Insuring Privacy During Labor

I've suffered from depression most of my life. I've taken medication for it on several occasions, but prefer to deal with things in other ways. I have had a great relationship with my husband for 10 of those years. I feel very secure with him, and hope that together we'll make good parents. Everything that I read about coping with fear of labor deals with the labor itself. My fears aren't about the labor, but about the surroundings. I'm going to have the baby in a hospital with a nurse midwife. To me, giving birth seems like a very private issue, like intercourse, itself. The idea of having other people around is terrifying to me. I've had in my life some really horrible sexual experiences. I've read that this can be a hindrance during labor, but I haven't read what to do about it. It is one thing to tell someone to come to terms with such things; it is a very different thing to do. How can I cope with this fear?

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ABOUT THE EXPERT

Peg Plumbo CNM

Peg Plumbo has been a certified nurse-midwife (CNM) since 1976. She has assisted at over 1,000 births and currently teaches in the... Read more

I know what depression is like as someone very close to me has suffered from it also. And diet, exercise and human support ARE key ingredients to living with this condition.

During the postpartum period, women are often too busy and distracted to take care of these needs and so much of the attention will be directed now to the newborn that sometimes the mother gets lost in the shuffle. It is especially important to see that these requirements are met after the baby arrives. As hard as it is going to be, take some regular time for yourself and some separate time for you and your husband together.

You refer to the literature that now abounds on survivors of physical and sexual abuse and the effect of that abuse on pregnancy, labor and birth and mothering. Although it is different for every woman, you will require consistent, nurturing, expert care. You should get that from a nurse midwife. In this day, however, it is rare to find a midwife in solo practice or even in a small enough practice where it is practical for her to promise to be there for the birth. If you have that advantage, and you feel good about her and the way she practices, hold on and develop a relationship. If the practice accepts nurse midwifery students, you may be able to make arrangements for her to be at your birth. Student nurse midwives are wonderful because they have the time to devote to a few mothers and are looking for families to deliver.

Another option is for you to "contract" with two nurse midwives in the practice. That way if one cannot come, the other one would.

I delivered a baby yesterday and because everything went so smoothly, the only people in the room were the parents and one nurse and myself -- and then the baby! You could request that this be the agreement if possible. In the event of a difficulty - fetal distress, meconium in the fluid, the need to consult with a physician etc.- it probably won't matter to you because you will be so focused on your efforts and the baby's well being.

I would encourage you to ask your midwife what adjustments can be made and/or assurances given to have the type of birth you want. Take a tour of the labor unit and ask the same questions of some nurses there.

I have had many clients with such a history and for the most part, if they have a supportive caring spouse or partner, they share the experience with each other and focus on the process and on their partnership working together to birth the baby. The midwife complements this relationship, allowing the couple to make informed decisions and assuring safety while considering the parents' wishes. She may have to negotiate with the physician consultant, buy time and communicate important issues to others, but she is there with you and for you.

Talk with your midwife (midwives), make two appointments back to back if necessary, and if you are comfortable with their plan and their care, put some of your trust and reliance in them. You could make more frequent visits than would be typical. Nothing should be "routine."

I wish you a peaceful and happy pregnancy and birth.

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