Re: [ozmidwifery] fear

[Gloria Lemay]

I think it's so important for midwives to study hypnosis and get an understanding of how the human brain works.  In fact, I think we all need to be in intensive therapy all the time so that we don't put our own insanity on to the births of others (and, yes, I'm including myself in that comment).  Yes, saying your fears out loud does diminish them.  Having fears racing around in your head with no place to say or write them out makes the mind a very unsafe playground.  When I was going through a very stressful court case, I read an article that said you should get up every a.m. and write across the top of a page  "Today my biggest fears are__________ " and then just empty your mind onto the page.  It was amazing to me what came pouring out  when I did this and it would mean that I didn't need to keep obsessing all day long.  It really helped a lot.  With regard to the women who say they won't or don't want to push.  Agree with them! "Yes, I know how you feel.  I don't want you to push.  If you feel an overwhelming urge to push, just pant and get above it.  Do not push.  It's really okay.  Your baby can come out without you doing anything."   Get the thinking brain out of the way.  Pushing a baby out is a no brainer.  It happens in the old brain at the base of the skull, not in the neocortex where the will is located.   It's the same as if you woke up in the a.m. and said "I really don't want to have a b.m. today".  So what, if your body wants to go, it will.  You can trust that with birthing women, too.  I'll paste in below an article on these matters that I wrote for Midwifery Today Magazine. Gloria Courage by Gloria Lemay According to the Merriam-Webster dictionary, courage is a noun meaning “ability to overcome fear or despair.” Notice that fear has to be present in order for courage to exist. The English word “courage” is derived from the French word for the heart, coeur. Finding the heart to continue doing the right thing in the face of great fear inspires others to become nobler human beings. In midwifery, we see women and men facing their fears in birth; we ask them to have faith in the face of no evidence. We demand that they be bigger than the circumstances and, when they conquer, we get a renewed vision of how life can look when our fears don’t stop us.  This is the source and inspiration for our own courage. The paths of parenting and midwifery push me up against my fears and despairing attitude on a daily basis. Luckily, I have found teachers and teachings that have inspired me to keep going despite my rapidly beating hummingbird heart. When my daughters were very young and I was juggling my heart’s desire to be a good parent and make a difference in childbirth, one of my friends told me to use the affirmation, “My vulnerability is my strength.” I thought she was insane and argued that if I lived by that slogan my children would surely perish. I was sure that my strength was my strength—and by strength, I meant my ability to force and push life to suit my will. I now know that true strength is the elusive quality of being able to strengthen others. At that time, I trusted my friend and, on faith in her alone, began toying with sharing my vulnerability. I tiptoed into revealing my fears and apprehensions to a few “safe” people and slowly began to realize that what my friend had given me as an affirmation worked a lot better than my stoic, stubborn, brave warrior act. After a few harsh lessons, I began to realize that it wasn’t up to me to conceal worrisome information from the parents at a birth. In fact, if I am afraid at a birth, the best thing I can do is name the fear boldly and ask everyone else present to say what fears they have. One of my dear clients released her membranes at 36 weeks in her second pregnancy. Her first birth had been a beautiful, straightforward homebirth and I was deeply invested in her second birth being just as great. After four days of leaking amniotic fluid, she began having regular, intense birthing sensations, and we decided to go to the hospital for the birth. I drove and the parents were in the back seat of my car. As we approached the hospital, I had white knuckles as my hands clutched the wheel, and a ball of fear formed in my gut. I started picturing the cord being whacked off immediately and the baby being taken away from mom. I looked in the rear view mirror and saw the father with his eyes looking terrified. I said, “What’s your biggest fear right now, Brian?” He replied, “I am afraid we’re going to have a cesarean.” I never imagined this would be his fear. A cesarean section was not even a possibility. I explained, “Your wife is having strong birth sensations. . . . she has already had one vaginal birth and the baby is small—for sure, it will be born vaginally.” He asked me, “Then, what are you