Tuesday 25 November 2014

Fear of Childbirth, latest research.

 Seen on the Royal College of Midwives web page.

 ‘Fear of childbirth’ and ways of coping for pregnant women and their partners during the birthing process: a salutogenic analysis
05/09/2014 - 14:15
To explore ‘fear of childbirth’ and its impact on birth choices among women and their partners in Northern Ireland.
Jean Greer BSc, RM. Anne Lazenbatt PhD, MSc, BSc. Laura Dunne PhD, BA.


‘Tokophobia’ is defined as morbid fear of childbirth (Bhatia and Jhanjee, 2012), and this diagnosis has recently been endorsed within the UK as an indication for planned CS (NICE, 2011). This decision seems contrary to current trends within maternity services that focus on promoting normality in birth (Gould, 2012). However, there have been concerns for some time among midwives that the conceptualisation of fear of childbirth as a pathological process, situates the problem within the individual woman, and deflects attention from maternity care provision (Walsh, 2002).
All the women feared the pain of labour and were reassured by the availability of a 24-hour epidural service. Despite this, the majority of the women (65%) expressed hope that they could labour without an epidural, although they lacked confidence in their ability to cope and feared the pain would be too severe. Six of the primigravidas in this study (40%) had already been advised to have an epidural during labour by family or friends and all the men wanted their partner to have as much pain relief as possible during the birth“She [her mother] said: ‘If you want my advice, you get an epidural as soon as you go into labour because you’ll never be able to cope.’ You see they all know me and know what I’m like” (W10, prim).
 Four participants (11%) identified midwife support as a resource to help them cope with birth. These were two multiparous women and partners. Recalling previous births,
they described how the midwife had reduced their fears: “...from what I could see, the midwife had everything under control and like it seemed ok... so I was pretty relaxed” (M3, third baby).
Normal birth was still very alluring for most of the women in this study. It has been reported previously that women idealise normal birth while also rejecting it as dangerous (Maier, 2010). Most women in this study (89%) aspired to a normal birth but more than half (68%) feared they would not be capable of achieving it safely without medical intervention. Gould (2012) contends that this is a consequence of the language of risk that is used when offering birthing choices to women. This perception of riskiness reduces the comprehensibility dimension for women, and increases their need for resources to help manage birth. 
See the post 'Progressive Muscle Relaxation'.
It is little wonder that women today have tokophobia as our society teaches them through the media, family, friends and health professionals that contractions WILL be painful while ignoring the simple fact that uterine smooth muscle was never designed to cause the sensation of pain during a normal first stage of labour.

Thursday 16 October 2014

It's BLOG ACTION DAY!

16/10/2014 is blog action day and OXFAM have asked bloggers around the world to take part. We are to post blogs on inequality. Inequality with regards to childbirth, don't get me started!

According to Oxfam 800 women die every day in childbirth. Just 5 of them are in high-income countries. The WHO have been saying for decades that educating local women to become midwives would put a serious dent in that awful number of losses. Making simple drugs available to these midwives like Syntometrine would help to reduce the numbers of PPH. Of course then they would need a fridge or portable cool box that I used to carry as a community midwife.

Also according to Oxfam there are 85 people who have as much wealth as half of the people on the planet combined. Who are these people? Gods? Unfortunately they did not give out names or addresses of the 85 so will have to do some more digging before I send out the begging letters.

Ironically, one of the richest nations of the world has very little in the way of equality when it comes to childbirth. The USA have a terrible record of forcing women into a medical model of care no matter what their risk factors are. They do not have midwifery led care and you have to see a doctor throughout your pregnancy and be delivered by a doctor as well. Doctors in the US seem to know nothing about normal labour and birth so how can women hope to birth normally? All they need to do is allow home births (banned in most states) and train midwives (not obstetric nurses) how to empower women to take charge of their birth and support them safely in their choices. Simple.

One young Indian lady that I booked told me that she wanted to lie down for her upcoming birth with an epidural in situ and have an episiotomy as a doctor removes her baby with forceps as this is what she went through in India at her first birth. I was speechless for a minute or two there. At the end of our hour long booking session she was so happy to be looking forward to birthing in a pool at the stunning birth center that I was working at then. Low risk women should not be given the medical model of care unless they have risk factors and even then they can labour normally with a bit of care and attention from midwives.

So, the answer to inequality within childbirth seems to be to train and pay more midwives to deliver midwifery led care for all women, whether they are rich or poor. Sorted.


HAPPY PARENTING

Sunday 8 June 2014

Basic human rights in childbirth.

The world is finally waking up to the very sad truth that many women have their human rights taken away during pregnancy and childbirth.

https://www.indiegogo.com/projects/human-rights-in-childbirth
http://birthanarchy.com/choke

Women around the globe are finally beginning to speak out against the treatment they received in labour that has stayed with them and haunted them ever since. My third labour was such a time that I was treated with cruelty and inhumanity whilst I was at my most vulnerable. My fourth was born at home and was my second pain free labour, bliss.

If more women learnt how to approach labour so that the first stage was pain free, then instead of worn out exhausted women facing their second stage, you would have strong women who would question interventions that were against their basic human rights.

Once society wakes up to the basic truth that uterine smooth muscle was never designed to cause the sensation of pain during a normal contraction then we can finally take back labour from the medical model of care. It is the way we approach labour, with anxiety leading to adrenalin production, that can cause all the problems and pain.




Saturday 1 February 2014

Never ask a doctor about a pain free labour.

Have just been reading Your Pregnancy Week by Week written by a professor of obstetrics and gynaecology. OMG. There is no mention of adrenalin, secreted when we are anxious or stressed, holding the cervix rigid and harder to open. This is the main cause of painful and long labours.
The word 'pain' is generously used during descriptions of all the stages of labour. The reason given that smooth muscle should cause pain in this way is that the blood supply is cut off whilst smooth muscle is contracting and so leads to "the release of painful chemical substances". I think they mean lactic acid which, if you read my post 'Why Labour Hurts - 2', you will find that the release of lactic acid is avoidable if mum is calm and not secreting adrenalin. The Author must have a constant epi-dural on the go for every time a meal is eaten and the smooth muscle in their stomach starts to contract! I bet xmas was fun.
The author does however say that caregivers should "encourage you to keep upright and active for as long as possible rather than confining you to a bed, in order to allow gravity to play its part in helping you to reach the active phase" (of labour). Well done doc, staying upright in labour, on a comfy chair or birth ball, will use the force of gravity to help keep the contractions pain free.
Your Pregnancy Week by Week is a beautiful book untill you get to labour, then the fun stops and you are convinced that you will be in PAIN, propaganda at its worse. On hypnobirthing I found the comment "you will need to be hypnotized into believing that you can control the pain of your contractions". Really?
Never ask a doctor about a pain free labour cos they do not have a clue. All that time spent at doctor school sudying human tissue and how it works has not taught them that uterine smooth muscle was never designed to cause the sensation of pain during normal use. It is the things done to us by doctors that mainly cause all the pain that they are so fond of.
When you have successfully experienced your pain free labour by relaxing and staying upright please write to your local hospital and ask them to inform the doctors that 'yes' it is possible for smooth muscle tissue to work without the release of "painful chemical substances".
All it takes is to believe, the truth.