Peggy O'Mara

A Quiet Place

Killer Fear

October 31st, 2009

by Peggy O’Mara, Editor and Publisher

While grocery shopping at our local food co-op last Saturday, I ran into an old friend. He told me that he’d been walking the aisles in a daze of fear, wondering how much hydrogen peroxide to stock up on for the coming pandemic. Our conversation seemed to calm him down, but later I wondered how many other 
parents were so terrified.

In response to the recent hysteria about the H1N1 virus, or swine flu, we have created a new online resource section, www.mothering.com/health/swine-flu. Swine flu, however, is just one of many terrifying possibilities. Our challenge as parents is not only worry over swine flu in particular, but rampant fear in general.

The deceptive thing about fear is that, because of the biochemical response that initiates it, at first it feels exciting. In our stressful society, we become accustomed to the high of this adrenaline rush and think it normal. But it’s not. In fact, when our experiences regularly trigger the release of adrenaline, fear can kill us.

When we are fearful or anxious, our muscles need more oxygen and glucose, which means that our heart pumps faster and our blood pressure rises. Cortisol is one of the hormones involved in this process; prolonged high levels of it in the bloodstream can damage the heart, contribute to obesity (especially of the gut), and weaken the immune system.

High cortisol production also leads to increased amounts of fatty deposits in the liver, which in turn can create a range of metabolic disorders.1 In 2008, a team from the University of California–Los Angeles showed that increased levels of cortisol prematurely age immune cells and thus make people more susceptible to illness.2 Cortisol suppresses the action of telomerase, the enzyme that keeps cells young.

Not only is fear bad for our health, it colors our perception of reality. While we like to think that reality is an objective fact, we actually see the world not as it is, but as we are. That’s why everything looks bad when we’re depressed, and wonderful when we’re happy. Beliefs come from information we have learned and experiences we have had. Conscious or unconscious, our beliefs determine our biology and our behavior. We might even have unconscious fears from something we learned as toddlers—childhood programming becomes adult habits of perception and belief.

So our experiences shape our perceptions, which in turn create our beliefs. Our beliefs then reinforce our perceptions, because we now see the world through the filter of these beliefs. Unfortunately, even erroneous beliefs can be self-reinforcing. If we believe the world is a fearful place, for example, we may see other people as distrustful. If, on the other hand, we see the world as benevolent, we may expect people to be friendly and helpful. Some would say that we even create our experiences by our perceptions and beliefs.

How can we change our relationship to fear? How do we respond to the rampant fear stimulated by our sensationalistic mass media? Do news sources exist that will not trigger a release of adrenaline? Do we simply shut out some or all media? Are we as careful about the types of media we allow to affect us as we are about what media we expose our children to? And, perhaps more important, do we recognize when we have experienced a stressful situation or have been in a prolonged state of fear, and then give ourselves time to calm down, rest, and recover? Or are we, along with so many others, simply addicted to fear?

We can become addicted to fear because there is a certain romantic appeal to the tragic side of life. One need only look at the proliferation of vampire fiction to see the appeal of the victim mentality. And yet, with all we now know about the long-term effects of prolonged fear and anxiety, as well as about how we can lay down new, more healthy neural pathways in the brain, playing the victim is not only unhealthy, it has become passé.

We can become victims even when we think ourselves immune to such a thing. When we fall prey to the fear and anxiety stimulated by the media, we, too, have allowed ourselves to be victimized. In my own attempt to stay clear of fear, I have taken more notice recently of the effects that stressful experiences have on me. I often recriminate myself because of my sensitivity, but I just can’t get disturbing images from the media out of my head, sometimes for days or weeks. I have come to appreciate this sensitivity, and am less and less willing to be traumatized in the name of entertainment, or even in the name of being “informed.”

