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The Impact of Fear on Birth

Dear Jackie while this article is not specifically about VBAC the ideas discussed may help prevent unecessary C's from having to be undergone. Best wishes, Rayner and Sachi Garner

When we conceived a daughter in 1980 we both wanted to have as natural birth as possible. We had read Childbirth Without Fear by Dr. Grantly Dick-Read and much of what he wrote seemed very sound to us. So we prepared as thoroughly as we could.

Sachi's grandmother had delivered two children by herself while working on a sugar plantation in Hawaii, so we had a precedent, and we read whatever we could find, particularly on other cultures practices and attitudes to birth. So we felt confident that we would be unlikely to need specialised intervention and care. We also spent a great deal of time throughout the pregnancy, ventilating our concerns and anxieties about birth and our relationship.

As this was Sachi's first birth we decided to have a midwife although we were tempted to go it alone. We found a very competent, kind and attentive midwife and we were set. When Sachis's waters broke her contractions came in very strong and powerful and we both felt that it was only a short time before she would give birth. To our surprise as soon as the midwife and two friends who were going to give support arrived, everything stopped! Sachi's contractions ceased, and she had lost her serene look and had become agitated and restless. When I looked at her closely I could see that she was breathing rapidly, had dilated pupils, and was starting to shiver. (Some of the classic symptoms of the flight or fight syndrome).

So I sent our friends and the midwife out of the room to make tea, and told them some issues had come up which we needed to deal with. Not to worry about any noise that may be made. Then I encouraged Sachi to get angry and she began to beat on pillows, kicked out with her legs and screamed with rage. As soon as she stopped, as if on cue her contractions restarted, and we called the midwife and friends back in.

(As flight is not an option, the mother will need to discharge the Adrenaline with physical exertion. One of the best ways to trigger rage is to get the birthing mother to crouch on the bed or floor on her hands and knees, and start to roar like a lion from a deep a place in her belly as she can. For some reason this seems to release hidden rage. Then if she is encouraged to beat on pillows or a mattress this will discharge the adrenaline, and contractions will then resume without extreme pain.)

It was the most amazing, and moving experience of my life to be there, kneeling on the bed with cupped hands ready to receive Fonda. Sachi was squatting with our friends behind her partly supporting her, relaxed and in control, when Fonda's head emerged. Fonda opened her eyes, (our only light source were candles,) and I became totally lost in those deep brown eyes that seemed to be so full of old wisdom and love. Then with a slight wiggle the rest of her emerged and I placed her lovingly on Sachi's breast.

After the birth was over we got to thinking, why was the flight or fight reaction stimulated? Then we realised that although the midwife was very warm and loving we didn't really know her. Unconsciously Sachi may have felt a threat to her survival and reacted accordingly. That in spite of her preparations, classes in prenatal yoga, relaxation classes and her conscious knowledge of how kind and loving her midwife was, her primitive self had automatically reacted and closed down.

All species are equipped with this flight or fight mechanism in order to get away or fight off any predator that interrupts, or invades the birthing environment. We obviously posses this same primitive response judging by the number of births which I have attended where this same phenomenon occurred, the reports that I have read, or heard about since our birth; of failure to progress, or a birthing mother arriving at a hospital only to find her contractions stopped and her cervix ceasing to dilate. On being sent home, contractions will often restart and sometimes birth will take place in the car or ambulance on the way back to the hospital.

I think that the power of this unconscious mechanism has been underestimated. Many parents that I have talked to have been disappointed and sometimes felt wanting, that in spite of all their preparations, Bradley and Lamaze classes, etc., their birth was very painful and distressing. That in many cases medical intervention became necessary because of the threat of foetal distress.

There are cultures that only employ midwives who have been lived in close proximity with the birthing mother all her life or close relatives who will not arouse that unconscious reaction. In such cultures labour often takes minutes once the water bag has broken, and discomfort is minimal. (I suspect that if there are unexpressed antagonisms, and hostilities present between caregiver and birthing mother this may still create tension, and delay birth no matter how accustomed to each other they may be.)

Dr. Grantly Dick-Read writes: Fear is the natural protective emotion without which few of us would remain alive for many days. Its intensity varies from precaution and doubt to uncontrollable terror. Even mild anxiety can make a woman tense, thus causing the circular muscles to resist the expulsive muscles of the uterus. A tense woman has a tense outlet to the uterus, giving rise to the saying "Tense woman - tense cervix." A tense cervix means a long and painful labour in the majority of cases, for the mother is closing the door against the progress of her baby from the uterus.

For some time now I have been suggesting to physicians, midwives, and doulas, that greater awareness is directed at diagnosing the arousal syndrome and taking steps to help the birthing mother to discharge the adrenaline which is in her bloodstream, before using pharmaceuticals to mask the pain.

An alternative would be for private birthing rooms to be equipped with a video camera, and a two way wireless, and the birth monitored by health professionals in an adjoining room or central viewing station. Part of the prenatal caring would be to instruct the mother to be and her companion in the simple practice of an uncomplicated birth. Without comparative strangers present the flight or fight reaction may not be stimulated. If complications arise, qualified help is immediately on hand, and the safety and comfort of the two most important people, the mother and child, would be assured. Rayner Garner

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