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Birthing Pangs

Nine-month nightmare


NO BIRTH PANGS: At the Birthing Sanctuary in Goa (top and below), the mother can expect to celebrate her pregnancy through laughter, dance, music, and interactions with other women.

Think childbirth and you picture a bonny baby in the arms of a radiant mom. But some women have tokophobia or the fear of giving birth. Psychiatry and alternative forms of birthing have come to their rescue.

Here's a home truth for all you consumers of that ideal of the all-conquering mother who goes valiantly into childbirth and emerges triumphant with the trophy - she's not every woman. Some are so petrified of the potential pain and possible complications arising from pregnancy and childbirth that not only do they find nativity stories nightmarish, but they put a safe distance between themselves and a home-grown foetus in spite of an ardent desire for a baby.

The term for this fear is tokophobia, borrowed from the Greek word for childbirth, 'tokos'. While most women know and expect a certain degree of labour-related anxiety and pain, some are possessed by an irrational fear that renders childbirth an ordeal that must be escaped. You'll know them from their blanched faces at a TV rerun of Father of the Bride 2, or when they suffer a blackout on mention of the words 'perineum tear'. In their paper titled, 'Tokophobia : an unreasoning dread of childbirth', published by The British Journal of Psychiatry, authors Kristina Hofberg and I F Brockington, categorised types of the condition as primary tokophobia (phobic avoidance of pregnancy dating from adolescence), secondary tokophobia (could result from a traumatic delivery), or tokophobia as a symptom of prenatal depression. Some years ago, British actress Helen Mirren admitted to developing a lifelong revulsion to childbirth after watching a video on the subject in her teens that led to her subsequent childlessness. Some women who are scarred thus are content to have no children, others desire them but would rather give the nine-month manufacturing process a miss.

If in the movies women are depicted as being painwracked in labour, and men are shown to have regular fainting fits in the birthing room, a dedicated viewer can only expect the worst. There are, of course, horror tales from the crib that have been handed down by our mothers, detailing vaginal tears and other such details.

A 35-year-old career consultant from Noida, who doesn't wish to be identified, says she and her husband had always wanted two children, but after the birth of the first (born breech and necessitating a C-section ), and the Post Traumatic Stress Disorder she experienced, she can't put herself through another pregnancy. "The very thought of it strikes me cold, " she says.

In a country like India where 31 children are born every minute, it might be inconceivable that there are some women holding back. Dr Shamsah Sonawalla, associate director, Psychiatry Research and consultant psychiatrist at Jaslok Hospital in Mumbai, says that about five to six per cent of women experience tokophobia and she believes the medicalisation of childbirth - a largely 20th century development - could be one of the factors that influence this condition. "No doubt hospitals have reduced infant and maternal mortality rates considerably, but their association with illness and death can set off panic buttons in sensitive women, " she says.

It is important to trace the root of this terror, she points out. Once this is done, the fear can be controlled. Three Rs can restore a woman's commitment to childbirth should she choose it: reinforcement (of the message that childbirth is natural), reassurance (that a healthy lifestyle and routine checks and measures can help prevent complications in birth) and relaxation (anxiety lowers the pain threshold).

Back in the day when women popped out a dozen babies at home with practically no assistance, they hardly had any of today's luxury of resistance. They may be more empowered to make their own choices now, yet it's not as if fewer women (afraid of childbirth but desirous of children) are getting pregnant, it's just that there are more alternatives available to them, says Dr Amit Dhurandhar, obstetrician and President of Birth India, a resource base on birthing. "From elective C-sections to alternative forms of birthing like hypno-birthing and water births, and psychiatric assistance, there are means to help a woman work through her pain, " he says.

It's partly why alternative birthing centres have proliferated lately, and they're determined to advance a positive and reparative birthing narrative that's removed from the impersonal and industrial model that hospitals have come to epitomise. Kasia Wierzbicka, a Pole who recently opened an alternative birthing centre in Goa called the Birthing Sanctuary, says it has been created for pregnant women and family members, to prepare themselves, physically, emotionally, and spiritually, to receive their baby in love.

At the Sanctuary, the mother can expect to celebrate her pregnancy through laughter, dance, music, art, nature, and interactions with likeminded people;be indulged like a diva;find support in other women;heal her own birth trauma;learn how to trust in her body completely on the journey of natural pregnancy, birth and motherhood;and improve relationships with the father of her baby'.

"Hollywood and Bollywood have been promoting the misconception that birth has to be traumatic, when it doesn't have to be painful, but ecstatic and transformative, " says Wierzbicka. It is to return to the traditional ways of nature and nurture that the Sanctuary also offers courses that will train women in midwifery and train them also to practice as doulas - women who offer the mother emotional support and assistance with massages, baths and the preparation of nourishing food.

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