Dealing with worry and fear

[Momtotwo2004]

When I'm not pregnant, I'm sure I want a homebirth. I am a big advocate of natural birth and feel confident that it's safe, if not safer, at home than in the hospital. I always plan that my next baby will be at home.

Then...when I'm pregnant....I chicken out! Last time I ended up going with a midwife hospital birth and it was as perfect as it could be. I just got scared and the what if's got to me.

This time, I'm 16 weeks and still seeing the homebirth midwife. I don't feel comfortable going to the hospital for a variety of reasons (distance, child care, etc.) and homebirthing just makes more sense to me and I am more comfortable with it than I was ever before.

And yet I'm still plagued by those what if's. I'm about a 15-20 minutes drive to the closest hospital and I just can't help thinking that in an emergency, my choice to be at home could be what ends up harming my baby, if not worse. These thoughts *mostly* come in the middle of the night and in the day time I can sort of push them aside or rationalize them. I do have a good sized supportive homebirthing community of friends but still also have a few people (including my family) who just don't think it's safe and will make comments. And those comments start up my anxiety.

Does anyone else deal with some anxiety and worry about this choice? Is that normal? I keep wondering if it means it's not the right choice, as though I should feel completely confident and unconcerned. I also can't help but wonder sometimes if my worries are intuition that something might go wrong (I admittedly have anxiety on a regular basis, not related to pregnancy.)

[JamieCatheryn]

Worries are normal, they're the work of pregnancy, I read from someone once. You have so long to plan that there's time to process and plan and emotionally work out things. Rather than push them aside I try to answer my what-ifs. Sometimes the answers aren't pretty, other times they're reassuring, either way I have to accept them. There is always a chance of something going wrong anywhere and I have to accept it. But the chances are low of terrible things, and for most situations we could respond appropriately and make everything turn out ok. So, yeah, what if ___ went wrong? Well, we'd do ____. Labor itself for me can be the worst thing ever for a little while of it while it's most intense but it goes on and comes out wonderfully. I guess I have to trust that's how everything will be.

Midwives are trained to counsel you through some of this too, maybe you ought to discuss it with her?

[Lit Chick]

I am a worrier too. And when I had my HB, I was totally fine.
I had a lot of what-ifs at first too. What helped me get over them was a few things -

1. One of my very best friends had a homebirth, and she had the best birth experience of anyone I knew, even with a slight complication (she needed some massage and pitocin due to heavier than normal bleeding post partum). Maybe even because of that complication - her MW has been there, done that, and handled it without a fuss and everyone was fine. It's because of her that I started thinking about HB for me. When she first told me, I thought she was nuts, but when I got pregnant I knew it was the thing for me.

2. Reading a LOT. Ina May's Guide to Childbirth was the most helpful to me, I think.

3. Having a midwife that I adored. She and all her students are wonderful. I'm instantly at ease with them. By the end, they knew me as a person, not just a patient. I had no doubt they would take better care of me than any doctor. They also have all worked in developing countries and have seen and dealt with some scary things. So, I know I'm in good hands with people who have seen both normal and abnormal and know what to do.

4. I hate hospitals. Really really hate them. So, my fear of traditional docs and hosps was less than my fears of the "what ifs".

I also had people who initially were rather opposed to my HB - but I was armed with a lot of knowledge to toss back at them. And it also helped that my mother had 3 kids naturally, and one was unassisted in the hospital - she went so fast that my godmother caught my brother. She had a few what-if concerns, so she met my MW and asked her questions and was totally at ease.

If you are not comfortable, talk to your MW. If she does not make you feel better... well, go with your gut. Find a MW or a doctor that inspires confidence in you.

Have a happy birth, whatever you choose!

[SelenaJean]

Originally Posted by Momtotwo2004

Does anyone else deal with some anxiety and worry about this choice? Is that normal? I keep wondering if it means it's not the right choice, as though I should feel completely confident and unconcerned. I also can't help but wonder sometimes if my worries are intuition that something might go wrong (I admittedly have anxiety on a regular basis, not related to pregnancy.)

This is exactly how I've felt for most of my pregnancy. I thought maybe there was something wrong since I was not all completely confident like it seems other homebirthers are. Talking with my midwives about my feelings has been a huge help and they are so reassuring. It's completely normal to be nervous and they have even said they worry more about clients who are not at least a little nervous/worried etc. Are you able to call your MW just to chat when these feelings pop up? Ina May's guide to childbirth was also a big help to me too. I also refuse to discuss my birth plans with any nay sayers in my life.

