The loss of trust-

I feel like I need to write this experience down because if I don't it will pass me by like a brief shadow. If I do that I'll forget that I don't want to do this again...or at least that I should do something more than what I did this time.

I came onto shift to a woman who had been stuck at 7cm for 6 hours. The baby looked like it was doing fine but the mom had developed a fever which means she could have an infection going on. The epidural she had was beginning to wear off and she did not want to be feeling any pain.

The doctor I was working with was pretty patient in waiting but because she was getting a fever he was more worried. After 7 or 8 hours at the same dilation it was decided to do a c-section. I actually think the mom was wanting one way before that. I could tell she was tired of waiting and did not like feeling any of the pain she was having. Because the doctor kept putting it off though the decision to have the c-section came much later than she would have liked(I'm just guessing this by how she responded when it was finally decided...as if she was breathing a sign of relief).

Everything was going pretty fine until they started pulling the baby out. She started say that she could feel that. I could hear the panic in her voice. We asked if it was just pressure or the pain. I didn't hear the rest of the conversation but it sounded like it was mostly the pressure of the baby being pulled out that scared her(it can be a pretty intense feeling). Right after the baby was born I glanced at her and saw tears in her eyes. I came over and told her how beautiful her baby was. But she just nodded a sad little nod.

As soon as the baby left the CRNA called me over and told me he was going to put her under general anesthesia because she was starting to feel everything. He had me hold the oxygen mask on her as he was getting other things ready. I looked in her eyes and she looked terrified. Things had been explained to her but I'm not sure she really understood what was happening. The CRNA gave her some medication to put her to sleep and as he did so she began to shove at my hands to get the mask off. At this point if I had taken the mask off it could have harmed her but I hated holding it on her when she was so frightened and obviously didn't quite get what was going on.

Everything turned out ok...sort of...mom was healthy baby was healthy. But psychologically I'm not so sure. This was a c-section that might have been prevented(she was induced early used an epidural was not able to move around to help dilate her cervix). These kinds of things are all so iffy though. Things might have turned out exactly the same. Her wishes were respected...she wanted this c-section...I guess she thought it would be easier.... Did she really understand the implications of a c-section...did anyone talk to her about the complications...no. We never do. We shove a paper in their face and ask them to sign it. There is no discussion of the pro's and con's.

We didn't do such a good job of being with her through this particular journey. I think this journey turned into a bit of a nightmare for her....and I don't want to forget that....I don't want to forget that this hurts women psychologically...and while I did a horrible job of being there for her I want to do better next time. So I don't want to forget her fearful eyes or the horrible feeling of forcing the mask onto her face when she didn't want it or didn't understand(even though it was what she needed to stay alive). I hated that feeling...I don't want to feel that again....I'll have to decide what I need to do so that next time my own feelings of distaste for my part in this can become something better. I want to become something better than this...and I sorry a woman had to be hurt at my ineptitude.

I'm sorry for all those who've had to suffer at the hands of those they once trusted.

Fear and Pain-my own experiences

The one time I really feel like I understood this concept was my last labor. I was getting into good active labor and I really started tensing up. I think I was a bit more worried this time about what to do with my kids and just making sure they were going to be OK in general. My fear in this case, was that our baby sitter wouldn't be able to make it or that my kids would wake up in the middle of the night and be worried. I remember thinking how this labor seemed more difficult and I couldn't figure out why. I felt a lot more tense and the contractions hurt more than I expected at that point.

At this point, I remember thinking I needed to breath. My focus then shifted away from my worries and concerns, to just relaxing and letting my body work. I was amazed at the difference it made. I was much more able to cope and the sensation of pain was diminishing.

It makes sense to me that pain would diminish as our fears and tensions diminish. When we are afraid, we tense up. Just thinking through this, I bet that when we tense up, our body's contractions have to work harder to push through that tension. In a way, it creates more work and more pain for our body to work against the tension brought on by fear.

Fear tension cycle

I've just put together a few quotes I've found about the effects of fear/tension/pain. Some of these quotes were written for those experiencing back pain or chronic pain, but I feel they can apply to labor pain as well. I'm going to add my own experiences in another post.

