So many birth questions, need your wisdom.

[Steffi]

Hey everybody, i am TTC my first baby and have spent 11 years coming to the decision to finally try because i have such bad anxiety about it all. I have done alot of research and am finding that other mum's advice is the thing that is helping me to feel more confident the most. I have decided to have my first baby at a private hospital with an obstetrician which i have copped alot of negativity for from many directions in the past few weeks so in starting this thread i don't want to cause an ongoing debate about private hospital v's homebirth but would really appriciate some advice on the following. How to minimize the risk of tearing and or episiotomy. I am scared as a panic sufferer that i may have a panic attack during birthing, has anyone else had this experience?. Methods of natural pain relief. and of course anything else you think i should know. It'd great to know i have you guys for support.

[BellyBelly]

To reduce your risk of tearing avoid positions on your back when pushing. Avoid directed/managed pushing - opt to push on your own. I doubt its an option in a private hospital but waterbirth helps too. Slow down when baby is crowning to allow your perineum to stretch.

Episiotomy - just say no. Avoid forceps or vacuum which make one more likely, meaning avoid epidurals which make assisted delivery more likely.

Good luck - definitely get a doula, they will help reduce intervention at birth and help with your anxiety. Try Lisa Chalmers at Australian Doulas - her or one of her doulas will be able to help and are great.

[The[cookie]Doctor]

Hey Steffi. Congratulations on making the decision to TTC - and good on you for making your decision about private and an Ob. The most important part of your decision is to take control of it and be proud of it. If you don't take anyone crap they won't say anything .

What I suggest is to do as much reading as you can in preparation for the birth. Believe me, it may freak you out - I had a melt down 20 weeks in because I was so scared. But knowledge is power - it really, really is. Try getting a hold of "New Active Birth". It is an excellent resource for learning about the best positions for a great birth, etc. I think "Birth Skills" (Juju Sundin) comes highly recommended as well.

Also, I haven't BTDT myself, but if you are a sufferer of anxiety and panic attacks it may be an idea to look into Hypnobirthing or Calmbirth - they will help you employ techniques to help you through your birth.

The best method of natural pain relief is knowledge - once you know what sort of effect your choices for pain relief will have on your baby then you can feel a lot more confident in your ability to get through it. Read up on the effects of pethidine and what effect epidurals have on your labour. Hypno/Calmbirth, as I said, will help you employ coping techniques.

Something you may also want to consider is a Doula - a non-emotionally involved support person for your labour. I know you said you have faced negative remarks with your decision to have an Ob - is there anything that has made you think an Ob may be the wrong choice? If you have read anytthing or are worried about unnecessary intervention I think a doula would be a great support to have. They will also be there for you throughout your pregnancy to help with any questions.

Have a read through all of the articles on the main site - they are all full of great information.

Hopefully this helps somewhat, good luck with TTC, hope it's quick for you!

[Steffi]

Hey, thanks guys. Cookie monster i have chosen a private hospital that actually has rooms to cater for a home style birth with minimul intervention but i like the knowledge that if i change my mind i can move down the hall and have an epidural. I will definately get a hold of those books if im able and have a read, i have been reading soooo much. It would be great to be able to get through it with just gas and air and hypnobirthing which i definately plan to learn more about, thanks for your advice on that too
I have also chosen a couple of ob's that support natural birth choices and are not pushy. I would like to have another person for support but have spoken to 3 doulas now and find them to be a bit one sided. I understand where they are coming from but i need to feel secure and don't seem to when i have spoken to them. On the other hand i have found chatting to the midwives on the hospital tour priceless and since they will be supporting me throughout my birthing experience i guess thats the best thing for me. Keep the advice coming, i'm taking notes

[fionas]

Hey Steffi

Just want to second Ash on the Juju Sundin book. I was driving myself a bit bonkers when I was pregnant but it really calmed me down because it concentrates on what you CAN do to manage your labour rather than just saying why you shouldn't have an epidural etc. etc. It's full of practical techniques that I found really helpful. And her big thing is that as long as you know you've tried your best, you can't feel disappointed with your labour.

Given your fear about panic attacks etc., I also think, as Ash said, it would be useful for you to look into hypnobirthing.

