Tag Archive | birth preparation

Tuesday Tidbits: Cesarean Awareness Month Round-Up

motherbaby

April is Cesarean Awareness Month and a lot of great resources have been catching my eye! First, there is a free webinar about the “Natural Cesarean” coming up on April 11th.

If you’re a first-time parent, make sure to check out 10 Tips for Avoiding a First-Time Cesarean from Giving Birth with Confidence. This blog also has a response to the question of Are “Big Babies” Cause for Cesarean? 

And, of course, also check out ICAN’s blog for an ongoing collection of Cesarean Awareness Month related posts as well as helpful cesarean awareness information on a year-round basis.

Science & Sensibility offers a great round-up of resources for clients and classes with regard to cesarean births, cesarean rates, and cesarean prevention: April is Cesarean Awareness Month! Resources for You and Your Classes

One a related note, Science and Sensibility also has a two-part series of posts analyzing the role of doulas in reducing cesareans for mothers using Medicaid:

Medicaid Coverage for Doula Care: Re-Examining the Arguments through a Reproductive Justice Lens, Part One

More fundamentally, however, we argue that doula benefits cannot be captured solely through an economic model.  Neither should doulas be promoted as a primary means to reduce cesarean rates.  Both strategies (economic benefits and cesarean reduction) for promoting doulas have significant barrier.

Medicaid Coverage for Doula Care: Re-Examining the Arguments through a Reproductive Justice Lens, Part Two

However, greater attention needs to be paid to issues of privilege and oppression within the doula community at large.  Advocates need to consider how the prioritization of the cesarean rate as a primary research or policy issue reflects a certain level of unexamined privilege. For those facing spotty access to health care, cultural and linguistic incompetence in care settings, the detrimental effects of the prison industrial complex and the child welfare system on families, and the effects of poverty, racism, and/or homophobia in general, there are other, perhaps equally pressing concerns surrounding childbirth than over-medicalization. Certainly, unnecessary cesareans and over-medicalization are detrimental to everyone, but we need to understand how the effects of these problems play out differently for differently situated people and not limit advocacy to these issues.

When I consider coercion into unneeded cesareans, I think of my own post addressing the flawed notion of Maternal-Fetal Conflict and from these earlier thoughts, I created the little graphic for Citizens for Midwifery seen above.

I think it is fitting to remember that mother and baby dyads are NOT independent of each other. With a mamatoto—or, motherbaby—mother and baby are a single psychobiological organism whose needs are in harmony (what’s good for one is good for the other).

As Willa concluded in her CfM News article, “…we must reject the language that portrays a mother as hostile to her baby, just because she disagrees with her doctor.”

via Maternal-Fetal Conflict? | Talk Birth.

I was honored recently to make a series of sculptures for mom recovering from a traumatic cesarean and hoping for a VBAC in the future. I hope to make a more detailed post in the future describing these figures and what they’re trying to communicate!

March 2013 070

I dug into the archives and found some older posts either about cesareans or relating to cesarean prevention:

Book Review: Understanding the Dangers of Cesarean Birth

Cesarean Awareness Month

Cesarean Trivia

Cesarean Birth in a Culture of Fear Handout

Guest Post: Abuse of pregnant women in the medical setting

Becoming an Informed Birth Consumer (updated edition)

The Illusion of Choice

ICAN Conference Thoughts

Helping a Woman Give Birth?

Distraction, Concentration, Surrender

In my childbirth classes when I cover “labor and birth 101,” I talk about the traditional stages of labor—early labor, active labor, transition, pushing, and third stage (placenta). I also talk about the “emotional signposts” of labor—excitement, seriousness, and self-doubt, as well as about the fear-tension-pain cycle and the excitement-power-progress cycle. Recently, I finished reading the book Painless Childbirth by Giuditta Tornetta and she elegantly described the three phases of first-stage labor in a three-word format that I found extremely accurate and helpful, as well as fresh and interesting. The first phase is distraction—during early labor, it is most helpful to continue to go about your normal life as if nothing is happening. Do not give your contractions any attention until they strongly request your attention! I tell my clients to just do what they would normally be doing—-if they would be sleeping, sleep. If they would be walking the dog, walk the dog. Watering the plants, eating dinner, etc., etc. Just keep up the normal routine until you need to give the birthing energy more attention. Without distraction as a tool, labor can become very long and exhausting—if you think of yourself as in labor from the second you feel anything, you are much more likely to experience a 24 hour labor than if you do not think of yourself as in labor until you are completely absorbed by its sensations.