"One of the first things that happens to all of us when we’re under stress is that we tense up—preparing to take action as part of the ancient fight-or-flight pathway in our body. When we can’t run or express our distress, and that distress is chronic, we tense even further. Interestingly, the words for emotional tension and muscle tension are the same. We feel tense emotionally and our muscles also tense up. And this is painful. Remember the last time you had a muscle cramp? You can’t move or think of anything else until that muscle relaxes. All manner of ordinary circumstances, such as fear of loneliness, financial failure, or having to deal with a difficult co-worker, child, or spouse can all result in muscle tension that we’re not even aware of. It’s not surprising that exactly the same class of drugs, the benzodiazepines (such as Valium and Ativan), can relax both muscles and anxiety. But these drugs don’t solve the problem; they merely mask it, and worse yet, they are highly addictive.

Chronic back pain results from stressful thoughts or emotions that aren’t released fully but instead are held in the form of chronic muscle tension. If you then believe that your back is damaged, you may begin to brace yourself, or begin assuming positions to guard against potential damage. This behavior and the beliefs that fuel it then trap you in a vicious cycle of pain and fear. The longer this goes on, the more it leads to psychological conditioning that deceives you into fearing physical activity. It has been found that fear of pain, especially in back pain sufferers, plays a very important role in the perception of pain. Frustration, anger, and depression further deepen the cycle."

http://www.drnorthrup.com/womenshealth/healthcenter/topic_details.php?topic_id=58

"Injury and chronic pain contribute to muscle tension because muscles automatically contract around a painful site to support and protect the area.

Furthermore, if you adopt a guarded position to help protect yourself from pain, this will lead to further muscle contractions. A guarded position might mean walking with a limp or holding your neck in an awkward position. In this way, the muscle tension arises from a painful condition and then further contributes to pain. Furthermore, muscle tension can put pressure on nerves, leading to tingling and numbness."

http://prc.canadianpaincoalition.ca/en/coping_with_muscle_tension.html

"A MODEL OF PAIN-RELATED CYCLES

Much felt pain includes secondary pain resulting from pain-fear-tension cycles. Indirect actions that shift elements of the pain-fear-tension cycle or the related positive cycle are often able to decrease felt pain signals. By the time pained clients get to a bodyworker, it may be that most of the pain is secondary or that what started the cycle no longer exists
Primary pain or signal pain causes reflex holding, a splinting of injured or threatened parts by tight muscles, an early shift toward secondary pain cycles.

This double cycle summarizes the many ways we can lower or raise pain signals. Decreasing tension or fear can improve pain, just as tension and fear go down when pain stops. The linked positive cycle shows why gentle, pleasurable, rhythmic movement within your window of comfort not only leads to more effective body use, but can also decrease pain signals.

Physiologic background and assumptions:
In health, pain is a signal that something needs attention. Chronic pain also signals something needing attention, even when a response to stop the signal can't be found.

Secondary pain involves local muscle spasms, which limit circulation as tight muscles mash blood capillaries, cause waste products to accumulate, and produce pain signals. Holding against pain tightens muscles to create more tension, pain, and fear.

In the body, lower motor neurons (nerve cells) in the spinal cord extend out to the muscles and control contraction. Unless they are stroked and relaxed by signals from upper motor neurons in the brain, lower motor neurons fire all the time, causing muscle contraction, rigidity, and loss of control. In stroke, for example, loss of upper motor neurons results in rigidity and loss of relaxation ability in affected body parts. Tetanus produces rigidity because the nerve endings from upper centers are poisoned by tetanus toxin.

Increased sensory signals (like those from touch or gentle movement) give information about the body to the upper motor neurons of the functional mind. This sensory information lets these control centers automatically balance needed tension and release unneeded tension. Blocks to taking in sensory signals from the body are added pain, fear, tension, trying hard, tight goals, pressure, and thinking instead of feeling.