I’m also more willing to give myself extra time to recover from stressful experiences, rather than just press on in the face of feeling overwhelmed. It’s probably my age that has given me permission to indulge my idiosyncrasies—by this time in life, I have finally come to accept myself. Self-acceptance is an antidote to fear. In times of strife, it helps if we refuse to abandon our authentic selves. It also helps if we simply tell the truth, and choose to place ourselves only in harmonious and balanced situations.

Often, when we’re afraid, we feel intimidated and act before we’re ready. But during such hard times, it’s more important than ever to act only when mind and heart are in alignment. And when we feel gripped by fear, one way out is to communicate directly and act immediately to alleviate the fear.

Fear is often accompanied by worry, but worry is absent when we’re lost in the moment—so it’s helpful to cultivate practices and thinking that help us maintain a moment-by-moment focus. Meditation, yoga, biofeedback, and visualization are such practices.

Because we often worry when life feels out of control, setting comfortable limits and boundaries is essential, as is refusing to overextend ourselves to make things happen—even when others create an unnecessary emergency.

If we take the time to observe ourselves and our states of mind, we will find other antidotes to fear and worry. They are but the storms and low points of our emotional life; they are not who we are. We are more complex than our emotions.

Whether it’s fear of something imagined—the possibility of swine flu, avian flu, smallpox, terrorist attack, financial ruin, falling meteors—or of an emergency actually taking place in the present moment, there are things we can do to escape the grip of fear and therefore bring more oxygen to our brains so that we can think more clearly and make better decisions. Here are some things to do:

Name that emotion. The next time you feel out of control, practice naming your emotions: This is anger. This is envy. This is disappointment. When you feel strong emotions, they may seem stronger because you are experiencing several at once. Differentiating them helps you to have a better relationship with them, and 
to understand what they’re trying to tell you.

Change your thinking. Even when you’re in a foul mood, resist the temptation to let your thoughts wander in negative directions: to what’s wrong with you, to old problems, to things that make you angry. Think in ways that you know will bring out your positive emotions. For example: Rather than a problem or a bad experience, focus on plans and actions for the current day.

Focus outside of yourself. Try to direct your thinking away from problematic thoughts and emotions. Think of a lovely fantasy vacation, something you want to make, something you’re looking forward to, someone you love. Make a special place in your imagination where you can go when you’re experiencing prolonged stress.

Practice positive thinking. Positive thinking is a skill that must be practiced. People talk about having “a spiritual practice”—it’s called that because you have to practice being spiritual. The practice is about working with what is, whether we like it or not.

Stand by yourself. Often, when we’re afraid, we lose perspective on our good qualities. When you’ve experienced something stressful, treat yourself the way you treat your child when she’s had a bad day. Have a nice meal. Drink a cup of hot tea. Cover up with a blanket. Sit by the fire. Listen to relaxing music. Don’t turn against yourself in hard times—take care of yourself.

Use a mantra. A mantra is a word or phrase that can be repeated over and over again. It can drown out negative thoughts and help you keep your focus in the present. Music can be a mantra. Prayer is a mantra. The sacred syllable Om is used as a mantra in eastern religions. My adult children have offered me helpful, secular mantras such as “It’s all good” and “No worries.” I recently saw a wonderful Israeli film, Ushpizin, in which the mantra was “All is God.” The Buddhist monk Thich Nhat Hanh offers up the mantra “Breathing in I calm myself. Breathing out I smile.”

The “Litany against Fear,” from Frank Herbert’s novel Dune, has served me as a mantra of sorts for 40 years, and was especially helpful during pregnancy and birth. I’ve memorized the words, so I’m ready with them at a moment’s notice. I even act them out:

I must not fear.

Fear is the mind-killer.

Fear is the little-death that brings 
total obliteration.

I will face my fear.

I will permit it to pass over me and 
through me.

And when it has gone past I will 
turn the inner eye to see its path.

Where the fear has gone there will be 
nothing.

Only I will remain.