The second phase is concentration—contactions have now become what Ina May Gaskin would term “an interesting sensation requiring my complete attention.” This phase corresponds to the Bradley Method’s emotional signpost of “seriousness.” I tell my clients that this is when she stops laughing at your jokes and stops even seeming aware that you’re talking. (She IS still aware however, and we will address this in a later post about undisturbed birth, prompted by another new book I am reading called Optimal Birth.)

The third phase is surrender and this corresponds with the transition portion of active labor and the “self-doubt” signpost. I think the concept of surrender during labor is one of the most profound and transformative elements of giving birth. If you can embrace the notion of “surrendering” to birth rather than staying in “control” of it, I think this can revolutionize your perception of what is happening in your body and your life. While hard to express in words, the experience of surrendering to my own body’s power was a transformative experience in my life (particularly since I am a “controlling” sort of person in “real life”—maybe this is why this term and experience holds such meaning to me). With surrender comes “flow”—there is such value and beauty and strength to be found in letting go and just letting it happen; letting “the might of creation come through you.” This was the most profound truth I discovered in each of my birth experiences.

Birth & Culture & Pregnant Feelings

“Giving birth is not an isolated event in a person’s life. A woman births with both her mind and her body and participates in the attitudes toward childbearing of her culture and her family.”

This quote from the book Pregnant Feelings by Rahima Baldwin reminds me of two other relevant quotes about culture, birth, and women’s choices:

“Although pregnancy and birth is a richly intuitive and instinctive process, a woman will prepare her ‘nest’ and birth according to the style of her culture, in the same way that a particular species of bird will build its nest with whatever is available.” –Pam England

“One does not give birth in a void, but rather in a cultural and political context. Laws, professional codes, religious sanctions, and ethnic traditions all affect women’s choices concerning childbirth.” –Adrienne Rich

I think we get onto slippery ground when we start talking about how women just need to “educate themselves” and then they will make different (i.e. “enlightened like ours”) choices. If education was all that was needed, we would see much different things in our present birth culture (more on this later!). As Pam England would also say (paraphrased), thousands of factors seen and unseen go into the resulting birth experience, it is hard to point to one, two, or three factors and say “that was it! I have it all figured out.” (Reminds me of another quote that women birth as they live.) With regard to the second quote, I have to ask myself whether couples truly have a free choice of where to give birth? Ultimately speaking, yes they do, but according to my clients’ perspectives insurance companies and the political climate surrounding midwifery in our state dictate their birth location, as well as opinions of family, friends, books, and so forth. I do a “pain pie” exercise during my classes and after I do it, I always talk about how sometimes choices are actively stripped away from women and we need to keep that in mind when we hear “bad” birth stories—not, “she ‘failed’ or made the ‘wrong’ choices” but that her pieces of the pie were taken away from her (sometimes forcibly!).

The reason I initially marked Rahima Baldwin’s quote is because I am fascinated by how my birth experiences continue to inform the rest of my life–while not the defining moment of motherhood for me, I continue to draw upon the lessons of birth throughout the rest of  my life, as well as retaining a total fascination with the subject. I wonder why I’m so “stuck” on birth? Why fixate on this one element of a lifespan? Does it mean I’m not “moving on” somehow—like a high school football player still reliving the glory of that touchdown from 10 years ago? I think it is because birth touches something else. Something deep and raw and true and we glimpse something that we rarely glimpse in everyday life. A touch of the sacred perhaps. Magic. Mystery. Or is it a sense of personal power and satisfaction in being a woman? I know that the “birth power” experience is a rare one for me—I have never felt so powerful and capable and amazing as I did giving birth. I like to think about how this “birth power” sense could be drawn into the rest of my life—how can I live a powerful and affirming and amazing life, not just as a birth giver, but as a woman? Lately, I am finding some answers in feminine spirituality, but it is a question I love to consider and hope to write more about in the future.

Okay, moving back to Rahima and the quotes from Pregnant Feelings:

Anthropologists’ reports of women working the fields, going to a sheltered spot to drop their babies without any ‘preparation’ and then returning to work describe a kind of mythical natural childbirth that is nearly impossible for Western women. We are far too cerebral, and our twentieth-century consciousness intrudes between us and our instinctual selves. The fact that we question both how to birth and how to parent shows how awake our consciousness is. We must of necessity involve our minds in understanding what we do and create, for it is impossible to turn them off. Nor can we simply erase, or afford to ignore, our culture’s view that giving birth is a dangerous and painful event requiring intervention and technology. Rather, we must consciously replace that view with new knowledge and new images if we are going to be able to reclaim our ability to birth with harmony of mind and body.

