc was (screaming level), and I want to see if I can do this unmedicated." will help. Really. It's less frightening if you feel at least a little prepared, that you know you've gotten through something like this before okay.
posted by Melinika at 8:34 PM on October 18, 2005


Response by poster: Thanks so much, EVERYONE. Last night was the first night in a dog's age that I didn't have nightmares. Of course, I still had to get up to pee about 5 times, but at least I wasn't freaking out all night.

2 close friends just had babies and my sister and SIL (they live nearby) are both due with babies #2 and #3 at Thanksgiving and Xmas, so I'm not devoid of support. And I'm definitely keeping my options open as to the medicated/nonmedicated issue. I'd forgotten about the "walking" epidural.

You don't know how much it helps to have total strangers reassure me that I'm not crazy. Thank you, thank you, thank you.
posted by mdiskin at 2:24 AM on October 19, 2005


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