Keep your sense of humor. Humor is the universal antidote to fear, anxiety, and worry. Sit yourself down in front of a funny or uplifting movie. Listen to Monty Python’s Flying Circus. Play some games. Cultivate your inner prankster. When we’re thinking funny or silly thoughts, fear and anger vaporize.

There’s always something to worry about. If things aren’t going to work out, worry does no good. And if things are going to work out regardless, worrying about them will not help. Either way, worry is useless. It’s a sign of being off balance, over-
extended, overtired, or out of control. 
As parents, we can’t afford it. It robs our energy, ruins our health, and sets a bad example. Therefore, we must somehow find the courage to fight fear in hand-to-hand combat, cut off its head, and claim our birthright: Paradise is a state of mind.

NOTES

1. Ulrike Lemke et al., “The Glucocorticoid Receptor Controls Hepatic Dyslipidemia through Hes1,” Cell Metabolism 8, no. 3 (September 2008): 212–223.

2. Jenny Choi, Steven R. Fauce, and Rita B. Effros, “Reduced Telomerase Activity in Human T Lymphocytes Exposed to Cortisol,” Brain, Behavior, and Immunity 22, no. 4 (May 2008): 600–605.

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HPV Vaccine

October 12th, 2009

For those of you who want to know more about the HPV vaccine, you may want to order the audio of the NVIC presentation, “Gardasil Vaccine: Informed Consent?” by Diane Harper, MD, MPH, MS. Harper has worked in all aspects of HPV associated diseases, specifically cervical cancer prevention. She is the leading international expert on HPV vaccines and has worked with both Merck and GSK to develop Gardasil and Cervarix.

Before Harald zur Hausen identified HPV as the cause of cervical cancer in 1976, it was the most common cancer in the world, with a rate of 50 cases per 100,000 women. Today, cervical cancer is the fifth cause of death among women in developed countries with a rate of three cases per 100,000 women, but it is still epidemic in developing countries.

Seventy percent of HPV infections resolve within one year; 90 percent resolve within two years. Only 10 percent of infections will persist and 50 percent of these will be cancer precursors.

Of those who get cervical cancer, 50 percent never got a pap smear and ten percent had a pap more than five years before. Mass screening programs for HPV infection have had dramatic effects. Finland saw a 75 percent drop in cervical cancer when women participated in mass screening. When 70 percent of women in a society participate the rate of cervical cancer drops.

There are risks associated with a pap smear, however, including the stress and anxiety of screening, of abnormal results, of false positive results and of the treatments. There are also possible relationship traumas from the diagnosis of sexually transmitted disease (STD). The treatments, colposcopy and biopsy of the cervix, increase the risk of preterm delivery, low birth weight, premature rupture of the membranes and cesarean birth.

The vaccines, Cervarix and Gardasil, are highly effective against most types of HPV viruses, but not all of them; Merck is working on a supplemental vaccine. Coverage requires three doses of the vaccine and is costly⎯$375 for the series. No efficacy trials in girls under fifteen years of age have been done. The duration of efficacy is unknown for all recipients. On the package inserts, Gardisal publishes efficacy of five years and Cervarix publishes 7.5 years. According to Harper, “If HPV vaccines are not effective for at least 15 years, then no cervical cancer is prevented, only postponed.”

In general, the vaccine has proven safe for most women, but results from the Vaccine Adverse Events Reporting System (VAERS) indicate that 29 percent of vaccine recipients feel dizzy and faint. Thirteen cases of Guillain Barre’ have been reported to VAERS, and thirty-two deaths. The risk of adverse events to HPV vaccine is 7 events per 100,000 vaccinated.

At this time, the HPV vaccine may reduce the incidence of HPV, but not cervical cancer. There will be no substantial decrease in cervical cancer until 70 percent are vaccinated. Screening alone is as effective as screening with vaccines in preventing HPV infection. Screening is still essential.

