{Ottawa Doula} What to do when you're afraid of birth

After posting about the NHS's plans to offer c-sections for free in the UK, I have noticed an increase in traffic from people googling "scared of birth, should I have a c-section."

This has really touched me, and I wish there was some way I could reach out to these women and give them a hug. So here's my way - a blog post!

Preparing for birth can be a scary and overwhelming experience. I remember coming home from my first prenatal class, curling up into a ball and having a huge cry. The reality of what I was about to face hit me over the head like a ton of bricks, and I didn't know how to deal with the fear.

I studied for birth like it was a PhD comprehensive exam. When I would hear about other women's wonderful birth stories, I would suddenly become fearful - what if that doesn't happen to me? What if I can't do it? What if it all turns out "bad"?

The thing I've come to realize as a doula is that a woman who is well prepared, and well supported, can have a positive experience regardless of the outcome. Happy birth stories can happen in any hospital, with any care provider, as long as the woman feels like the director of her own experience.

Here are some information and tips for women out there who are scared of birth and considering a c-section instead:

1) What are your specific fears? There are most likely 2 or 3 things that you are dreading - for some women, it's the pain; for others, it's the possibility of a tear; others fear things like vomiting, being naked, or losing control (by making too much noise, fainting, or doing other "crazy" things)

2) Write out a plan of how you will deal with this fear if it does happen. Visualize it happening, and then visualize yourself dealing with the situation. Talk to someone about your fears, and have them work through them with you.

3) Hire a doula. Your husband can not be your "everything" and he will be scared as well. Most likely he has his own set of fears. If you can't afford a doula, ask for a friend or family member who has given birth (and who has a positive birth story to tell) to support you.

4) Make sure you have a good caregiver. You all know my thoughts on midwifery care. There is no one better equipped than a midwife to calm your fears.

5) Take a GOOD prenatal class. The classes offered at the hospital are usually biased and extremely boring. Look around for prenatal educators in your community who offer alternative classes. Here are a few great ones in Ottawa:

Ottawa Childbirth Education Association http://www.ottawacea.com/

Birthing From Within Classes http://primadoulas.ca/?page_id=22

Bradley Method http://www.healthy-beginnings.ca/

It's worth the money - another option is to hire a doula who is a childbirth educator, and ask her for some one-on-one classes in addition to your prenatal appointments.

Any other tips or thoughts out there for women who are afriad of birth?

{Ottawa Doula} Midwifery: Fact and Myth

It's not shocking to me at all how often I come across regular folks who have no clue what a midwife does.

I was there, too.

Before becoming pregnant with my first child, I gave no thought to my care provider. I pictured myself visiting my family doctor and being referred to an obstetrician. It was the fortuitous meeting I had one day with a local midwife that changed the course of my life forever (I guess you could say my pregnancy changed the course of my life forever, but I'm going for dramatic effect here!)

I interviewed this student midwife for a short one-month placement at Hopewell (Ottawa's only eating disorder support centre - as a side note, all midwives are expected to do one community-based placement; women with eating disorders get pregnant too, hence this midwife was particularly interested in this issue) She opened my eyes to the possibility of having a midwife care for me during my pregnancy.

So I would like to share with you some of the things I've learned about midwives, which will dispel some of the myths floating around out there. These tidbits are designed to surreptitiously indoctrinate gently urge you to seek out more information about midwifery care.

• You cannot have an OB (or family doc.) and a midwife; you can  have one or the other. There are exceptions - some women advocate for "shared care." These are generally women who are higher-risk but would like a compassionate, caring midwife to support them in their medical decisions.
• Midwives are highly trained professionals. They have not stumbled out of the forest wearing birkenstocks, and they don't arrive at your birth with a dirty towel and piece of shoestring
• Their training program is 4 years long, most of which is hands-on clincial experience
• Midwives care for low-risk pregnant women - they will not take on women who clearly need the expertise of an obstetrician.
• Midwives DO deliver primarily in hospitals. Yes, they do homebirths as well, but only if you're a good candidate, and only if you actually want to!
• Midwives will call in an OB consult if something abnormal comes up during your pregnancy/birth. Often this is just a quick face-to-face with an OB, whereby they give some advice and then you are back in the care of your midwife. Sometimes, transfers of care happen, but most midwives will stay with you and support you throughout.
• Midwives are trained to view birth as normal, until proven otherwise (OBs are trained to view birth as abnormal, until proven otherwise)
• Midwives discharge you from hospital earlier - which means less time stuck in semi-private rooms with other crying babies (and maybe even crying mommies).
• Midwives visit you at home in the postpartum period. AT HOME....like, on your couch!! I can't stress enough how amazing this is.
• A midwifery appt is usually 30min long, and allows for lots of discussion time. It's casual, and you get to meet with both your primary midwife (many times) and your secondary midwife (several times). An OB appt is 15min long, and if you go to the Ottawa Hospital, you will most likely never see your OB. You'll see a different resident each time.
• A midwife catches your baby. An OB "delivers" your baby (like a pizza), and they will arrive in the room when the head is crowning.
• Midwives have signicantly better outcomes than OBs - lower rates of intervention (e.g. episiotomy) and lower c-section rates
• Midwives practice informed decision making and informed consent. That means, every single little thing that happens during your pregnancy/birth is discussed beforehand, and you always have the right to refuse. Hospitals claim they practice these things too, but it's variable.

There are probably many more points I could add, but I hope this dispels some of the myths you have been hearing about midwives here in Ontario. As you may have read from my last post, there is a big push for more midwifery care here in Ontario. A birth attended by a midwife costs less than one attended by a family doctor, and significantly less than one attended by an OB.

We are now headed in a direction where soon, most low-risk pregnancies will be followed by midwives. It may not happen next year, but certainly in the next ten years. It just makes sense.

If you've had the care of a midwife, please share your story below! What was your experience like?