Basically, I guess what I'm advising is to look at pain management techniques rather than relying on willpower and crossing your fingers.

It's also important that you trust your care providers. Hopefully you will build a good relationship with your ob - I trusted mine 100% and he really calmed me down when it got to the pointy end. Not sure from your post whether you will get midwifery care throughout your pregnancy (rather than the labour itself) but if not, that's where a doula will be important because they can support you through the labour and not just at the tail-end when your ob will be there.

[Lulu]

It's a real pity you have had a bad run with doulas. Seems none of them have picked up on your worry and just let you know your choices - so you can choose on you own.
Do follow up with Kelly's suggestion, her recommendations would have to be good .

[Trillian]

Hi Steffy, it isn't so much that one option is better than the other because millions of women birth in hospitals everyday and have beautiful births, its more that sometimes in a hospital setting it is hard to get exactly what you want from your birth without having to fight for it - that's where education is so very important so know what you want and what your options are.

Doula's are meant to help educate you and give you suggestions that you may not have thought of - they are very experienced at what they do and know so much. I suggest you keep looking for a Doula though because it is the only way you will get continuity of support during your labour because while Midwives are great (worth their weight in gold really), they aren't able to stay with you 100% of the time as they will have other women to attend to.

If you are worried about your anxiety during the labour, the calmbirth and hypnobirthing classes should help with that a lot. If the hypnobirthing works well for you then you wont need that trip down the hall

[BellyBelly]

Great suggestions, I think calmbirthing would be great. If you are anxious or stressed in labour, your body will produce adrenaline which counteracts oxytocin, the labour hormone - a flight or fight reaction. Now in caveman days this was very useful - it would stop the labour so the labouring mother could go somewhere safe when she felt threatened. But today, if labour slows or stalls due to anxiety or whatever, they look to the mother and call it failure to progress. They dont look at the circumstances of the mothers care as to why this is happening or any existing conditions she has. So up goes the drip, the need for an epi to cope most of the time (esp if your first) and then possibly assisted delivery if you don't push effectively enough.

I actually know one of the doulas you have met, I know her extrememly well and she is the most gorgeous, generous and kind woman, who would have only been thinking of helping in this circumstance. Perhaps the anxiety you are feeling is clouding how you feel on this topic. I know she would never force or persuade people to have a homebirth or whatever, she would have only tried to let you know based on her vast experience that what goes on at that place. If you are not interested in finding out these things, perhaps you need a doula who will just agree with everything and not play an active role in advocacy, just being there to hand hold etc. When you are a doula and see things over and over again, it is very hard to not tell a client, because you genuinely care for their wellbeing, you want them to be prepared and consider options if its highly unlikely she will not get the birth she wants with the choices she makes.

[christy]

I started having anxiety issues when I was pregnant with DD2, I started getting panic attacks. I was trying for a VBAC and was having a hard time with it all. I had a doula and an empowered VBAC. I did have a moment in my labour when I felt I let down my support person, but BUT I was empowered and making the decisions myself. Decisions I "knew" in my head what those choices were and why I made the decision I made.

I was feeling extremely anxious all of a sudden, almost flighty, and I was doing my calmbirthing/hypnobirthing and I took some of my rescue remedy drops and then popped into the shower... I couldn't settle and I couldn't settle enough to focus on my breathing & relaxing my body and I knew that was why my surges were getting more and more "painful" because before then they were a going with the flow sort of thing. I asked for some help with pain relief, but I asked for what I knew would relax me back to where I needed to be mentally. So definately not gas...

Anyway... the thing for me was making an empowered choice. I researched everything, I understood that being calm was pain relief in itself.

I would highly suggest having a doula, getting into some calm birthing, and researching things like pain relief. Read :"A Thinking Womans Guide to Better Birth" by Henci Goer. Its fantastic.

I personally had the worst pressure from the OB, our midwives were good, but I did have to stand up for what I wanted.

[Lucy]

Steffi,

The other girls have given you wonderful advice.

I especially think that looking into CalmBirthing or some form of hypnobirthing would be a good idea for you. (I used it for my final birth and it was wonderful.)

i have found chatting to the midwives on the hospital tour priceless and since they will be supporting me throughout my birthing experience i guess thats the best thing for me.