Loved this. The mythical woman giving birth by the side of the road and popping back into the field to work is strongly ingrained amongst “natural birth” advocates. Some women draw strength from the image—“if she could just squat in the field, so can I!” Others make a joke of it—“are you one of those nuts who encourages women to just squat in the field?!” And others are doubtful that it has any basis in reality. I also suspect that if said women did ever exist they did not return quickly to the fields because they wanted to do so, but because of the framework of their culture and those seen and unseen factors that shape our lives—perhaps their other children would starve if they didn’t run back to the field, perhaps the overseer would beat them, etc., etc. It doesn’t mean those women were stronger or more capable, but perhaps less valued and less cared for than they should have been.

Okay, back to Rahima again:

Our task is to integrate our minds and bodies, so we can give birth in a way that feels whole and nurturing—to ourselves as parents and to our babies…We cannot go back to ‘natural childbirth’ in which we just let it happen. There must be knowledge of birth and an assumption of responsibility for our own health care and for decisions affecting ourselves and our children. There exists for us the exciting possibility of giving birth with full awareness, participating in the joy and exhilaration of working in harmony with the tremendous energy of creation. But it does not occur automatically or unconsciously…

The potential for conscious birthing can exist independently of the place of birth, although some places require more watchfulness than others….Let us just say that it is actively giving birth in an environment which is woman-centered and child-centered, in which the cues are taken from the birthing woman while she experiences fully the sensations and emotions of new life coming into the world through her. She is not medically managed or manipulated, but is supported with the knowledge, love and experience of her attendants (doctors, midwives, husband, other support people) to birth in a way which is safe, yet does not deny the intense physical, emotional, and spiritual aspects of giving birth.

Birthing in this way is rare in today’s culture…less than 5 percent of women in this country today experience ‘purebirth’ [positive birthing/conscious birthing]…

Given the wealth of images of birth that surround us, our task is to recognize that none of them adequately denies or exhausts the potential of birth. Perhaps their infinite variety can help to free us from any one fixed idea of giving birth and help us to realize our freedom to birth in the way that is right for us. We cannot control the energy of birth, but we can control our response to it by deciding to be open, relaxed positive, noisy, grouchy, whatever. We don’t need to behave in a certain way and we can accept ourselves and our births without self-judgment.

What caught me about this section was the mention of not being able to go back to a time when we could just “let it happen.” Though I feel like getting out of my own way and “letting it happen,” was a personal key to my own births—that the surrender is what gets the job done—I agree with her point that there is no letting it happen in today’s culture. A long time ago someone mentioned in an online forum that they were not planning to take birth classes or read any birth books because they felt like they should just let it happen and not have any preconceived notions; that cluttering up their heads with this other information would cloud their ability to do so. While I hear the motive and feeling behind this sentiment and believe there is some (perhaps idealized) truth to it, I simultaneously feel like it is impossible to do this, because women do not give birth in a void or outside of their culture. Women give birth in a context, usually involving other people (even with unassisted births, there is usually someone else there). If you enter the birth room (the aforementioned woman was planning to give birth in a hospital, not unassisted) without any ideas or pre-knowledge about what to expect or what you want, the stories and dramas and ideas and myths and preconceived notions and reading and media-exposure of all the other people present DO enter the room and impact your birth. You cannot just “let it happen,” because they will not just let it happen. Right or wrong, this is the environment in which many of us our building our birth nests.

I’d like to close my thoughts with another quote. This one is from one of my favorite birth books, Transformation Through Birth by Claudia Panuthos. In giving birth, regardless of our nest and our choices and all the seen and unseen elements shaping our lives, perhaps we can simply, “…celebrate ourselves for our courage to birth. The real question becomes not, ‘Have you done your breathing exercises?’ but rather, ‘Can you love yourself no matter how your birth, where you birth, or what the outcome?'”

