Matrona Monday: The Plague of Fear

Welcome to Matrona Mondays! In Roman times, Matronas were those women who were known as the “Mothers of their Family,” or strong, respectable women in the community. "Matrona" is also the name for female Roman deities known as the Protectresses of a tribe or community. Each Monday, we will feature a voice of one the Matrona's in our community. These women, though different in history and practice, are united by the passion to support and empower pregnant and birthing families around the globe. 

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Our society is undoubtedly plagued by fear. We try to ignore it, pretend it’s not there, but it often haunts us day and night. In some ways, fear can be healthy. It tells us when something is wrong or that something can cause us harm and to avoid that. However, when does fear become something that hinders our everyday lives or prevents us from being happy or pursuing happiness? 

I had a client tell me a story about how she had mentioned to a co-worker she was having a home birth and her friend told her a barrage of home birth horror stories about babies or moms dying or there being really bad outcomes. “How could you ever do something like that to your baby?,” as if she had just told her she was delivering her baby into a vat of acid or razors. Society has somehow been tricked to believe that the only safe place to deliver is in the hospital setting. In reality, the hospital has only been a trend for the last 100 years and yet, society is thousands, possibly millions, of years old. How did we survive all those years of birthing without the hospital or the OBGYN?? You guessed it, midwives!! Birth was not feared in our early civilization but celebrated. The ancient sculptures the Aztecs made of women birthing their own children or of paintings of midwives holding and supporting women as they birth support this fact even more. There was no fear and if there was, there was someone there to encourage the mother and bring her safely through her birth, the midwife. 

When someone is afraid or fearful, we're told their body goes into fight or flight mode. However, scientists are beginning to realize that there is another mode: freeze.

Fear can literally cripple someone and prevent them from being able to function, including birthing their own baby!

These fears can be having a c-section, tearing, pooping herself, not being a good mother, not being able to handle the “pain,” being told she isn’t good enough, baby not breathing right away...the list goes on and on. Below are some things I have noticed in my own practice, but have also seen it repeated and confirmed by research. It’s time we put an end to birth fear and return to our roots of celebrating birth!

Fear Hinders Labor

Fear makes the female body literally “close up.” Because the body is meant to relax during birth, if there is fear present, a woman’s body slows or stops labor until mother can get to a “safe” place to have her baby. This is a mechanism that has developed from women birthing in the wild (all mammals have this instinct) as the body knows when it is safe to deliver baby and when it is not. History shows countless stories of women in full labor whose bodies stopped labor when a dangerous situation presented itself. For some women, a woman's body can interpret this “dangerous” situation when she arrives at a hospital. The bright lights, loud alarms and an unfamiliar environment can all decrease a woman’s natural oxytocin levels and hinder the body’s ability to get comfortable and feel “safe.”  It’s no wonder Pitocin augmentation and induction rates are so astronomically high! These women report having intense labor and knowing they needed to get to the hospital, and as soon as they hit the unit’s triage desk with bright lights and unfamiliar sights, sounds and smells, their contractions all but disappear, even if they are at an advanced dilation. This “closing up” is also discussed in Ina May’s book, Guide to Childbirth when she mentions the Sphincter Law. When a woman must transfer from out of hospital birth, she will be more dilated at home and upon a check at the hospital, is significantly less dilated than she was before. Sphincter law is directly related to fear.

Others’ Fear Hinders Labor

So many women are all for home birth, but their partner or family members are not onboard. Or the partner/family member says they’re on board, but underneath there is a brewing pot of fear just waiting to boil over! I have seen so many cases of mom’s labor stalling because she can sense the fear of her partner or family member, which inevitably increases her fear. We can sense when someone else is afraid. It’s an instinct that tells us we should be afraid as well. Just as our own fear can slow labor down, the fear of someone else can make just as strong an impact. I have often had to talk to clients interviewing for a home birth about the importance of both partners being on board with out of hospital birth because the husband’s lack of support will come out in her labor pattern. I have even seen moms kick family members out of the labor room because their fear and anxiety was palpable and causing significant delays and difficulties in the labor. Often the removal of these individuals results in the immediate progression of labor for mom. 

Negative Thoughts Increase Fear (and Pain)

Fear is not only a feeling but often expresses itself in thoughts. When someone says something negative to another, that thought bounces around in our head and cripples us with paralyzing fear, causing everything to freeze! Think about it: someone tells you “you can’t do _______ (fill in the blank), or “you’re not good enough for ________.” If you don’t have excellent coping mechanisms, the skill of positive self-talk, and facts to get you through these statements, eventually all you will be able to hear is that one person’s voice bringing you down and playing even more into your fears. Some women don’t even know these thoughts are present until they are in labor and then suddenly a flood of emotions, thoughts, and feelings comes rushing in at our most vulnerable point in life and if not addressed appropriately, dashes us on the rocks of fear. When a women is preoccupied with negative thoughts, she cannot focus on her baby, the contractions or how to keep her pain under control. The most fearful women I have encountered in my career were the ones who reported the most pain and feeling the most out of control. When you let someone else’s thoughts fill your mind, you are no longer in control; they are. 

So what are some ways to reduce fear in our lives? It surrounds us every day so it is important to have excellent coping mechanisms available to battle fear at the root!