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Informed Consent

October 7th, 2009

George Annas, JD, MPH, delivered the opening keynote address of the 4th international NVIC conference, “False Choices and Worse Case Scenarios: How Taking Informed Consent Seriously Can Improve Public Health.” Annas is the Edward R. Utley Professor and chair of the Department of Health Law, Bioethics and Human Rights of Boston University School of Public Health and professor in the Boston University School of Medicine and School of Law. He is co-founder of Global Lawyers and Physicians, a transnational professional association of lawyers and physicians working together to promote human rights and health.

I was inspired by Annas’ early work, The Rights of Hospital Patients, an American Civil Liberties Union (ACLU) guide and found it invaluable when my son was hospitalized in 1982. This book has been updated and is now published under the title The Rights of Patients.

All 50 states have legislation that delineates the required standards for informed consent. In order for informed consent to occur, the practitioner must disclose to the patient the benefits and risks of and alternatives to any treatment, procedure or drug. It is critical that the patient receive enough information to make a decision and not be coerced into making one.

As a member of the public health community, Annas is a supporter of vaccines, but defends the right of individuals to seek exemptions from them. He says that 90% of people want vaccines and that lack of access to them is the problem, not exemptions from them.

Annas is critical of the military mindset that has crept into public health since the creation of Homeland Security. He would prefer that trusted health officials be in charge of health policy because citizens do not respond well to threats about healthcare policy. A past NY Academy of Sciences study found that if there really were a smallpox epidemic, 60% of people said they would not get a vaccine. Some were afraid of vaccines, and some were afraid of getting smallpox from the vaccine. When asked who could convince them to vaccinate, people said that it would have to be a trusted non-government physician, or a credible public figure. Annas said that all public health experience has shown that there is “no force on earth strong enough to get someone to do something they don’t want to do and think is not in the best interest of their family.”

Currently some states are debating whether or not to require physicians and hospital personnel to be vaccinated for swine flu, but this was not successful with smallpox and Annas does not expect it to be with swine flu. New York is currently the only state to require RNs and MDs to get seasonal and swine flu vaccines and Massachusetts is considering doing so. Current guidelines at Boston Medical Center “require all hospital personnel to be vaccinated unless they refuse vaccination.” According to Annas, one just has to sign a form.

Annas recalled what he called the 1976 “swine flu fiasco” in which 50 million people were vaccinated for a flu that never materialized. Guillain-Barre’, a known risk factor from swine flu vaccine, however, did materialize with an incidence of 1 in 100,000.

Even those who favor aggressive health policy, according to Annas, are in favor of volunteerism, of urging people to get vaccinated rather than attempting to force them. He quoted Obama’s inaugural address in which he said, “It is a false choice between security and liberty.” In a healthy population human rights and dignity are required.

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Parents Will Fund The Research

October 4th, 2009

Well, the vaccine conference is over, at least for me. There is one last panel tonight on vaccines and political action, but it’s time for me to rest and to catch you up on this amazing event. I had originally intended to blog everyday, but the conference schedule has literally been non-stop and this is the first chance I’ve had to organize my thoughts.

The conference presentations were uniformly excellent, the material diverse and far reaching and the attendees inspired and activated. There is no doubt in my mind that we have reached a critical mass. It is just a matter of time before we resuscitate the informed consent doctrine in the US. Perhaps it is the fear of mandatory vaccines for swine flu that finally will tip the point.

In the spirit of The Seven Traits of Highly Effective People, I want to “start with the end in sight.” I will tell you about the end of the conference and then go back to the beginning. Over the next two weeks, I will blog about what I’ve learned from the sessions.

Barbara Loe Fisher, co-founder and president of the National Vaccine Information Center (NVIC), made her closing remarks joyfully today. Just yesterday, Dawn Richardson, president of Parents Requesting Open Vaccine Education (PROVE), suggested that since the government was unwilling to fund research into comparing health outcomes between vaccinated and unvaccinated children, we do it ourselves.