Tips for Emotional Well-Being During Pregnancy

I got a lot of wonderful responses to my question about emotional well-being during pregnancy (associated with my giveaway of the book Birth Space, Safe Place). So, courtesy of a lot of wise women, here are some top tips for supporting your emotional well-being during pregnancy and birth:

  • Peaceful Beginnings doula services shared “I think my best tip for emotional well-being during pregnancy (and life in general) is to let go of guilt. We can only do the best we can with the information we have at the time, no more, no less.”
  • Yasmel shared that her most helpful tip, “would be to find whatever gives you positive thoughts and use it, a lot. I loved the book Ina May’s Guide to Childbirth and whenever I started second guessing my homebirth decision, I would open it up and just read the birth stories in it.”
  • Heather appreciated a helpful tip from her sister: “I was having alot of people question my birthing choices and telling me that my baby and I were going to die. None of which happened. She told me that ‘you can’t expect people to agree with your choices or behave respectfully about them. All you can do is know that you are doing what’s right for you and your child and that is all the matters. Don’t let them change your mind with fear. It has no place in childbirth.’”
  • And I especially enjoyed Ahmie’s advice: “remember that cats purr while giving birth. Figure out what makes you ‘purr’ while you’re pregnant and find ways to do more of that as well as to bring those tools to the birth-space with you.”
  • One of the most simple and yet important tips was shared by bubbledumpster, “Trust yourself,” and echoed in several other comments, such as earthmothergypsy who said, “I think one of the best helps emotionally is to encourage mamas to trust in themselves, their bodies and their babies. By giving them support in a way that they don’t feel undermined they can build the above trust in themselves.” And inoakpark who said, ” learning to trust your body (and trusting the people who will be with you at your birth to hold that space), is vital for an emotionally secure pregnancy and birth.”
  • bee in the balm offered another elegantly simple tip “to breathe, just take the time to come back to center and be and breathe.”
  • Nicole d shared that her best tip is “meditation on good/safe birth… the normalcy and miraculous nature of it. So much of pregnancy stress is uncertainty and fear of the birth process. The more you can trust in the process of pregnancy and birth, the more joyful and peaceful pregnancy can be.”
  • For Lee-Ann, “emotional wellbeing came with knowledge, the more I read and the more I normalized the birth process in my mind, the more research I did, the more confident and at peace I became.”
  • Rebekah made an excellent point about honest during pregnancy: “I think being open and honest with yourself and talking to your baby openly helps. It benefits no one to ‘pretend’ like everything is perfect and is okay to have trials, doubts, and fears.”
  • Jessica benefited from midwifery care: “One of the things that helped me a lot was having a midwife that I knew and trusted implicitly. I knew that my body and my baby would know what to do, and that I had a wonderful woman who would let it all unfold!”
  • And whoz_your_doula pointed out the benefit of taking time for yourself: “For me that took the form of meditation and prayer. The early morning is my time for deep reflection before the house begins to stir.”
  • A similar tip was shared by Gentle Beginnings: “I feel it is very important for a woman’s emotional well being to take a few minutes each day to spend time alone. To sit quietly and think about the precious child growing inside them, to disconnect from the world, to envision how peaceful they want their birth to be, to take a stroll in nature and to connect with their inner self. I think we can all benefit from these simple suggestions, but feel it is especially important during pregnancy and childbirth.”
  • Helpful for birth educators as well as couples, Janet shared that her favorite tip is “teaching the mom and her partner to work together towards open and honest communication before hand. I find a lot of the mothers I teach think, ‘Oh, well we talked about it once and I think we are on the same page,’ only to be completely blind-sided afterwards. Keeping these lines of communication open before, during and after pregnancy makes for a much better emotional state for all.”
  • Jamie moved us back to the trust theme: “Trust yourself. Trust that your body knows how to be pregnant and how to give birth. Be positive in the changes your body is going through and how you are being prepared for motherhood in all facets of your being. Know that you can do this—you are doing it!”
  • And another excellent and simple tip was shared by Heather Richins: “My tip is to make sure you stay well fed and hydrated. It is hard to feel good emotionally if you don’t feel good physically.”
  • Deborah had more than one to share: “1) Eat well: increase protein and raw fruits & veggies, and drink lots of water. Decrease refined foods, white flour products and sugars. 2) Exercise: walk, swim, yoga, etc. 3) Talk: find someone you trust and be honest about how you are feeling.”
  • And finally, Kathy offered a comprehensive collection of tips: “to be conscious of their needs each day. This includes physical,emotional, and spiritual. For the physical; Eat well. Whole foods, including whole grains, fruits, vegetables. Protein intakes needs to be adequate for a pregnant woman on a daily basis. Eating often to keep your blood sugars level is especially important for warding off mood swings. For the emotional; Trust yourself and others who care about you. Surround yourself with positive people who support you in what your doing. Communicate your needs and wants. Be willing to be honest and vulnerable. Pregnancy can often ‘stir the pot.’ Being willing to work out your feeling and talk to someone you trust and bring about personal growth and sometimes, bring about healing the past. For the spiritual; It is just as important for the spirit to be fed, as it for the body. Fellowshipping with others of the same faith is uplifting to the spirit. Take time for reflections and meditations each day. Keep a journal.”

