It’s been exactly four years today since I had the shock of my life! The labour and birth of our first child, was to me, akin to being involved in a road traffic accident. My husband described it as like the opening scene from Saving Private Ryan. Overdramatic? Perhaps. But the experience certainly left me traumatised and with an intense tokophobia. This very real psychological fear of childbirth was explored by Hofberg & Brockington (2000) and found that even pregnant women desperately wanting their unborn child, felt termination was their only option as they were so terrified of childbirth. This subject deserves some exposure.
As a midwife, I thought I knew exactly how I would cope with labour, how I would manage it, and envisaged a beautiful serene birth and immediately falling in love with my baby! Ha! A far cry from how it played out! When I thought I was approaching being fully dilated, we went to hospital to meet my colleague who was kindly on call to look after me. Turns out I wasn’t even in labour at that point. Demoralised? Indeed. I was experiencing something I had told many expectant mums myself and had just gently reassured them that it would happen eventually. Empathy in hindsight was a humbling moment. I had pretty much already reached my pain threshold and was crossing over into pain I couldn’t cope with. The problem is – that means nothing if you are not in labour! Take two paracetamol and have a warm bath is the standard advice at this stage. Luckily for me being an insider allowed me some preferential treatment so I was able to have entonox (gas and air) early and six hours (!) later I was allowed an epidural just on the cusp of entering active labour. Preferential treatment of any kind is not something I agree with professionally or personally but it happens, and at that point I would happily have chucked myself out of the nearest window to end the pain so just wanted the relief. Immense relief it did bring, not only to me, but emotional relief to my husband as well who was feeling my pain vicariously (and so he should!).
Unfortunately the relief didn’t last as my epidural catheter moved and the pain returned with me then too far along and too hysterical to even attempt a re-siting. Again extra care in the second stage of labour (fully dilated to delivery) kept the wolves from the door (the obstetric doctors) and two and three midwives at certain points giving it their best shot round me to get me to an unassisted birth. This, although done with the best of intentions, in some ways served to prolong my distress as I felt my pelvis would explode from the pressure of my son’s head. I distinctly remember asking them to cut me open and with that I didn’t mean a caesarean, I simply meant kill me and get the baby out. Eventually he was born, and at that point I expected the immediate flood of relief to follow. It didn’t. The intense pain continued through the expulsion of the placenta and perineal repair, and only subsided when it was all over and I fell into a post-trauma inertia. It was another four hours before I held and fed my baby, and eight days before I could bring myself to give him a name, having spent most of that time crying with shock, pain, and exhaustion. Luckily for me the birth did not lead to postnatal depression, instead I became ferociously over-protective of my son, never leaving his side, perhaps with the knowledge of what I’d had to experience to have him in our lives.
Within six months we wanted a sibling for our son and this overpowered my fear of going through it all again. Once pregnant though, the fear began to escalate and the flashbacks played like a film on repeat in all it’s gory detail – the sights, the sounds, the emotion, the pain, things that were said etc. One thing was for sure, I wanted a better experience this time, and opting for a caesarean section just wasn’t on my agenda. I had come across a book that initially had angered me greatly – ‘Childbirth Without Fear‘ – by a man, no less, Grantly Dick-Read. Originally published in 1942, GP Dick-Read was a champion of natural childbirth, and states that “there is no physiological function in the body which gives rise to pain in the normal course of health”, in other words – there is no reason that childbirth should hurt. Now anyone that has given birth and felt pain will understand my initial anger. However – upon further reading – this man talks a lot of sense! The Fear-Tension-Pain Syndrome is explored in great depth and the conclusion that “fear is the most important contributory cause of pain in otherwise normal labour” absolutely resonated with me. His ‘Dick-Read Method’ of childbirth reassured me and gave me confidence that a better childbirth experience was possible for me. We signed up for one to one hypnobirth classes with Life Designs and I had EMDR therapy to resolve the trauma of my first birth. I was sceptical at first but amazingly the flashback horror film that would replay in technicolour was more of a foggy memory following EMDR – I still know what went on during my first labour but the all the detail became dulled. The painful memories dissipated and allowed me to concentrate on the hypnobirthing (book link) techniques I needed for my fast approaching due date.
The end result? Laboured at home, coped very well, only went to the delivery suite at 9cm dilated, and delivered our 9lb 5oz second son facing up instead of down, just a couple of hours later, using only entonox. Okay, I didn’t have a textbook hypnobirth, it still bloody hurt, and I definitely have no desire to ever do it again but I felt sooooo empowered – a complete contrast to my first experience. I did it! The reading/hypnobirth/therapy preparation helped hugely and gave me the confidence in myself I needed. Even if you’re not sure whether it’s for you, the above links and books are worth a read for anyone experiencing tokophobia, supporting pregnant women or are of course pregnant.
8th Jan 2014 – Just wanted to add a link to a BMJ research article just published that found fear of childbirth to be a strong predisposing factor for postnatal depression: http://bmjopen.bmj.com/content/3/11/e004047.full?sid=3d7e1471-b7e5-47b9-8c43-b800fa86a653