Barbara offered that NVIC would immediately begin to take donations to fund such a scientific study, to be conducted by independent, credentialed researchers and published in an important medical journal. In just the last 24 hours of this conference, NVIC has raised $110,000 for this study and will issue a press release regarding it tomorrow, Monday 5 October 2009. This is an historic moment.

I would suggest that you go immediately to the NVIC website and sign up for their newsletter so that you can receive the press release. While you’re at it, make a donation to NVIC. Family membership is just $25. Their mostly volunteer staff has been doing so much for all of us since 1982 and they operate on a budget of less than $300,000 a year. Barbara said that if they had more funding for the organization, they could:
Mount a national advertising campaign.
Offer a 24 hour a day national vaccine reaction reporting hotline.
Create statewide legal and medical networks.
Coordinate state leaders working for state exemptions.

Dawn Richardson from Texas, who suggested that parents do the study, has developed model state language for a medical exemption. She did a session Thursday night on “State Organizing To Get & Protect Vaccine Choices” and I’ve asked her to write an article for us on this topic. Look for it in early 2010. More tomorrow.

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At the Vaccine Conference

October 1st, 2009

I’m in Reston, Virginia right now, here to attend the 4th International Public Conference on Vaccination put on by the National Vaccine Information Center (NVIC). The conference is being held from Thursday, October 1st through Sunday, October 4th, 2009. Monday, October 5th, is a group lobbying day on Capitol Hill. The day includes a congressional briefing on the Vaccine Injury Compensation Program (VICP) and time for conference participants to visit their own state legislators to discuss vaccine safety issues.

I always love visiting the DC area, probably because I’ve come here mostly to attend vaccine conferences or congressional hearings on vaccines. I knew that the conference would give me the impetus I wanted to get my blog started because I’m eager to share all of the fabulous information I will be learning during the next three days. It will also be an opportunity for me to solicit great articles for 2010.

I intend to keep you posted on the exciting presentations from the conference. I’m particularly looking forward to hearing George Annas on “Informed Consent,” Vicky Debold on “Vaccinated and Unvaccinated: Measuring Outcomes” and Andy Wakefield on “Vaccines and Inflammation.” I’ll especially watch out for any information to help you quell the swine flu hysteria.

I’ll be giving the opening speech Friday morning on “The New Health Journalism: Challenging the Status Quo” and will post my talk online later that day.

On Friday evening, I’ll be the moderator for the “Mother & Child Panel” with Amy Lansky, Stephen Marini and Jeanne Ohm. What a lineup! On Saturday, I have the honor to moderate Bob Sears, who will talk on “The Alternative Vaccine Schedule’ and Larry Palevsky on “Getting Sick to Stay Well.” And Sunday, I’ll be thrilled to moderate Joe Mercola’s talk, “Take Control of Your Health.” I can’t wait to meet him.

And, Saturday night, I will receive the Courage in Journalism award from NVIC. I cried when I read Barbara Loe Fisher’s email letting me know. She wrote, “I would like to present you with the NVIC’s Courage in Journalism award in recognition of your many years of leadership in framing the paradigm shift that is occurring in child health toward achieving wellness without constant use of multiple vaccines or drugs.”

More on all this soon. Stay tuned.

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Does it Hurt?

September 1st, 2009

Issue 156 – September/October 2009

It’s safe to say that the No. 1 worry for most pregnant women is pain during labor. Secretly, you ask yourself, “Will I be able to handle it?” But it’s hard to know if you’ll be able to handle something you’ve never experienced before, especially when the cultural messages about birth in the US do not inspire confidence.

It’s understandable that you might be afraid of the unknown, but your experience of pain in labor may be more within your control than you realize. The amount of pain you feel during labor is affected by your perceptions of pain in general, and your beliefs about pregnancy and birth in particular. A supportive environment during pregnancy can help you to change these perceptions so that you feel more ready for a natural birth, which is, by definition, drug-free.

