Fear containment

December 1, 2010 at 7:20 pm

A little over two years ago, I wrote a post about facing my deepest fear surrounding my upcoming home birth: a dead baby. It’s interesting how each pregnancy is different, and the things we worry about can also be very different.

Yesterday morning, I woke up to pee (again) sometime after 5:00 a.m. My kids were all still sleeping, so I headed back to bed, but I couldn’t fall back to sleep. Suddenly I was overcome with wave after wave of fear rolling through my head. I’m afraid I’ve “used up” all my positive birth luck. I’ve had three great vaginal birth experiences. For whatever reason, I feel like I can’t expect them all to be good. I’m afraid I’m “due” for a difficult birth experience. I’m afraid it’s my turn to see the other side of birth… the complicated side where unexpected things happen and you end up going to places and doing things you never dreamed you would.

I’m not afraid of a dead baby this time. I feel totally confident that my baby and I will be “fine.” But “fine” can manifest itself in a LOT of different ways. I think my deepest fear this time is that our “fine” will be… me getting transferred to the hospital for an emergency cesarean under general anesthesia, me waking-up in a daze with no idea whether my baby is a boy or a girl, me seeing my baby for the first time and feeling like that little child is a stranger to me, me struggling to bond, struggling to breastfeed, struggling with excruciating physical pain, struggling not to plummet into depression and despair, hearing those dreaded words, “All that matters is that you and your baby are OK.”

Sure, there are worse things than ending up with a c-section. Absolutely. But that’s my honest-to-goodness deepest fear at the moment. I really don’t know if I could experience a cesarean birth without plunging into a deep depression afterward. I don’t think I could come out the other end with my soul intact. (I’m not suggesting that other women can’t keep their souls intact after giving birth via an incision. I’m only speaking for myself.)

So how can I contain these fears? Last time, I contained my fears with “my husband, my midwives, preparation, and God.” The same internal and external resources should help me this time also, but I suppose I just need to apply them to this specific fear.

1) My husband
I know that my husband will provide me with superb labor support. And I know that superb labor support reduces cesarean risk. I know that he knows how strongly I feel about avoiding unnecessary interventions, particularly cesareans. So I know he will not allow me to be cut open needlessly. I also know that he will be a rock of strength and love in the event that I do need a cesarean. He would be wonderful and instrumental and crucial in my recovery and healing. I know I can count on him.

2) My midwives
My midwives’ cesarean rate is approximately 1-3%, depending on whether they’re assisting a first-time or experienced birthing mother. Their hospital transfer rate is approximately 2% for women like me who have given birth before. I know their combined experience and positive energy produce ideal birthing circumstances. I know they have faith in me and will not jump to transfer needlessly because I saw it first-hand during my last birth. When my son’s heart tones indicated that he needed to be born NOW, they had faith in my ability to make that happen. If I had been a first-time mom, they said, we probably would have transferred immediately to the hospital. I know that I probably couldn’t have picked better birth attendants in terms of avoiding unnecessary hospital and surgical interventions while maintaining optimal safety.

3) Preparation

I’m a natural-born risk-avoider. I’ve been dodging risky business my entire life. My neuropsychologist stepmother has always told me I have superb frontal lobes, the part of the brain where impulse-control and risk-assessment and decision-making happen. I spend a lot of my time thinking about risk-avoidance, being extremely cautious (i.e. paranoid)… almost to a fault. I think excessively about the potential and various outcomes of small actions (like putting this or that into my mouth). But I’m going to contain my cesarean fears with faith in my frontal lobes. I have faith that all my thinking excessively about risk-avoidance will serve me well in avoiding a surgical birth experience. I have spent the last 7+ years studying everything I could get my hands on in relation to birth and improving birth outcomes. I believe that applying all of the things I have learned will reduce my cesarean risks considerably. And knowing how hard I worked to prevent and prepare would surely ease the inevitable ache I’d feel in the event that I did need a cesarean.

4) God
God has told me that my baby and I will be watched-over and “kept safe” as I give birth. And I have faith in that promise. And, while I believe God wants us to have positive, wonderful birth experiences, and that we can receive divine assistance as we strive for those wonderful birth experiences, I also believe that sometimes God has plans and insights we don’t understand… sometimes we need difficult experiences to learn crucial life lessons… sometimes a mother might need to give birth via cesarean. We can experience hardship and difficulty as a result of poor planning, poor preparation, and/or poor decisions. But when we have done our very best and trials come our way, I feel confident that those trials have a purpose. So I have faith that God will watch over my baby and me, but I also have faith that, even if keeping my baby and me “safe” means a cesarean birth, God will give me the strength I need to bear that burden. Somehow I will get through it, and somehow it will be an experience I’m grateful for in retrospect, because somehow it will teach me things I never could have learned otherwise.

Ahh. I do feel better now.