Monday, July 9, 2012

what are you afraid of?

‘The only thing we have to fear is fear itself.’
‘A life lived in fear is a life half-lived.’
‘Feel the fear ... and do it anyway.’
Cliches abound about fear, more particularly about how to get over your fears: take a deep breath, square your shoulders, trust to luck, God, or gravity, and take the plunge into whatever it is you’re afraid of (exams, a really deep swimming pool, the Great Pit of Carkoon) . Less attention is directed at the source of fear: fear, instead, is dismissed as irrational, pointless, disabling, and ‘all in your head.’ While it may be true to say that fear is all of those things, I think it is no less true to describe fear as rational, focussed, enabling and physiological.  
Take childbirth, for example (somebody, please!)
I have to confess my innate cowardice and say that one of the things that put me off having children sooner was fear of childbirth (and also fear of losing my identity, autonomy and ambitions - but that is a story for a another post, one that I am more keen than ever to write after reading Anne-Marie Slaughter’s recent article on whether women can have it all in The Atlantic).
I don’t think I’m alone with my fears, either. According to the The Association for Improvement in the Maternity Services (UK) there has been an unquestionable surge in women's birth anxiety in the past 20 years. Evidence in the Journal of Obstetric, Gynecologic & Neonatal Nursing suggests that one in four women now currently suffer high levels of childbirth fear.
And it’s no wonder. We’ve all heard the horror-stories - unbelievable pain, bodies ripped to shreds, uncaring doctors, incompetent midwives - and felt our eyes water at the thought of pushing something pumpkin-sized out of something that is ... well, let’s just say, ordinarily not pumpkin-sized. Fear seems a pretty rational and sensible response to all this, if you ask me. 
A couple of years ago, however, I did indeed get pregnant and found myself in the position of having to face down my fears and find a way to manage them. Not only was the die now cast, but fear could also potentially make the birth process worse by increasing stress levels and producing unhelpful adrenalin. Talk about your vicious circle. 
Fear of the unknown was at least as much a part of it as fear of pain. As Western women tend to live in smaller nuclear families, have fewer children, have them in hospital, and have them later in life, many women (and men, for that matter) do not routinely experience the trials of childbirth as a ‘normal’ part of life. Instead, it is shrouded in mystery, often interventionist, and made to seem as an irruption into normal life. 
Rather than pretend I wasn’t afraid, I soon realised that I would need to face my fears. These included fear of painful natural labour and fear of epidural needles, fear of having an unwanted caesarean and not being strong enough to get through the birth. And that’s all without even starting on hospital food and institutional night-gowns.
Facing birthing fears is partly about demystifying the process. New Zealand has been a leader in championing midwife care, home births and natural births as a way of returning to the idea that childbirth is a normal part of life, and pregnancy is a state of health. Doulas - who are not midwives, but birthing support people who assist before, during and after birth - are common overseas, but are relatively new here. In the UK, mothers, doulas and midwives are using the internet and social media to help each other overcome their fears about childbirth. They mainly do this by telling each other their stories. Hearing what actually happened to other women in the recent past, rather than having your imagination run wild with worst-case scenarios and well-meaning yet ghoulish advice and anecdotes, has helped women who use this service face their fears.  
As I prepared for birth, I too heard birth stories. Some were of empowered natural births, without any form of intervention, of which the women who experienced them were immensely proud. Some were stories of grief, of ideals shattered and lives endangered. Some were stories of fears faced, and dealing with whatever twist the birth process took as it came up. Each was different, but each reminded me that women can do this. No matter how bad - and there were a fair few where something went pear-shaped - each of these women got through it and lived to tell the tale. Their talking cures not only helped them work through their experiences, but also helped prepare their audience, lifting their confidence and working on their expectations.
I have told my own tale elsewhere on this blog, so I won’t repeat it here. Instead, I offer some of my hard-earned tips for facing your fears:
  • Don’t watch birthing videos (unless you really want to). Face it, as the mother you are not going to experience birth this way anyway, so what purpose will it serve, other than scare the bejesus out of you? 
  • Admit you’re afraid (assuming you are, of course) and address what you’re afraid of. Positive affirmations are one thing - ‘every contraction brings my baby closer to me’ sounds nice and uplifting - but if you don’t really believe it because you’ve worried about how you’ll cope with that contraction - never mind the bloody baby - then it’s not going to be much use.
  • Have some coping strategies up your sleeve. Even if things don't go according to plan, having some different things to try - acupressure, going for a walk, getting in a birthing pool, running screaming from the birthing pool - gives a sense of control in the face of the uncontrollable and affirms that you’re not completely helpless in the face of pain. 
  • Surround yourself by people you trust, including partners / family / friends and the health professionals who will assist you. Knowing you have professionals in your corner who will let you know what’s going on, and give you space to make decisions is invaluable - they’ve been through this birth business before and have experience and insight that us first-timers don’t. Knowing you have family or friends in your corner who will support you when you need it, fight your corner if you can’t, and still be there after everything they witness is equally important.
My birth experience did not end up in any way being what I wanted or expected. But facing my fears to some extent, reminding myself that six billion people wouldn’t be here if women couldn’t do it, trusting the people around me to provide any help I might need kept the fear at arms’ length. I was not afraid during the labour and birth; although I had some decidedly mixed feelings immediately post-birth, fear wasn’t one of them! I can honestly say that the only time I felt afraid in the whole process was when I was taken to theatre for the second time and they were going to put me under a general anaesthetic. My fear was not that I wouldn’t or couldn’t deliver a baby or survive the pain - I already had - but that I would not wake up. 

At which point, I really had no option but to feel the fear and do it anyway ...