But what is labor pain like, anyway? Its nature is so couched in mystery and overdramatized by the media that you’re probably terrified of it. Pain in labor is the result of the dilation of the lower, narrow portion of the uterus, called the cervix, which must open to a diameter of 10 centimeters in order to allow the baby to pass through. In labor, the job of the cervix is to stretch from an opening the size of the tip of your nose to an opening the size of a circle drawn on the palm of your hand. No wonder you feel a stinging sensation as this is happening.

This dilation of the cervix happens gradually and rhythmically. During a natural childbirth, the contractions that stretch the cervix last for only 45 to 90 seconds, and peak in intensity at about 30 seconds. There are breaks between contractions during which there is no pain at all. The reason you can have confidence in your ability to handle these contractions is because of their very rhythmic nature. You have to handle only one at a time!

Pain in labor is not like the pain from an injury—persistent, constant pain that requires attention. Tooth pain, for example, is throbbing and relentless. You have to get to the dentist. Unlike tooth pain, pain in labor lets up. It is not aching but stretching. A toothache hurts; labor stings.

If you’ve ever had a massage, particularly a Rolfing session, you may have experienced what it feels like when a knot in a tight muscle is smoothed out by the strong pressure of someone’s fingers. There is a distinct stinging sensation, depending on the degree of pressure. You squirm from the stinging, but you can handle it. You can handle it because the practitioner tells you to breathe with it, and because it’s over quickly. It’s the same during labor: The pain is manageable because it doesn’t suddenly begin as a gripping pain at full intensity. It generally starts as a mild tightening that slowly builds, in strength and intensity, to a burning sensation. The contractions come in waves.

Although I can give you a general description of labor pains, no two women experience it in exactly the same way. In fact, the perception of pain in labor is uniquely subjective. In one study, a group of pregnant American women were compared with a similar group of women from the Netherlands. Each woman was given the same information beforehand about the risks of pain medication during labor. Only about 33 percent of the Dutch women asked for pain medication during labor, while 83 percent of the US women did. Forty-eight hours after birth, the American women noted that they had generally anticipated a painful birth and the need for drugs, whereas the Dutch women had anticipated less pain, and thus less likelihood 
of the need for drugs.

This study tells us a lot about how our expectations can affect our experience of labor. We are affected not only by our expectations about what birth will be like, but also by the perceptions and beliefs about birth we have inherited from family and culture. You can examine your own perceptions and beliefs about pregnancy and birth by asking yourself the questions in the box on this page.

Perhaps the most important factor in reducing your perception of pain in labor is to reduce your experience of stress. One important way to reduce your stress is to have the companionship of another woman during labor. A number of well-designed studies show that continuous labor support is one of the most effective methods for reducing pain in labor. One study reported a 30 percent reduction in requests for pain medication among women who used a doula for labor support. Clearly, you’ll be less likely to want drugs if you don’t feel alone.

Women who take childbirth-education classes also tend to request less pain medication. Most such classes teach breathing techniques, the purpose of which is to give you something other than the pain to focus on during the contractions and to help you stay in the moment. Practicing meditation is another way to learn to be in the moment, and can help prepare you to take labor contractions one at a time.

During labor, there are many things you can do to soothe the discomfort of the dilation of the cervix. You may enjoy a shower or bath in early labor, or a birthing tub as labor progresses. You can ask your partner to use the tips of the fingers to lightly and rhythmically stroke the bare skin of your abdomen, back, or thighs. This will help you to relax and focus. Massaging the inner thighs, buttocks, or lower back can also help to relieve pressure during labor.

Scent is another natural labor soother. Some essential oils are relaxing, and reduce sensations of pain by increasing the production of endorphins, the body’s natural pain relievers. Examples are lavender, chamomile, sweet geranium, jasmine, neroli, rosewood, lemon balm, mandarin, and cedarwood. Try them during pregnancy and choose ones that appeal to you.