afraid of?” I told him honestly. “I’m afraid that the baby’s cord will be cut too quickly and the baby will be taken away from Karen.” This had not occurred to him but he knew that my experience was a better barometer of things to come. He asked me what we could do to prevent this. I was able to tell him that it was very important to take the doctor aside and tell him this: “It means everything to my wife and I that the cord be left to pulse and that the baby be placed on her skin until the placenta comes out.” We did a couple of “dress rehearsals” of what had to be said and then went in. The staff at the hospital respected the parents’ wishes to have the cord left intact. The birth went beautifully. I would have wished that the baby didn’t have as heavy doses of antibiotics as he was given (with resulting colic for months) but having a birth that involved no induction or anesthetics was a big accomplishment in these circumstances. There was a period in my career when I was unable to divest myself of fear and dread. I wanted to have a breakthrough and so I decided to “import” some courage into my city. I thought about my heroes in the midwifery movement and asked myself, “Who is the bravest person I know?” The answer was, of course, Nancy Wainer Cohen. Her book Silent Knife had kept my feet in the room at VBAC births where every cell in my body had been screaming, “What the h--- are you doing here?” I was sure that if Nancy came and lived at my house for a few days, I could get some courage. My husband picked her up at the airport and she came into my house and hugged me, wracking with sobs. Nancy cried her way through several boxes of tissue at the workshop she taught for my students. Her visit was four days of snot, tears and intense passion for healing birth. I learned so much about the vulnerability and strength connection from her. Nancy is still my hero in the courage department and she continues to live her life with her heart pinned right on her sleeve. The sharing other midwives have done about their fears has strengthened me to face my fears of birth. One midwife wrote in Midwifery Today that “The drive to the birth with all the ‘what ifs’ running through my head is the hard part; when I walk through the door and see the woman, all that disappears.” Another midwife told me, “The scariest thing for me is the first prenatal class of a series. Meeting new people who have so much riding on my teaching is enough to give me an ulcer.” An acronym for fear is: F= false E= evidence A= appearing R= real When I am most afraid, it is because I have forgotten the truth about how loved and blessed I am. The fear can dominate and stop me or it can be used to alert me to something to which I am deeply committed. Using a journal to write out fears in the morning helps to clear the mind. Once the fears are on paper, somehow they seem less foreboding. Being in action is another antidote to the paralysis that accompanies fear. Any action—cleaning your desk, organizing a drawer, making a phone call—will bring a new perspective and lessen the dread. My favorite philosopher about fear and courage is the Wizard of Oz speaking to the cowardly lion. “Courage is doing what’s right even though you’re afraid,” he said. I have learned courage from birthing women and other midwives. We are here to inspire and raise the bar for each other on what’s possible in the domain of courageous action. Gloria Lemay is a private birth attendant in Vancouver, B.C. She is renowned as a birth practitioner and is a strong proponent of a woman’s right to homebirth. Visit her Web site at www.glorialemay.com.   Ceri & Katrina wrote: On 05/02/2006, at 12:36 AM, Susan Cudlipp wrote: "What is your biggest fear right now?"  She didn't answer for a couple of contractions then suddenly burst out " My biggest fear is that I won't be able to birth the baby"  What do you know - lip went and baby started to appear! This fascinates me too. Is is just a matter of verbalising that fear??? I know it sounds dumb, but most women when questioned say that they fear the pain.....no denying that it is going to hurt, so is it a matter of just verbalising it?? On a similar matter.... the last couple of weks, I have had 2 women simply stump me. One with an epidural, one without. Both reached 9 then 10 cms dilation, and decided they did not want to push. They were adament they did not want to push, that they wanted "the baby pulled out"!!! Despite reasurrance that they could do it, and that unless they were unwell or the baby distressed, they baby would NOT be pulled out and they certainly would not be taken for a LSCS, they continued to say "No I dont want to push", "I'm not going to push" "it is going to hurt too much!" They eventually had the baby when the next shift took over, but I was wondering if anyone else had encountered this before??