I appreciated all the responses and think that emotional well-being is such an important subject. I feel like, especially with a first baby, it is an often overlooked element of birth preparation—a lot of time and energy is spent on the physical health of the pregnant woman, but the emotions are assumed to kind of take care of themselves, to perhaps be no one’s business, or to be dismissed summarily as “crazy pregnancy hormones” and “mood swings of pregnancy!”

Skipping Birth Class?

Yesterday, I watched a short clip on why people don’t take birth classes. The comment that I found most interesting from the expert interviewed was: “The instructors in a lot of these classes –are a little bit doctrinaire about their point of view. They made an issue out of saying  ‘You’re not a real woman if you need drugs. She should go through labor and childbirth on her own with help from your spouse with breathing techniques. They made it a kind of a contest. A lot of mothers today don’t want it — they want to go in and have their baby with a pain free a time as possible.” I find this perspective about “a contest” sad and disheartening and inaccurate. It is also slightly amusing–seriously, I know NO ONE who would say to someone else “you’re not a real woman if you need drugs” least of all a professional person teaching a birth class! I think this might be an example of what someone says being different than what someone else hears: i.e. the instructor says, “all medications have an impact on the baby. Additionally, many women find a very satisfying sense of personal mastery from giving birth without medication.” The person hears, “you’re not a real woman if you need drugs.”

This reminds me of an excellent section I’m re-reading in the book Mother’s Intention: How Belief Shapes Birth about judgment and bias. The author also address how the word “balanced” is misused in childbirth education–as in, “I’m taking a class at the hospital because it will be more balanced.” Balance means “to make two parts equal”–what if the two parts aren’t equal though? What is the value of information that appears balanced, but is not factually accurate? Pointing out inequalities and giving evidence-based information does not make an educator “biased” or judgmental–it makes her honest! (though honesty can be “heard” as judgment when it does not reflect one’s own opinions or experiences). She says, “Every person has a lens. Every opinion is biased, including the ones you hold. The question is, what created the perception leading to a particular bias?…When it comes to childbirth and parenting, when someone dismissed information as ‘biased,’ what it actually means is the information does not fit their already held biases. It is our insecurities that bring up defensiveness in the face of judgment, or perceived judgment, as the case may be…You may never even have a thought in your head that the other person could have or should have done anything differently, but they are seeing your actions through their own lens and making assumptions.” (i.e. if a mother had a homebirth it may be assumed she hates doctors and hospitals). I think this is exactly what was happening in the video clip–because a birth educator shares the benefits of natural birth, the assumption is that she “hates epidurals” and thinks you’re “not a real woman” if you have one!

As far as the “contest” idea goes, I’ve mentioned this before–just because someone runs a marathon, for example, doesn’t make the person who opted out of the marathon bad or “less than” 🙂

The expert in the video clip referenced above also emphasized several times that the time investment in classes is just too much and parents just “don’t want to invest.” So, now perhaps this IS “doctrinaire” or unpleasant of me, but I also find it a little frustrating that people are apparently unwilling to invest the time in preparing for their children’s births–most people watch more than 8 hours of TV a WEEK, but 8 or 10 hours of birth classes total is too much to invest? I hope my classes are exciting and informative and useful to the parents that come to them. I also realize that week after week CAN feel like a lot, which is why I designed my single session classes. I get a lot of interest in the single session classes and I’m glad I came up with them, because I think it allows me to better meet more people’s unique needs! In fact, so far this year, I’ve done only mix-and-match classes (from 1-4 weeks), no full six-week-series’ (perhaps they are a thing of the past?). I find I get clients who are very well-informed and interested and that these classes “hightlight” the things they are most interested in learning about, though they often tell me at the end that they wish they had signed up for more classes!