One of the most important ways to relieve discomfort during labor is to change positions. Get off your back. Birthing upright can make labor shorter and less painful. Alternate among sitting, standing, and squatting; squatting can widen the pelvic outlet by 25 percent. Walk around during early labor. Get up on your hands and knees during contractions.

A number of acupressure points can also afford pain relief. In China, acupuncture is used instead of epidural anesthesia in 98 percent of births. The homeopathic remedy arnica, indicated for sore muscles, can be used effectively during labor. The herbs skullcap and catnip relieve pain, and calm and relax the body. Chamomile tea helps to control pain by relieving tension. Nutritional supplements such as calcium, vitamin E, essential fatty acids, and magnesium can ease labor discomfort. Ask your birth attendant for herbal, homeopathic, and nutritional recommendations specifically for you.

If it isn’t obvious by now, pain in labor is intensified by fear and tension. Tension can be the result of poor expectations regarding birth, and you can become fearful when you feel disturbed during childbirth. Childbirth is an involuntary process, and no one can help an involuntary process. The point is not to disturb it.

If you feel disturbed during your labor you will produce adrenaline, which slows the production of the hormones of labor: Your body, assuming you are in trouble, prepares to stop labor, and start again at a more opportune time. The uterus is the only muscle in the body that contains two opposing muscle groups: one to contract and open the cervix during labor, and another to close and tighten the cervix to stop labor. If your body produces adrenaline at the same time that your uterus is contracting, you will feel more pain.

If, on the other hand, you are undisturbed during birth, your body will release a cocktail of chemicals that will alleviate pain, give you an ecstatic rush after childbirth, make your baby irresistible to you, and help your breastmilk to let down. This cocktail is one of the many benefits of drug-free birth.

Drugs in labor unequivocally disturb the labor process. The cocktail of local anesthetics used for epidural blocks can cause varying degrees of maternal, fetal, and neonatal toxicity, according to the Physicians’ Desk Reference. While the efficiency of pain-relief methods during labor has been studied more than any other medical aspect of pregnancy, the adverse effects of these drugs on mother and baby have hardly been studied at all. We do know, however, that while the placenta reduces the effects on the baby of drugs given the mother, about 70 percent of any medication given the mother does reach the baby.

Narcotic analgesics such as Demerol, Nubain, and Stadol slow the baby’s heart rate and affect her respiratory system while she’s still in the womb, and, if given too close to birth, can also affect her breathing after birth. Babies of mothers who receive such narcotics show general sluggishness and sometimes have trouble in the early days. Remnants of the narcotics stay in the baby’s bloodstream for weeks. Long-term consequences of narcotics on the baby’s health are unknown, although a well-designed case-control study in Stockholm showed an increased risk of drug addiction among children exposed to pain-relieving drugs during labor.

I know you’re afraid of the pain of childbirth. I was too. We all are. Even after I’d had my first child, I always dreaded it. But the pain was never bad enough to make me want to stop having babies. I handled it.

It’s something you, too, can handle. Don’t let others underestimate you, and don’t underestimate yourself. You can’t expect yourself to know everything, especially if this pregnancy is your first. Find another woman in your area who has experienced drug-free birth and ask her to be your guide. Allow yourself to be supported and nurtured during your pregnancy. Model your pregnancy after the pregnancies of those who have had successful natural births. Find a practitioner who has lots of experience with drug-free birth and who believes in you. Believe in yourself. Your baby does.

Pregnancy and Birth

A look at your own perceptions and beliefs

  1. What do you believe about your own birth?
  2. What does your mother believe about your birth?
  3. How would the women in your family complete this statement: “The women in our family are _______.”?
  4. How would the women in your family complete this statement: “Childbirth is _______.”?
  5. What do you believe about sex?
  6. What do you believe about 
pregnancy?
  7. What have friends told you about pregnancy and birth?
  8. What three words do you associate with pain?
  9. What are your three most secret thoughts about childbirth?
  10. What do you fear most?


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