Positive assumptions are pain as signal, pain as message, pain as tool, pain as accepted (even if disliked). A negative assumption is pain as enemy. Even excessive, unwanted, unneeded pain, if assumed to be an enemy, is fought against and the rejection of hurting body parts creates disconnection and limits healing. Because body feedback is so important, signals not listened to will get stronger, not a response we want with pain signals."

http://www.joeleegriffin.com/Trager/Pain_Signals.htm

Taming Our Tigers

Pam England uses the description of a tiger to represent our fears. While we all experience fears it is important that we learn to deal with them before they overcome us: especially during labor.

I found a great handout that talks about this and wanted to share it. You can find it here.

In this, it discusses some reasons why fear is not beneficial for our labors and I thought I'd share my own thoughts and experiences about these.

• Increased pain for mom: Fear tends to increase muscle tension. The more tense our

bodies are, the more pain we experience.

• Possible increase in heart rate, blood pressure, and breathing rate. These can develop

because fear activates adrenaline, and a fight or flight response.

• Possible complications with labor: Adrenaline neutralizes the effect of oxytocin, the

hormone which stimulates labor contractions, which dilate the cervix, and bring baby

down through the birth canal. If fear blocks oxytocin, it may lead to longer labor, failure

to progress, more medical intervention to move labor along, or to deliver the baby.

I'll save each one of these points for later posts. I've also blogged about this quite a bit and I've added the posts under my blog series sections.

Mothers bring forth life

"Mothers bring forth life; medical corporations do not. Birth can be simple, powerful and loving."

I recently took care of a mom that had not been able to get pregnant for 9 years. For her, this process of pregnancy and birth had been very medical, and there was a great deal of fear involved. I understood that her fear was coming from the fact that this had been a much desired child that had taken medical care to conceive. But through her fears, I saw the face of a great love for this child come through. It was amazing, to say the least.

This birth was also very medical, due to how the physician preferred to practice. The baby was also experiencing some difficulties and needed to be born quickly. It was a birth that could have been traumatic.

I encouraged mom, to focus on what she could do. Staying focused on her baby and staying calm to allow her placenta to be able to perfuse her baby more(stress can cause the blood flow to deviate away from the uterus to support other vital organs). Her husband was so fabulous at helping her to stay calm and focus on what she was doing. After baby was born, she was taken away to make sure things were OK, but all other procedures were delayed and she was back with mom within a few min. tucked in skin-to-skin. This was something the mom requested and I loved the delight she had in her eyes as she did this. It was neat too to see how the baby really did do better sitting right next to her mom.

The reason I mention this instance with this quote is because this was absolutely the moms birth. I felt her strength and abilities take over when they needed to, and her desire for her baby to be with her was neat to watch. This was a birth that was very medicalized, but I still felt the truth of these words from this quote. We did not bring forth this life, the mom did. I hope she realized this.

The fear/pain/anger of tramatic birth experiences and how to overcome?

This is a site with some brutally honest, painful expressions of what one woman felt like after her c-section. http://www.cesarean-art.com/ It brought tears to my eyes to think that she felt so much pain about what happened to her. I also know that not all c-sections cause this kind of pain, but I think we need to understand how some women have felt about what happens to them.

I think we need to understand the pain, but what I would really like to show, is peaceful healing pictures also. So, I'm asking for some...How have you healed from traumatic birth experiences, what has allowed peace to come back into your lives? How have you found love instead of fear and hate? How have you overcome the feelings of fear, loss, and anger? While I appreciate this artists expression of the pain she felt, I would also like to show expressions of finding forgiveness and love afterwards. So, to anyone who would like to, please share.

c-section

More doctors are coming out now in favor of the idea that c-sections may be safer and better for mom than a normal vaginal delivery. This is a hard one for me to swallow. Now, research has not shown this to be absolutely true, but it got me to thinking. What if it was? What if c-sections were safer? What would I choose? Would I have a choice? Something deep down within me wants to run away from those ideas. Birth has become such a part of me that if someone were to tell me that I would be making a bad choice to give birth vaginally, I'm not sure how I would react. My births have helped define who I am as a woman, a mother, and a person...would that have been the same if I wasn't given the choice. I wonder if something sacred would be taken from us.