Strategic Tips to Significantly Reduce Fear

1. Get the Facts

This is so important! When someone tells you something that increases your fear, make sure they’re right! Or even better, go find quality research that supports the truth and remind yourself of those facts when someone wants to rain on your parade. There are many quality research articles which support that out of hospital birth is safe for healthy, low risk women. Some even go so far as to point out that out of hospital birth is safer than hospital birth for healthy, low risk women. [Citations for a few of these articles are at the end of this post.] Now realize that no matter how many articles you throw at someone, you may not be able to change their mind. That’s fine. I’ve decided not to be in the business of changing a stubborn person’s mind and it has relieved me of some significant stress; you should try it too! ;) 

2. Positive Self-Talk

I get a lot of rolling eyes when I talk to my clients about this one, but I have seen it work miracles!! Positive self-talk literally puts fear right in its place - out of your mind. How can you be fearful when you are reminding yourself that you are courageous, you are strong, you are beautiful, you were made to do this, you are capable…on and on! You can’t. The next time you hear someone’s nasty comments or words flitting in the back of your mind, turn it right back out the door with a statement exactly opposite of it. I know you will see a world of difference!

3. Meditation

Now, this looks different for each person but I think it goes right along with the positive self-talk. Meditation can be yoga, praying, reading the Bible, quiet time, or anything that removes you briefly from all the negativity and fear the world has to offer. Basically, you are filling your mind with positive thoughts while relaxing your body and relieving it from all the stress fear causes. I actually read a statement recently that said that one day of worry (a subcategory of fear) is equivalent to working a 40 hour work week. Can you say holy cow?! What damage fear does to our bodies and our babies! Research has shown that increased cortisol levels associated with excessive stress and fear can cause significant problems for your baby and even affect them as adults. Now don’t go getting fearful about having too much fear - that’s not the point! We need to rest and fill our body with positivity. So take some time to medicate on those positive thoughts, shutting the world out, even if it’s for just 10 minutes.

4. Take Responsibility   

The only person who can make you fearful is you. The top three suggestions lead to this one major point and that is that you must take responsibility for your actions or reactions. If you choose to have an out of hospital birth, you must take responsibility for any and all outcomes. If you have a hospital birth, you must take responsibility for any and all outcomes. You are in control of the place you birth (as so far as your medical condition will allow, of course). No one else can tell you what to do or how to do it (and they shouldn’t).  Now this does not mean bad outcomes caused by others. This means that you must be ok that an operating room is right around the corner in the hospital, that the epidural rate is 95%, the cesarean birth rate is more than 30%, and you will likely be tied to the bed on continuous monitoring for majority of your labor (at many, but not all hospitals, of course). This also means you must be ok that an operating room is more than 5 minutes away at your home or a freestanding birth center, that we don’t have many medical interventions (continuous fetal monitoring, forceps, or vacuum), and that you cannot get pain medication. There are risks and benefits to both and the decision on where you birth must be yours. Take responsibility to end unhealthy fear now. There are things to be afraid of but when you have hired a highly competent team to care for you, your birth is not one of them!

And if all else fails and someone is still trying to ruin your birth with their ugly stories, tell them to stop. Boundaries are healthy and in a society where boundaries are often overstepped without regard, it’s time we start becoming healthy again and telling people no. That, of course, is another blog for another day! 

Citations

Cheyney, M., Bovbjerg, M., Everson, C., Gordon, W., Hannibal, D., & Vedam, S. (2014). Outcomes of care for 16,924 planned home births in the United States: The Midwives Alliance of North America statistics -project, 2004-2009. Journal of Midwifery & Women’s Health, 59(1), 17-27

Nutter, E., Meyer, S., Shaw-Battista, J., & Marowitz, A. (2014). Waterbirth: An integrative analysis of peer-reviewed literature. Journal of Midwifery & Women’s Health, 59(3), 286-319.

Tiffany Jorgenson is a Certified Nurse-Midwife (CNM) who has been serving the Front Range as a registered nurse and midwife for the last six years. In March of 2015, Tiffany opened a home birth practice (Mountain Miracles Midwifery, Inc.) to serve those families who desired a home birth and wanted insurance to cover their care under a CNM. Tiffany has been honored to serve these families and hopes to change the way out of hospital birth is viewed in the US and help women empower themselves to be leaders in the pregnancy, birth and postpartum care they desire! 

Tiffany has been married since July of 2010 and she and her husband are Colorado natives and proud to call it home! Tiffany graduated with her Bachelor’s in Science Nursing from UCCS and obtained her Master’s in Science Nursing from Frontier Nursing University. Her experience ranges from low risk out of hospital birth all the way through high risk in hospital birth and everything in between; though she only manages low risk clients at this time. In her free time, Tiffany enjoys LONG road trips with her husband exploring the US, walking her puppy and being outdoors in beautiful Colorado.  

Tiffany Jorgenson, MSN, CNM
Mountain Miracles Midwifery, Inc.
www.mountainmiraclesmidwifery.com
https://www.facebook.com/mountainmiraclesmidwifery/ 

Jolene Hamann has been a Certified Nurse Midwife since 2007, and has had the pleasure of catching babies and caring for women in New York, Illinois, and now Colorado. She has four wonderful children with her photographer husband, Dave - Josh, Fox, Ryker, and Molly. Helping women on the sacred journey through pregnancy, birth, and life is her calling and her passion. Her hobbies include sleep, and maybe a little reading sometimes. You can reach her atcsobgyn.net or on facebook.