People, for the most part, like to talk about the birth of their children. Some will wax long and poetic about how it “changed their lives” and “what a magical moment it was” and on and on. I tend to be in that group. Then there are others who like to do what I like to call “war story-ing”. You run into them at baby showers a lot. A group of two to three women all trying to one-up each other on whose birth was the scariest, most painful, the absolute worst. Words like “stem to stern” and times like “20 hours” start popped up in conversation. Meanwhile, the mom to be is sitting there, cupcake balanced on a pastel paper plate, hooked on every word and picturing what might await her in a few weeks. Sometimes these war story tellers have had a genuinely traumatic experiences that they need to process in a safe and supportive space and sometimes they are just trying to “win” the made up game. Either way though those stories have made an impression on that mom-to-be.
So what do you do if you’re this expecting mother? What do you do about all these “scary stories” and “negative messaging”? There is one school of thought that says ignore or block out all negative messages about a birth experience. “A mind troubled by doubt cannot focus on the course to victory” said Arthur Golden. This can be really good advice. But the question then is how much do you ignore? When does “blocking out negative messaging” become “ignoring red flags”? And if you are willfully blocking out evidence based information about birth are you really prepared for labor? Let’s look at the ideas behind the extremes and try to find a happy medium here.
Block out EVERYTHING scary about birth
So you’ve decided to have an unmedicated birth. You saw The Business of being Born, you saw your cousins video of their homebirth. This feels right and good. This is what you want and you trust your body to be able to do what it is meant to do. This is great, you should feel confident about this and you should feel excited. You tell your friends and family about your birth plan. Most are supportive but a few give you some side eye and your aunt even calls you crazy and starts “war story-ing” about her 4th degree episiotomy. You ignore her. You’re not 100% sure what “4th degree means” but you’re not having an episiotomy so you don’t have to worry about it. Depending on your care provider you might have more or less tests. You didn’t spend much time learning about what these test mean because you’re having a natural unmedicated birth. You’re body can do this, so it doesn’t matter what the test say. Nothing that they tell you is going to knock you off course. You write up your birth plan detailing things like lighting, music, labor and pushing positions. You give it to your care provider on your way out the door of one of your appointments. You really want to take a birth class, but the time and financial commitment you do not want. “Oh well”, you say, “that's why the good lord invented google”. At one of your next appointments your care provider talks to you about some of your test results. You don’t really understand what they’re saying. All of the words are a bit overwhelming and anxiety provoking. You’re so confused you don’t even know what questions to ask. You leave to appointment feeling slightly heartbroken but mostly just confused and scared. You think about calling someone or asking doctor google but you push that to the back of your mind. You can do this, this is what your body was meant to do. You have no idea what to expect from labor, but you have total faith that you can do this.
So what’s wrong with this story? Well let’s start with what’s right. This person actually does have a little bit of information. They have a rough idea about what labor and birth look like. On top of this they have a strong belief that they are totally capable of giving birth. That confidence will take a person a long way...but it won’t take you all the way. It’s great that she doesn’t hold onto the fear and stress of her aunts experience, but she also doesn’t explore or examine it. As a result she doesn’t know what led to that birth trauma or even the full extent of what that trauma was. She writes a birth plan, which is good, but she doesn’t bother to talk about it with her care provider. On top of that the birth plan doesn’t cover things like episiotomy, cord clamping, or if she wants to eat and drink during labor. This woman wants to take a birth class (good) but doesn’t make it a priority. A good class would have given her information about the test she was taking which would have enabled her be an active participant in the conversation with her care provider. She could have listened to the information and made an informed decision instead of avoiding making any decision because she didn’t have the knowledge and was too afraid to seek it out. As it stands this woman is walking into labor without a clear plan, with a care provider she doesn’t trust enough to ask questions, and having very little information about what birth is physically like. Do you think this person is prepared for labor? Do you think that confidence will last when transition hits?
Block out NOTHING scary about birth
This story starts off the same. You’ve seen Business of being Born, you’ve seen the video of your cousins homebirth. You want an unmedicated natural birth. But this time when your aunt tells you about her 4th degree episiotomy you ask “what’s that” she tells you. A 4th degree episiotomy sounds less than great to you. “Why did that happen” you ask. She tells you about shoulder dystocia. To you, that sounds terrifying. You go home and do some serious googling. The internet spits back a bunch of different stories, statistics, and theories. Some of this is verified and peer reviewed, some of it isn’t but you’re already down the rabbit hole. You decide to not look at infant mortality photos but instead stumbleupon youtube clips of the shows I Didn’t Know I Was Pregnant and ER True Stories: Pregnancy addition. You and your husband agree that the reenactment is totally corny, but secretly both of you wish that you hadn’t watched it. “Is that what birth is like”, you think, “I thought this was supposed to come naturally and easy!” You’d like to have that magical experience, but what about the risks? What about the pain? You’re just 25 weeks along but you’re already afraid of d-day. You have no idea what to expect from labor but you don’t think you can do it.
Yikes. In a matter of days this person has gone from being excited about birth to dreading labor. What happened? Well, this time she did try to learn a little more about her aunts experience and she learned some new scary vocabulary words. But then she dives head first into the internet without having a full context to what those vocabulary words actually mean. To make matters worse she reads indiscriminately instead of searching out good evidence based information. Then she goes looking for MORE scary birth stories, because let’s be honest here, sometimes we can’t leave well enough alone. The good news is all this happened in a matter of days, maybe just hours. There is plenty of time to find good information, to rebuild confidence, for her and her husband to build a support network and seek out positive birth stories. The bad news is, if she doesn’t kick her fear out of the driver's seat it's going to be a long 15 weeks.
There is something called the fear/pain cycle. Fear leads to tension, tension leads to pain, pain leads to fear, repeat. The idea is if you are afraid going into labor you will be tense, which will make the contractions more painful, which will lead to more fear. I think the same idea can be applied when you are preparing for labor as well. If you are letting your fear make the decisions for you during your pregnancy this will just lead to rash decisions and ignorance, which ultimately will lead to more fear. How do you kick fear out of the driver’s seat? The best way to do this is with knowledge and education. When you know what is ahead of you and you feel prepared for what might happen it’s easier to have TRUE confidence instead of just forced vibrato. When you know the right questions to ask, you can build a relationship of trust with your care provider or know when it’s time to switch care providers. When you are getting your informations from trusted sources you then don’t have to doubt or question your choices. Plus, when you have information about the whole picture (including the risks) it’s actually easier to block out the scary negative information. You know the risks. You know what to do if they happen. You have a plan and you’re at peace with what may or may not happen because YOU can make the choice because YOU are prepared. So yeah, tune out the naysayers but don’t tune out the information. Sure, research your choices, but don’t believe that everything you see or read about will happen to you or is even true. When you approach your labor form a place of ballenc you are ultimately standing in a place of strength.