Now, I am grateful that we have c-sections. There are times when it is absolutely life saving to have that, and those who give birth that way are not any less mothers. I just don't see that as being the optimal way in normal circumstances. Of course, some disagree and more and more people are being led that way. I hear doctors who much prefer c-sections, and moms who are afraid ro give birth any other way. I just wonder, are we losing something here? And if we are, what is it? Or maybe I'm just unable to face reality...progress is progress. Technology is here to stay, and it is useful and lifesaving. I'm just not certain we always understand what progress means....

Holding on

I know there are times in my life that I struggle and struggle just to hold on to my sanity. So many times I have wanted just to give up or not wake up the next morning to the same thing. But I've pressed forward, knowing that the struggle will not last forever and that at some point after the struggle I find great rewards from going through that struggle.

Because of this I have come to realize that, while things can be rough at points in our life, the struggle to hold on reaps benefits in the end. I see this in labor as women work to find their way through the emotions of labor. In particular I see the difficulties of giving in. This is not really about whether or not you get an epidural or choose to endure the pain...this is about our emotional state. Emotionally when women have given in (whether or not they have an epidural), I see a look of despair and helplessness. It pains me to see this, because I want these beautiful women to know how strong they really are and how important what they have done and what they are doing is.

I want to hold them and rock them and tell them to hold on...just hold on...in the end..after the pain...will be joy.

Dispelling fear

http://www.wealth-prosperity.info/2008/08/happiness-series-step-9-replace-fear.html

This is a blog that found me actually, but I loved the steps it used here to dispel fear and thought they applied very nicely to labor, birth, and motherhood. Here's the steps they list:


1. Be aware of your body
2. Be in the present moment
3. Embrace silence through meditation
4. Relinquish the need for external approval
5. Get rid of negative emotions
6. Have total knowledge of yourself
7. Don't judge yourself and others
8. Remove toxins from your body and your environments

I might blog about some of these later and how they apply to the birthing process. I thought I'd just post them now for reference and thought.

I'll be blogging about these steps a little more at http://www.crazibeautiful.com/GirlfriendToGirlfriend/ExpertHome.aspx?id=49

The spirit of "power, love, and a sound mind"

There is a scripture that has come to my mind often as I have been embarking on this task of overcoming the fear of labor and that is..

“For God hath not given us the spirit of fear; but of power, and of love, and of a sound mind.(” (2 Tim. 1:6–7.)

I have looked at this is this way...as humans we have the ability to act, to love, and to think and reason. All three of these things are a part of working through our own fear. I've obviously talked about love, mostly because I have felt like that is the most important part. But being able to reason and act on our thoughts is also important. I know that is when I decide on a course of action that I feel less fear.

I find it inspiring to know that we have been endowed with these three abilities to help us overcome any fear. That we have been given the spirit of power, love, and sound mind.

Gaining an understanding of our fears

I've deleted the last post I made, because it just didn't feel like what needed to be said:) Instead, I'm just going to mention how important I think it is to try and understand and gain as much knowledge we can about birth, labor, and what being a mother really means. This is an important part of overcoming our fears. When we can understand something, then we are better able to deal with it.

There are so many resources out there now a days for us to look at. On this blog I will add a list of some of my favorite resources. Now, I do tend to be more naturally inclined, so my resources will reflect that tendency. I do feel, though, that they will be useful to anyone. If anyone has a particular book or website they liked, please let me know and I'll check it out.

Fear and the stress response

I was going to write more about how to help with the fear of bad outcomes during labor, but I realized something....this is a very real fear that cannot be downplayed. Bad things can happen and it would be unnatural not to fear that. That said, though, we cannot let that fear control us.

