Thoughts of labor are entering Jen's mind this week. Says Jen, "As I steadily inch toward childbirth again, I'm nervous. Nervous for the pain and how to manage it. Nervous for just plain delivering a healthy baby, really. The whole event is so monumental, it seems hard to comprehend it all at once, just like pregnancy at times."

I approach pregnancy in segments. It feels safer somehow. Thinking about it all at once is too intimidating, but if I think about it as smaller goals, it's more manageable. It's like a checklist:

Thirteen weeks, end of first trimester and morning sickness, safe to tell people... check
Eighteen weeks, ultrasound to look at the baby and check all structures... check
Twenty-four weeks, baby reaches viability... check
Twenty-six weeks, end of second trimester, and things look even better for the baby... check
Thirty weeks, baby almost definitely would survive now... check
Thirty-seven weeks, full-term... check
Forty weeks, due now... check
Forty-two weeks, overdue... well, let's not go that far!

Now that I have reached the twenty-four week milestone, I find myself trying to use my little checklist not to think about labor. Too far ahead, I tell myself. But it really isn't. The information from the birthing center lists this week as the time to schedule our childbirth refresher class.

I've heard it said that childbirth is a pain you forget. Maybe for some, but that did not get programmed into my genetic code. I remember. I cringe, actually.

There are two encounters with physical pain in my life that I remember vividly. The first is when I had shingles for my 26th birthday (for the medical types among you, S1-S2 region - to translate that for the rest of you, where I sit). If you don't know what shingles are, it is a re-infection of the chicken pox virus. As I understand it, once you've had chicken pox, the virus remains with you. For some unknown reason, the virus will attack a single nerve ganglia in the body. The first sign is some tingling, then a few days later, redness and intense pain, and then blisters. They remain with you for days, and even after they are gone, some residual pain in that area can last for months to years. Shingles is most common in the elderly, but anyone can get it. I could not sleep with out a potent painkiller. Heck, I could barely sit. It was days and days of agony. This was pain with no purpose. I truly would not wish that on anyone, friend or foe.

The second memorable encounter with physical pain was labor and childbirth. At least this was pain with a purpose!! But even so, the back labor really threw me. Five minutes after my membranes ruptured, contractions were going full-tilt. With each contraction I simultaneously wanted to curl forward into the contraction and arch my back with the back pain. I remember feeling out of control with each contraction, barely able to remember to breathe. Focusing on something didn't help; there were too many conflicting messages coming from my body.

Now, as I steadily inch toward childbirth again, I'm nervous. Nervous for the pain and how to manage it. Nervous for just plain delivering a healthy baby, really. The whole event is so monumental, it seems hard to comprehend it all at once, just like pregnancy at times.

Last time I wanted and gladly accepted an epidural. The back labor was so intense I don't think I could have made it through without it. I wonder now, if I don't have back labor how will labor be different? What does "normal" labor feel like? Heck, I wonder if I will 'know' real labor if there is no excruciating back pain. When I am in the middle of it all, will I be able to recognize and/or push myself up to and beyond my limits. Will I fail in those attempts?

I've been trying to do some reading on different options to prepare myself, just like last time. But unlike last time, I really know what an author is writing about on certain topics. Sometimes, when I read things on either end of the childbirth philosophy spectrum, I can help but chuckle at certain blanket comments. Labor and delivery is different for everyone, and there are few absolutes. Mostly I am trying to keep an open mind about different approaches to the whole topic.

But I am still nervous, and it is a nervousness that is hard to name. It resides deep inside me along with basic other emotions like love and happiness and anger. It's not a fear that I can't do it, because I know I can (I've done it!). It's more about how to do it, how it will be. It's not fear of the unknown; it's fear of the known. That known will be here sooner than I know it. Will I be ready?

Yesterday we went to see a friend who gave birth to her third child within the last week. She expressed a similar fear of the pain of childbirth, and she'd already done it twice! It was reassuring to know that I am not alone in having this childbirth anxiety despite having done it already. Hearing about how the birth went, I was able to identify some things I don't want to do, but there is still a long way to go to identify exactly what it is that I am looking for. Not so much to have a birth "experience" but to address these fears - so they don't paralyze my decision making at the critical times.

As I held our friend's daughter, I was reminded that somehow, someway, I'll get through it. I have selected an excellent doctor and practice and feel comfortable with some of the decisions we have made already. I know that the birthing center has some excellent staff, and our friend gave me the names of some specific people she found most supportive. All these little steps on the way there are like my overall pregnancy checklist in a way. Taking little chunks at time.

In the end, maybe I'll never forget the pain, but it certainly will be worth


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