Before getting pregnant, I had this image in my head that giving birth is basically the worst thing to happen to anyone, ever. Honestly, the reason I wasn't keen on getting pregnant was that I couldn't face the idea of labour and delivery that I had built up in my head.
Blame horror stories from acquaintances, masochistic googling (“childbirth how painful”) or media depictions of women screeching their heads off as a team of doctors grab their legs and shout at them to PUSH. Pain, pain, pain; horrible, horrible, horrible, is the message that all women get, years before they even start to considering a family. No wonder we’re all terrified.
I’ve heard stories about antenatal classes in private hospitals here in Hong Kong, in which the (male) anesthetist comes in and tells you how painful childbirth is--literally saying that the pain is equivalent to getting your leg ripped off. It’s not hard to believe that most mums-to-be will opt for the pain relief--or even an elective c-section--after a story like that.
Pain is subjective and every birth is different. How can you even compare a traumatic limb amputation and the labour process!? It’s like trying to compare running a five-hour marathon and suffering from a five-hour migraine.
My original plan was to get a massive epidural at the very first twinge of a contraction and happily ride out the whole process dead from the waist down. However, I learned that the government system is anti-intervention, and if they think you’ll be able to make it to the pushing stage without drugs, they’ll hold off on the epidural (sure, the anesthetist is on his way! They’ll tell you... for three hours...) and let you deliver naturally.
The last thing I wanted was to get caught out with an unprepared-for drug-free delivery, and to then have to white-knuckle the whole thing. I’m not saying I don’t want an epidural, but I do want to be prepared to go without if I have to. Above all, I don’t want to be traumatized by birth, and as I had been panicky and nervous about it since day one, I decided to enroll in a Calmbirth course.
This program is a series of classes totaling 12 hours, designed and developed by Australian midwife, Peter Jackson. It’s nothing too freaky--classes that educate you on anatomy and the birthing process; a bit of cognitive behavioural therapy (stories and videos of good births) to rewire your associations of childbirth with trauma/pain/misery; workshops to help you think about the labor you want; and breathing and relaxation techniques.
Of course, the proof of the pudding is in the eating, and having yet to actually give birth, I can’t yet say whether Calmbirth has helped to turn my experience into a positive one. What I can say is that my outlook has gone from one of terror to one of reasonable confidence and an “OK, I can do this” attitude. And for that alone I’m really glad I did it.
I can’t give you the breakdown of all the classes (you’d be reading for hours), but these are the basic takeaways:
Fear-Tension-Pain Response
The basic premise of the Fear-Tension-Pain response is that if you anticipate an event fearfully, it’ll lead to tension, and that tension will in turn lead you to experience pain--a vicious cycle. The idea is to replace fear with knowledge about the birthing process, and replace tension with relaxation, thereby reducing pain. Common sense really, but it’s nice to have it spelled out.
Which brings me to…
How the Uterus Works
I found this tidbit extremely useful. To put it very basically, the uterus has three muscle layers. The first layer pushes the baby out, and it needs oxytocin (the feel-good hormone) to function. The second layer holds the baby in--if your body is telling you via an overdose of adrenaline that it’s not safe to give birth (you’re panicking, you feel unsafe, someone you don’t like has come into the delivery room), it’ll shut the whole process down. That’s when you get stuck, and that’s why it’s important to remain calm, to keep the oxytocin flowing and your adrenaline levels low.
Which is why you need the techniques of…
Breathing, Relaxation, Visualization
If you start hyperventilating or stressing out, you’ll set off a panic response in your body, which then diverts blood away from your uterus and towards your limbs in preparation for fight or flight. Because there’s a diminished blood supply to your uterus, it then starts cramping and working less effectively. But if you remember to take deep, slow, calm breaths, and use relaxation techniques and visualization tools (imagining the baby coming down, going to your happy place--whatever works) it’ll keep your panic responses to a minimum.
But you also have to…
Prepare for the Unexpected
Shit happens--especially during labour (and although I don’t mean that literally--that too). Everyone has an idea of what their ideal birth will be like but often it just doesn't happen that way. Calmbirth also teaches you to manage your expectations and make the best of a situation if things don’t go how you expected.
And this is the key really--so much of how you feel about your birth is how you choose to feel about it. Two people can have the same experience and one will think it was awful, and one will think it was great. I hope this doesn't sound hokey, but if you’re willing to accept that certain aspects of birth are beyond your control and that you can make the best of what you can control, you’ll have a better time of it.
Calmbirth doesn’t talk about birth in terms of “passing” or “failing” and it’s not staunchly anti-intervention. If you need an induction, an epidural, a c-section, that’s fine--but what can you do to make yourself feel good about your experience?
The Calmbirth course is run in Hong Kong by doula and pre- and post-natal massage therapist Kathy Kitzis. You can learn more about it at www.kathykitzis.com.