There would definitely be blood. An ambulance siren would peal in the background, and the blue flashing lights would illuminate our living room window. Passersby would stop, stare, and wonder at the spectacle of a half naked English woman being stretchered through our portuguese village, while my newborn babe cried in her dad’s arms. Retained placenta, birth gone wrong, terrible business. Surgery inevitable.
Or perhaps I would not even get that far. Maybe my little one would try to come out, but my body would prevent her. Fight against her. Birth canal too narrow you see, birth failed, do not pass go, do not collect your baby.
Or this could be my imagination talking. In reality, neither of the above situations were remotely likely to happen. Even so, my fears felt so real that it was hard to believe they had no basis in fact:
The first example is what I feared might happen during our third child’s birth because the placenta had been a bit lackadaisical arriving when our second child was born, and it freaked me out. After doing a little research and reflecting on the circumstances, I remembered that I felt really cold after Sam was born, but was feeling too labour-stunned and baby-struck to ask for a blanket. I was also reclining quite a bit. Both these factors influence the timely arrival of the placenta, but even so, a 45 minute wait for a natural third stage is not that uncommon. By ensuring I stayed warm and somewhat upright I would probably deliver the placenta in a more timely fashion. My midwife assured me that, though it would be unpleasant, he would be able to deal with a reluctant placenta at home. In case of postpartum haemorrhage he had drugs to administer and would be able to deal with the situation, though a transfer would be necessary. However, the likelihood of this occurring during the home birth of a third child after a low risk pregnancy was extremely small.
The second example is what I was told might happen during the birth of my second child by a nurse in the maternity hospital. I went in for a check up, and cried on him. I told him that I had had an assisted delivery with my first, even though she was only 2.4kg, and was scared I could not give birth naturally. I was terrified because I had had a third degree tear last time too. He smiled reassuringly. “You’re really fat you see” he said. “You gained so much weight that your insides pressed on the birth canal and made it smaller. If you’re not careful about what you eat this time, you won’t be able to birth your baby”. Now, I have researched this idea as best I can, and have found no scientific basis for it whatsoever. I can only guess that it is this guy’s pet theory and he decided to share it with me with the best intentions. In Portugal, it is still common practice to do weigh-ins with pregnant women, which is his job, and it is not for nothing that my friend and I refer to him as ‘The Ice Cream Police’. Even so, I am pretty incredulous that I was subjected to this nonsense.
It was through addressing these fears that I became convinced that the best thing to do when you or someone else tells you a horror story is to listen carefully, then analyse the crap out of it. I was inspired by a brilliant TED talk by Karen Thompson Walker, which talks about doing just that.
In this day and age, there is a great deal of fear-mongering surrounding childbirth in general. Home birth appears to be enjoying positive press at the moment, due to reports which confirm the safety of planned home birth, and the apparent popularity of retro shows like ‘Call The Midwife’. However, it has been controversial for some time, and there may well be scare stories in the press again in the not too distant future. In a climate where there are so many horror stories surrounding birth it can be so difficult to pick out the real dangers from the dramatic fictions. I believe it is much better to address fears about birth at leisure, during pregnancy or even before it, rather than be confronted by them during labour. By reflecting on the details of your fear, the story it is telling you, you can a) Assess whether the birth will likely play out as you imagine, b) Create strategies for dealing with problems, c) Review options, d) Visualise a more positive story.
For instance, during my second pregnancy I was so worried that I would once more give birth with the assistance of forceps and sustain another perineal tear. This time it would be more severe and I would not heal as well.
A) Assess whether the birth will likely play out as you imagine –
I examined scientific studies, and read anecdotal reports in chat forums. It seemed that women in my situation tended to go for a managed birth with pain relief and a planned episiotomy, OR an elective C-Section, OR they went for a natural birth, often using water, adopting a leaning forwards position. Either way, most fared better the second time around, with the most positive results coming from the last group. In large, rigorous studies, such as this one, home birth has been proven to be as safe for babies as hospital birth, and safer for the mother, in low risk pregnancies.
B) Create strategies for dealing with problems-
I now knew that I had a great chance of pre-empting birth interventions by going for a natural birth in a forward leaning position. I could give birth in water or even just labour in it, to soften my perineum and assist the scar tissue in stretching. I could control the birth of the baby’s head by breathing and resisting the urge to push too fast.
C) Review Options–
In my local maternity hospital the policy is that women all birth lying down with their legs in stirrups. Private clinics deal only with elective sections, and there are no birth centres specialising in natural birth. Therefore, we decided to plan a home birth with an independent midwife.
D) Visualise a more positive story-
With our strategies in mind I read tons and tons of positive birth stories involving home birth, water birth, birth of a second child, and birth after a third degree tear. This helped me to re-imagine how the birth would go and to get a general feel for the rhythm of the narratives: what happened, when, and how. I also listened to my Natal Hypnotherapy CDs often, which helped me to relax and anticipate my birth.
I am pleased to say that Sam was born naturally, speedily, and with no major bottom damage. We were really pleased with our experience of home birth, so we decided to have another next time. Evie, and the placenta which followed her, were born even faster with no complications and not a scratch to the perineum. Their respective birth stories are here and here. I wrote about what I learned from my first birth here.