That is wonderful. Do they run antenatal classes early on? If you warmed to them, maybe this is an avenue that you can explore to increase your confidence of the process?

But also be mindful that those lovely midwives may not be on shift when you are in labour?

For what its worth, I had vaginal deliveries for all three of my babies, in a private hospital environment. I had 3 blissfull births without any tears. BUT I had a VERY clear idea on what I wanted and what I didn't. Knowledge gave me this confidence to get what I wanted.

Good luck.

[Kazbah]

I had my Pip in a private hospital, and it was a vaginal birth

For pain relief, I had a TENs machine - in short, its an electrode you put on your back, and you have a control for it, run on 2 "aa" batteries. When you feel the start of a contraction, you press the button and it puts a little pulse through the muscles in your back, and the tingling there distracts you from the pain. I used it up to about an hour before the actual delivery - and only stopped then cause I hopped in the bath for about an hour! Well worth hiring in my opinion.

Good luck

[~Raven~]

But also be mindful that those lovely midwives may not be on shift when you are in labour?

Good point Lucy!

[Trillian]

I forgot to say earlier to get a copy of The Pink Kit - essential for you to learn to know all there is to know about your vagina so you can learn to trust it to do the job it's meant to do.

[Steffi]

Thanks so much everyone for all the great advice. Belly Belly i am sorry if i offended your doula friend in any way. I found her to be the best actually and was mainly referring to two other doulas i had spoken to that i found very pushy. I will not name names of course. I do have extreme levels of anxiety and i guess i was looking for some one to support my decision and help me along. I guess it's just my anxiety and the thought of not being within reach of pain relief and someone that will know what to do in the situation that i have a panic attack scares the jeepers out of me. To be honest i haven't given birth before but have been in situations before that required me to stay calm during and i had the most terrible panic attack of my life that went on for more than 6 hours. By that time i was ready for them to shoot me and the only thing that calmed me was being in the hospital and knowing that someone could help me and have meds on hand if i found i couldn't cope. It's hard to understand unless you have been in that position. I would love to have a completely natural birth and am certainly going to try and will certainly stand up for what i want but need to feel the reassurance of someone that knows what they are doing and that every avenue is covered if i need it. I am a pushover let me tell you and get easily confused. I have spent alot of time and research and years coming to the decision to have a baby and its hard for me to just abandon that and go with a birthing unit with the possibility of being transferred to a hospital last minute that i have had bad experiences with before. Im sorry, but i need the security that everything is available to me in order to relax. I hope you understand. I didn't ever mean to diss any doula in particular and am just a confused wannabe mum trying to get support.

[Steffi]

Thanks so much to all the wise mums that have given me advice. I will definately look into calm birthing and hypno birthing and get hold of those books and The Pink Kit. Where do i get The Pink Kit from?
I am so terribly confused but really appriciate your advice and can't thank you enough.

[Lucy]

Steffi,

The other thing to bear in mind is this: once you have concieved, you then have at least 7 or 8 months to "get to grips" with things!

I was a bit freaked out at "the how the hell do I go about giving birth" bit for ages, then once I fell pregnant, I calmed down about it a lot, did a lot of reading, asked a lot of questions, and things did feel like the feel into place in my head over the course of the pregnancy........

[Steffi]

Thanks Lucy
I wonder if it's such a big thing with other women as it is for me (anxiety about giving birth).
I mean i'm sure most women are fearful to a degree but i have an extreme fear, so much so that i have put off having babies for 11 years.
I really want to have a baby and i'm sure after the first i will be ok.
Reading all the negative stuff i have done recently about obstetricians i am now getting fearful about them and the decision i have made and am finding myself retreating back to waiting again.
I know i just have to do it but i'm so scared.

[Trillian]

Steffi, you can buy the pink kit from the BellyBelly online shop here BellyBelly Pty Ltd - Shopping Cart, as you can many of the other resources that have been suggested. Every women goes through some level of anxiety during her pg - and it is COMPLETELY NORMAL! Granted yes, that someone like yourself who does suffer from anxiety issues may have a bigger problem to overcome, but it is possible. It is a huge leap to make the decision to have a baby, but once you are pg you HAVE to come to grips with it, you can't hide from it anymore.