[Momtotwo2004]

I have brought it up with my midwife and she said that she has noticed with her clients that alot of it tends to do with the momma's personality. She said some women just make a decision and stick to it and never look back. Others are like me, worriers who tend to over think too much (my description, not hers.)

I really appreciate hearing that I'm not the only one who feels some worry. Like Selena, I see so many woman who just seem so confident in their choice. I'm well educated on the topic and yet still seem to have these worries. I think I will keep bringing it up to my midwife. The most worrisome thing to me is the idea of a cord prolapse. It's so unexpected and so dangerous.

[BtotheG]

I knew before I was pregnant that I wanted a homebirth. In fact, I wanted a homebirth before I actually wanted kids at all (dh and I were planning to not have children, but I knew that if we ever did, they would be born at home. And lo and behold...). I was totally committed to my choice and knew there was no way I was having my baby in the hospital.

All that said, I *still* worried about the "what ifs." They kept me up at night sometimes. Like PPs said, I just ran through them in my mind, researched a lot, and talked to my midwife. I had a perfect, amazing homebirth in October, and I'm so glad I did.

Emergencies can happen, but like you said, they can happen anywhere, home or hospital. The thing I kept telling myself was that I was *less* likely to experience many of the complications in the first place because I was staying out of the hospital. I was also confident in my body, my midwife and my transfer plan.

Since you brought up cord prolapse...my friend had her baby last month. Her water broke at noon - and apparently it was A LOT of fluid. She was planning a hospital birth, but was going to do most of the laboring at home. By 8pm, she knew something was wrong, and headed into the hospital (even though she wasn't initially planning to go in for several more hours). Turns out she had a cord prolapse, and she had a c-section at 10PM. I bring this up because her story showed me that issues can happen wherever you are planning your birth, but also that mamas have amazing instincts. She knew something was wrong and got the help she needed. It was also up to ten hours between when the cord prolapsed and when she had her c-section - and both her and the baby are fine. Had she planned a homebirth, I imagine it would have unfolded in pretty much the exact same way.

[mion]

I also reached the point of the hospital fears outweighing home birth fears. My second child had "sticky" shoulders, which I attribute to violent, coached pushing. Once the hospital "midwife" started talking about what I could and couldn't do as far as positioning, getting in the tub, etc., I genuinely felt more comfortable at home (she said she would not "allow" me to push in any other position than on my back so that she could be in control).

Also, I love my hb mw and feel safe with her. I read lots of positive birth stories, am re-reading Ina May, of course, and am finally reading Grantly Dick-Read's Childbirth Without Fear. I just finished the chapter on the physiological implications of fear, and I wish I would have read this book a long time ago. It is fascinating and is a reminder that feeling safe, wherever you are, is of utmost importance.

[Catherine12]

Maybe it would help if you reviewed some of the research that's been done showing the safety of homebirth. The mainstream perception of homebirth is that it is riskier - the truth is it is not. Although for some very time-sensitive complications being in a hospital might be safer, there are also added risks to a hospital birth: the risk of picking up nastier germs, the higher risk of c-section (c-section carries double or triple the risk of maternal death).

Here is a good study you could look at: http://www.bmj.com/cgi/content/full/330/7505/1416?ehom_

The maternal and infant death rate is similar (and very low) for home and hospital settings. But the risk of interventions, such as c-section, are much, much higher in the hospital. So from that perspective, you are safer at home.

I had a hospital birth the first time because I wasn't confident enough. I had homebirths for my second and third dc. The homebirths were a lot less stressful, and less frightening. I had some anxieties before labor started (I am also an anxious person) but once labor was underway I wasn't scared at all.

If you are concerned about people criticizing your choice, you could consider not telling them until after the birth. Or if they already know, tell them you've made your decision, it's an informed choice, and you aren't willing to discuss it.

[Marilyn82]

I'd recommend reading "Journey into motherhood: inspirational stories of natural birth". It's all positive birth stories and many of them are homebirths. I'd also recommend spending some time meditating each day, just connecting with your body and your baby and visualizing your perfect homebirth. If those thoughts come up, just let them pass.