Birth as a Rite of Passage

Part of my philosophy of birth is that it is a significant rite of passage for women, men, and families, not a medical event, emergency, or health crisis. I recently finished working through The Pink Kit and the little book that came with it had some thoughts to share on this subject in the “final word” segment of the book:

We would like to warn you against expecting a ‘perfect birth,’ or for that matter anything in particular, except that you will get through it, with your baby–just about everyone does, no matter what they know and do!

The fact is, there is no such a thing as a ‘perfect life.’ Think about what life passages you may have undergone so far–cutting teeth, starting school, menstruation, the first sexual experience, loved ones dying.

Birthing is also a rite of passage–into parenthood–and like any other passage, it comes upon us and we just have to deal with it. It’s an awe-inspiring experience, and it would be perfectly natural to want to prepare in some way. And you can do that. But to some extent the experience is still out of your control.

Giving birth is definitely the most significant and impactful rite of passage of my life–it is the the gateway to motherhood, which has been the single most life-changing role I’ve had. I believe that this significant, transitional, rite of passage is worthy of appropriate level of awe, respect, and preparation. It is a sacred passage. Accordingly, I also believe the birthing woman should be treated with reverence and respect.

Fears About Birth and Losing Control

A topic that frequently arises in birth classes is about the fear of  “losing control” in labor. Losing control, “losing it,” or “freaking out” are concerns expressed by women preparing to give birth. It is important to acknowledge that this is a common fear. I also like to ask parents to think about what “freaking out” or “losing it” would mean to them? I ask them to consider what benefits there may be to losing control. I also say, “What if you do freak out? Maybe, so what?! Maybe it is okay. Maybe it is good. Maybe it is helpful.” (This doesn’t come across in print quite the way it does in real life!) Surrendering to the flow and power of birthing can be of tremendous benefit. Losing it can mean letting go and letting the power BE. Letting the energy be. Letting birth carry you with it, instead of wrestling for control of it. (When discussing this topic, it is important to remain mindful that for mothers-to-be who are survivors of abuse, language about “surrender” and “letting go” can be very threatening and unhelpful.)

Thinking about “losing control” makes me think about the things that you can have over control of when it comes to your birth experience (I’ve also been reading The Big Book of Birth and it addresses this):

1. You can control who who choose as your doctor or midwife (and can choose to switch at any point in pregnancy if the match is not a good one).

2. You can control where you give birth.

3. You can control who you ask to attend your birth as support–your partner, your best friend, your mother, your sister, a doula. (Anyone who attends should be there for YOU, not because they want to “see a birth” or because you feel obligated to have them.)

4. You can control how you prepare yourself for birth and the education you seek to help you explore your options.

5. You can control the type of books you read and the information you seek about birth.

6. You can control how you care for yourself during pregnancy.

7. If you are having your baby in the hospital, you can control when you go to the hospital.

Hypnobabies rephrases the usual concept of “transition” in labor as “transformation.” This is the time in labor in which many women fear “losing control.” Women may also pass through another transformation point as they move from early labor into active labor–this is sort of a “moment of reckoning” in which it becomes clear that it is really time to DO this! Erica Lyon, who wrote The Big Book of Birth referenced above, addressed this subject really well:

“…as a mother shifts from early labor to active labor, she begins to have an awareness that the labor is getting bigger, strong, more powerful. This often translates into a feeling or idea that you are going to ‘lose it’ or ‘lose control.’ This is a temporary, transient feeling that tells you labor is progressing. It does not mean you will go running naked and screaming down the hallway of your birth facility. What is really happening is a momentary emotional state that reflects your ‘social self’ beginning to fold inward. Labor is not a rational process, it is a body function that is experienced as a gradually intensifying event. You do not think your way through it. You do it. “

Essentially, this is a point in labor when you stop fighting with the “birth power” and begin to BE it. The process of birthing becomes your entire focus. I remind and encourage people to welcome the increasing intensity of labor–and suggest taking a “make it bigger!” approach to greeting and welcoming contractions, rather than trying to avoid or minimize them.

Pam England from Birthing From Within also has a great article  about “Losing It” in labor.

Other posts about fear and birth:

Birth Fear
Fear & Birth
Fathers, Fear, and Birth
Fear-Tension-Pain or Excitement-Power-Progress?
Cesarean Birth in a Culture of Fear Handout
Worry is the Work of Pregnancy
Fear Release for Birth
What If…She’s Stronger than She Knows…