18 setembro 2013

Pain, Birth, and Fear


 “…if you want to know where a woman’s true power lies, look to those primal experiences we’ve been taught to fear…the very same experiences the culture has taught us to distance ourselves from as much as possible, often by medicalizing them so that we are barely conscious of them anymore. Labor and birth rank right up there as experiences that put women in touch with their feminine power…” -
Christiane Northrup

During my first pregnancy, I read like crazy. I felt like I was studying for the biggest test of my life, only it was impossible to know what was actually going to be on it. When I actually gave birth, I was delighted to find I was able to get out of my head and trust my body. Quite some time later, I figured out that information about birth does not equal knowledge about birth.
We spend a lot of time informing and educating women about their choices surrounding birth and are often then surprised that this apparent information does not translate into experience once in the birth room. Obviously, this is partially because the birth room is a context impacted by a large number of social, cultural, psychological, and environmental factors, but I believe it is also because with all of our information we still haven’t managed to help parents develop knowledge and the two are not the same. Parents are often not able to recall or to mobilize information resources while actually embroiled in the birth experience. They need an inner knowing and inner resources to draw on for coping.
via Information ≠ Knowledge

I also pondered (and continue to ponder) how women really learn about birth. Like I did, most of them seek out written information and this can lead to information overload…
With the wonderful world wide web available to us 24/7, the deluge of information we encounter (and seek out) during pregnancy can feel a lot like drowning. So many choices, so much to learn, so much to digest. There are times when everything seems to come into question — from what you eat during pregnancy to whether you should create a birth plan…
via Stop Birth Information Overload by Getting Back to Basics — Giving Birth with Confidence.


My all-time favorite article about the notion of this “information feeding frenzy” engaged in by pregnant women is by Pam England who explains the following:
It would seem at first glance that a mother who gathers lots of information during pregnancy is motivated and headed in the “right direction.” However, a more important detail of her preparation is her being aware of what is motivating her to become so well-informed. What does the drive for information feel like in her body? How does she know in her bones and gut how to use the information? And to what degree is she is aware of any of this?
If she is not listening to the subtle messages in her body, in her breath, in her dreams, or in the patterns in her thoughts and emotions, then she is acting from her conditioning and not from awareness. From the outside, no one may be able to tell the difference, but on the inside, she will feel the difference…
via Birthing From Within – Information Frenzy.

Which brings me back to this quote:
“I usually claim that pregnant women should not read books about pregnancy and birth. Their time is too precious. They should, rather, watch the moon and sing to their baby in the womb.” Michel Odent

And also to another of my own articles about information overload during pregnancy:
Many pregnant women have information overload. They are faced with more information than they know what to do with. They are bombarded by it. What they really need is “knowing.” They need to know: “What skills do I possess or can learn that will help me greet my birth with anticipation and confidence? What are my tools? My resources? Can I just let it happen?” As an educator I ask myself, “What will help them feel confident? Feel ready? Trust their bodies and their capacities?”
via Talk Less, Learn More: Evolving as an Educator

A lot of this information feeding frenzy, including that of my own first pregnancy, may be related to fear of labor, pain, and the unknown.
Could it be that human fear of pain is being used to generate financial profit? (the opium-is-the-opiate-of-the-masses model). Perhaps once the notion of palliative care reached a certain level of acceptance for the dying within the medical community, it began to spill over into other human conditions (the slippery-slope model). Or, perhaps we don’t want transparency at all (the denial model)…
I can think of many questions that fall under this topic…Why do we call the intense phenomenon of birth “painful”? How do our genetics, behavior, training and thought-processes affect our experience of pain? What about the health care culture – has it focused on relieving pain at the expense of what we gain from working with pain short of trauma or imminent death? How do we prepare women for working with sensation without automatically labeling it pain? Is the “empowerment” often attributed to giving birth what is learned by going through the center of the “there is no birth of consciousness without pain” experience? These questions are just a start…
via About Pain and Birth | Dancing Thru Pregnancy® Blog.

Could these fears also be tied to our cultural lack of appropriate vocabulary for pain?
A childbirth educator interviewed during the film briefly discusses pain and says that we need more words for pain, because it is ridiculous that we have only one word that is used to describe a hangnail, a broken leg, being hit by a car, and labor. I had already been musing about pain during labor and how we perceive it, talk about it, and so forth and this comment was additional food for thought for me. I’m thinking that there are many other words used to describe women’s experiences of labor and birth other than pain–a word that is limited in scope and that for some women may well not even apply to the experiences in birth
via Words for Pain

Or, to a fear of “losing control” during labor?
A topic that frequently arises in birth classes is about the fear of “losing control” in labor. Losing control, “losing it,” or “freaking out” are concerns expressed by women preparing to give birth. It is important to acknowledge that this is a common fear. I also like to ask parents to think about what “freaking out” or “losing it” would mean to them? I ask them to consider what benefits there may be to losing control. I also say, “What if you do freak out? Maybe, so what?! Maybe it is okay. Maybe it is good. Maybe it is helpful…”
via Fears About Birth and Losing Control

Or, perhaps more simply, to a lack of trust in our care providers?
I was interested to read a short segment in the book Labor Pain about studies on fear about birth. A Swedish study indicated that it was not pain that caused women the most anxiety about labor (44% of women had fear of pain). It also wasn’t fear of death of the mother or baby (55% worried about this). It wasn’t fear of their physical or mental capacity to give birth (65% feared this), but it was “lack of trust of obstetric staff during delivery” (73%).
via Fear & Birth

Men may also feel a lot of fear surrounding birth and have few ways to express it:
Although a man cannot feel the same pain as a laboring woman, I believe that many men experience a similar cycle of emotions in the birthing space to that which Dick-Read described, with a slightly different end product, namely: Fear > Tension > Panic. A man who is not confident in his partner’s birthing abilities, who is poorly informed, and/or who is poorly supported, becomes increasingly tense; and if this tension is not eased, then he spirals into an irreversible state of panic. This panic manifests differently in different men: some men become paralyzed by their fear (the familiar specter of the terrified dad sitting stock-still at the foot of the bed), while others spring into hyperactivity, bringing endless cups of water or becoming obsessively concerned with the temperature of the birth pool.
via Fathers, Fear, and Birth

I think it is also important to recognize the deep gifts to be found in facing our fears and doing it anyway:
We may feel guilty, ashamed, negative, and apologetic about our deepest “what ifs.” We worry that if we speak of them, they might come true. We worry that in voicing them, we might make homebirth or midwifery or whatever look bad. We don’t want to add any fuel to the fire of terror that already dominates the “mainstream” birth climate. And, we don’t want to lose “crunchy points.” We want to be blissfully empowered, confident, and courageous. And, guess what? We are. Sometimes that courage comes from looking the “what ifs” right in the eye. Sometimes it comes from living through them. My most powerful gift from my pregnancy with my daughter, my pregnancy-after-loss baby, was to watch myself feel the fear and do it anyway. I was brave. And, it changed me to learn that.
What if we can learn more from our shadows than we ever thought possible? There is power in thinking what if I can’t do this and then discovering that you CAN…
via What If…She’s Stronger than She Knows… | Talk Birth.


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