I deal with anxiety a lot too, and I am planning an HBAC right now. My worries are a little different (the what-ifs for me all involve needing another cesarean, which I am petrified of), but as an anxious-all-the-time anyway type of person, I sometimes have a hard time "turning off" those thoughts.

Spending time reading positive stories and meditating, seems to be helping

[jackiev0626]

Hi I know exactly how you feel. I am 100% positive I want a homebirth, but like you I had a lot of back and forth in my mind in the beginning. I just came to terms with the fact that emergencies can happen anywhere at anytime in any situation, but IMO going to the hospital increases these risks, and that's what I want to avoid. Then I would start breaking down each fear one by one and researching it and discussing it with my midwife.

Cord prolapse was one of my big worries as well, and the way my midwife explained it put my mind at ease. She said that cord prolapse is one of those true emergencies that could be catastrophic, but it could happen whether you are planning a home birth or hospital birth. She said you could have been seeing an OB through your whole pregnancy and planning on delivering at the hospital and go into labor at home and have a cord prolapse. You would rush to the hospital asap or call 911. Same goes for a homebirth. Planning a homebirth would not have caused a different outcome. That made a lot of sense to me.

I just realized it was useless to dwell on the negative which only stressed me out. Just think positive thoughts and like a PP said, trust your instincts! Listen to your heart, and eventually you'll just know what to do!

[Aka mommy]

Research and talking through the fears with the midwive's are what helped dh in this situation. He was more like what you're describing. He had nagging concerns and worries, where as I was very confident in my decision. What helped me was that I felt i made the best informed decision of all the options (having experienced a previous traumatic hospital birth) and that regardless of where I chose to birth my daughter, what was going to happen would happen. Meaning I could lose my child at a hospital, it isn't a safe haven which insures a live and healthy birth outcome. If i was meant to lose my child then I felt i had made the best decision to sleep with the aftermath.

[KBinSATX]

Originally Posted by JamieCatheryn

Rather than push them aside I try to answer my what-ifs.
...
Midwives are trained to counsel you through some of this too, maybe you ought to discuss it with her?

Same here. Those were the questions we asked before even hiring a midwife. Her answers to those questions is what made us choose her in the first place.
If you haven't already talked to her about this definitely ask her now!

[artemis33]

Originally Posted by Catherine12

If you are concerned about people criticizing your choice, you could consider not telling them until after the birth. Or if they already know, tell them you've made your decision, it's an informed choice, and you aren't willing to discuss it.

This.

But I understand completely - I have a lot more anxiety this time around. With DD1 I had planned a homebirth, but ended up transferring to the hospital after a very long labor (non emergency - just 'failure to progress') so some of my fears are centered around that. Also, we have moved and are quite a bit further from a hospital. AND I have another child to worry about!

I am anxious by nature as well and am just doing my best to work through all of these thoughts but keep myself as calm as possible.

to you!

[smidge10]

I am planning a homebirth with my first baby. Although I am a doula and midwifery student, I am still nervous. I am planning to practice as a homebirth midwife but this doesn't make the anxiety disappear. My plan of attack is continuing to talk to my midwife and family and to take a "Birthing from Within" childbirth ed class. I am hoping to become spiritually connected to my upcoming birth to balance what I know in terms of academics and science. It is helpful to know that others have doubts as well, because all of my midwifery classmates are so confident.

[averlee]

I think I was a lot more afraid of how a hospital birth might go than a homebirth. I was worried that people would do weird stuff to me & my baby. I was irrationally afraid that they would switcheroo my baby for some other lady's. I was terrified of the possibility of having a c-section (the rate is now 32% in the US). I was afraid they'd give me an episiotomy. I was afraid they would whisk my baby away, to another room or even just out of reach, while I was a crazy bleeding woman screaming "Give me my baby!" Of course I realize this is not the way most hospital births go...but I felt much safer at home.

[dannic]

I had never planned on having a hb, lol...just natural hospy births, but when my first pregnancy ended in miscarriage, I began researching and decided to us A FSBC. I birthed my first there, my second enroute to the same place. It wasn't until that happened and the subsequent transfer to the hospital that I began thinking about HB...by the time I was pregnant with our third, I was pretty sure that's what I wanted. Still, the entire pregnancy was a journey of faith, learning to face my fears, and embrace full responsibility for my health and that of my baby. It really is a leap from mainstream culture. There were times I had to go back and re-read things, pray, and meditate to overcome those fears. My mw was a huge part of that as well. Just talking it out with someone who understood was huge.
this time around, I still have occasional twinges, but I am much more confident in the birthing process. My main fears now hinge on my MW not making it, but we're resolving those as well. I think fear can be either an obstacle or learning process. I've learned to be alot more comfortable with working through my fears.

