Many women have decided that they want a pain-free delivery with an epidural (see Considering an epidural) even before they go into labor. It's good to know, however, that labor has to be well established before you can have an epidural, so you'll still experience some painful contractions. Epidurals generally work well, but sometimes the block isn't complete or is more effective on one side than the other. Some women decide to have an epidural because they know they're unlikely to cope well with labor pain. Many women start off saying that they don't want an epidural and change their minds halfway through-if it's your first pregnancy, you can't possibly know how you'll feel.
An elective cesarean is one that is planned and generally performed for medical reasons-for example, because of a low-lying placenta-and not simply because a woman wants to have one. Having a cesarean is major abdominal surgery and in most circumstances it is safer to have a vaginal delivery. Recovery after a cesarean usually takes longer than after a vaginal birth, so one is only performed if necessary.
This condition is an intense fear or dread of childbirth. There are two types: primary tocophobia predates pregnancy and can start as early as adolescence; secondary tocophobia is associated with an earlier traumatic experience in childbirth. This fear can manifest itself as nightmares, intense anxiety, or panic attacks.
If you have tocophobia, your doctor will refer you to a consultant obstetrician who deals in mental health issues, or you may be referred directly to a psychologist to discuss your fears. Some experts believe that hypnotherapy can help to tackle any subconscious fears of childbirth. An elective cesarean may be recommended if your fear of having a vaginal birth cannot be overcome.
You may need to experiment to find lovemaking positions that are comfortable. Most women find that the missionary position becomes increasingly uncomfortable as your partner presses on your belly. You may find being on top is enjoyable and does not put pressure on your belly. Lying in the spoons position, with your partner behind you, can also be pleasurable. Other positions that don't restrict your pleasure and are comfortable include sitting together, kneeling while your partner enters from behind, and lying side by side with your legs entwined.
Excerpted from Pregnancy Day by Day.
Copyright © 2008 Dorling Kindersley Limited.
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