The other night I watched the movie called Wait Until Dark. It's about a blind lady who has to outwit a murderer. Very tense, and I watched it right before I went to bed. Of course as I was falling asleep, I was hearing all the night noises and imagining it was an intruder in our home:) I would carefully get up to go check on the kids. My breath a little labored and my muscles extremely tight. Of course everything was ok, but I mention this because this was a moment when fear was affecting how my body was working. The same kind of thing happens in labor. Fear causes our body to tighten up and a mirad of hormones are d in response to the stress. If you can imagine those tense muscles while you are in labor, it makes sense that this would also slow down that cervix from opening up. Pain is also intesified as our stress response takes over and our sense of control diminishes.

Fear can help us. It helps us recongize danger and get help when we need it. If you listen to your fears, you may be able to catch problems that might not otherwise be caught. But...you must own the fear and not the other way around. You must take possesion of it. As I have said before about pain, you must look it in the face and acknowledge it, but let it pass through you,- use it for what it is worth and move on. As I have talked about love before, I would point in this direction again. Love could have a strong ability to allow you to control that fear. If you focus on that, your fears, though real, may not become overpowering, but you may overpower your fears and allow your body and mind to do the job it needs to do.

Now trying to apply this motherhood does not seem so far stretched to me. We need to work through our fears as a mother also. I would suggest the same thing--own your fears and move forward instead of pulling in and stalling. I really believe we need to teach our children the same thing.

The blessings of surrendering fear to love

This is just a quick blip I got from a lady who has done some home births and I loved how this fit in the topic of love.

"the true victory in labor and delivery is not the overcoming of pain and fatigue, but the realizations that come when we surrender our will to something greater, for the love of our children, and are infinitely blessed with feelings of peace, safety, and love."*

This can be a victory and it is not easy. It is a sense of surrendering to something greater than yourself. In all aspects of life this can be the case. As a mother I know I have felt the need to do this many times as I sense frustration set in. There are times when I say I can't do this, but you have to let it go and turn it over to something greater than yourself. For me that is a God that I have faith in, but for those who aren't religious, it can be something else. I think having an idea of the goodness and greatness of the cause of being a mother is helpful in this respect. If you believe that what you are doing as a mother is important than when it is hard surrender yourself to that cause. Fear can be replaced with peace, safety and love.

Now, I realize that fear is also foraged from the thought of losing your child and for the safety of yourself. I am thinking about this and hope to touch on this in the next blog. Until then I still feel like filling yourself with love is one of the most important things you can do in birth and in motherhood.

*quote is from Rachel Logan

Replacing fear with love

If any have read the Secret Garden, you know about the invalid, Colin who stayed in his room all day because he thought he was going to die. Once he learned to see otherwise, he learned to go outside, walk, and find great joy.

“So long as Colin shut himself up in his room and thought only of his fears and weakness and his detestation of people who looked at him and reflected hourly on humps and early death, he was a hysterical half-crazy little hypochondriac who knew nothing of the sunshine and the spring and also did not know that he could get well and could stand upon his feet if he tried to do it. When new beautiful thoughts began to push out the old hideous ones, life began to come back to him, his blood ran healthily through his veins and strength poured into him like a flood. … Much more surprising things can happen to any one who, when a disagreeable or discouraged thought comes into his mind, just has sense to remember in time to push it out by putting in an agreeable determinedly courageous one. Two things cannot be in one place."

The Secret Garden (1987), 338–39.

The one thing, above all else, that can replace fear is love. I had one mom tell me that when she was pregnant she couldn't imagine ever going through that again and she even began to wonder why women go through this in the first place. She ended up having to have a c-section, but when she first heard her baby cry, she understood why mothers continue to choose motherhood. It is difficult to describe the immense amount of joy that fills you as a new baby is born. You know at once that you love this child. I think of that as I begin labor and the fear of pain or other problems come into my mind. I hold onto that. The immense love and joy you feel at having a new child.

I think even those who haven't yet experienced that can find that same love and joy within their own lives and hold onto that. Even if it is only just a hope to feel that love. Hold on to that thougt as fears surround you. Hold onto the thought that there is a perfect love to be realized and let that thought engulf you. It is a nice feeling to think of also that this love I have felt for my children, someone has and still feels for me.