[etsdtm99]

for me, it is more about dealing with the responsibility than dealing with the fears.. i have fears either way, and i am way more afraid of what could happen with another hospital birth than i am of what could happen at home ... i am just worried that if something bad happened AT HOME it would be my fault, and everyone would blame me.. where if it happened at the hospital everyone else would assume everything was done, that could be done.. that bothers me. but, i am still planning a homebirth this time, and i am dealing with it.. with my last birth, i almost ended up with an emergency c-section because of complications from the epidural and i would ahve felt horrible.. i knew i was making a bad choice going to the hospital and being induced and getting the epidural and i did it anyway, afterall, no one would ever blame me - then i realized when things *almost* when horribly wrong, that i would blame myself because i knew better. i know that homebirth is safe and i believe that it is safer for me..

i could have written much of your post though, I am also 16 weeks and live 15 mins from the hospital . my midwife was able to really reassure me about complications and how she has dealt with several things that could have been emergencies and never got to that point because of the way she handled the situation..

[Nicole730]

I didn't read everyone's responses...so I'm not sure if this was mentioned.

I decided that whatever was going to happen was going to happen, whether I was at home or in the hospital. To be kind of morbid, I accepted that there was a chance myself or my baby could die, but I believed if it was going to happen, it was going to happen, my location wouldn't change that. I told myself these things early on in my pregnancy and by the time I neared my due date I had no fears at all. Once labor started I was just excited to see my baby, it never even occured to me something could go wrong.

[claddaghmom]

Originally Posted by Nicole730

I didn't read everyone's responses...so I'm not sure if this was mentioned.

I decided that whatever was going to happen was going to happen, whether I was at home or in the hospital. To be kind of morbid, I accepted that there was a chance myself or my baby could die, but I believed if it was going to happen, it was going to happen, my location wouldn't change that. I told myself these things early on in my pregnancy and by the time I neared my due date I had no fears at all. Once labor started I was just excited to see my baby, it never even occured to me something could go wrong.

Basically this.

In the earlier stages, I spent a lot of time working through the what ifs as I think it is wise to be prepared and to know some basic aspects about what you are doing. Sure, makes sense.

But towards the end you have to come to terms with the existential dichotomy of bringing life into this world...to die. And death comes for some of us sooner than others. As my mom told me, no matter how or when your child dies, even if you are in heaven looking down, you will blame yourself. It's a stage of grief.

So I felt it was just beneficial to move forward and put those fears aside, after working through them for so long. It was time to get rid of the niggling feelings and dedicate myself to the birth.

And then yeah, when I was in labor, those worries actually didn't get to me. I was surprisingly confident. My body knew everything was going to be okay. I had a weird "here or bust" commitment....an instinct?

[honeybee]

One thing that helped me calm the "what if" fears with my first homebirth was reading birth stories where things did not go absolutely right. I read Baby Catcher, and the birth stories in Ina May's Guide to Childbirth. There were a fewstories of transfers... and the Farm is a good deal more than 20 minutes from the nearest hospital. I also read a lot of birth stories here. I think really understanding how a midwife reacts, and what resources they have help me a lot.

Plus, I realize that the death of a baby is equally rare at hospital and at home. There are cases where BEING in the hospital is the cause of death or disability (iatrogenic induction/c-sections causing prematurity, a healthy baby catching one of the super-bacterias, etc.). There are cases where a death at a homebirth may have been avoided if you had been in the right hospital at the right time... with a nurse who was on the ball attending to you personally (rather than monitoring you and 3 other people from another room), 24-hour anesthesia available immediately (not always true, especially at smaller hospitals), etc. Most hospitals are not prepared to do c-sections in 5 minutes. They have to get the on-call doc and anesthetists there (if not physically in the building, then on the right floor), etc.

Next time you ask yourself these questions, also ask yourself... what if choosing to be in the hospital causes major problems for baby or myself? (after all, c/section increases maternal death rate by 4 times).