In surveys of pregnant women, it’s been found that up to 20% have a fear of childbirth. This fear is normal, but in some cases so severe that women delay or avoid becoming pregnant.
A study published in BJOG: An International Journal of Obstetrics and Gynaecology in 2012 confirmed that women who have a fear of childbirth spend longer in labour than those who have no such fear. In fact, labour was prolonged, on average, by an hour and a half. The rate of emergency C-section as well as assisted labour (using forceps or other interventions) was also higher. “Fear of childbirth seems to be an increasingly important issue in obstetric care. Our finding of longer duration of labour in women who fear childbirth is a new piece in the puzzle within this intersection between psychology and obstetrics,” says Samantha Salvesen Adams, the author of the study.
Why do women fear childbirth?
The reason for this all comes down to hormones. As natural birth advocate and obstetrician Michel Odent, who was one of the first to campaign for home-like birth environments, explained in an interview with The Telegraph in 2013, oxytocin, also known as the the love hormone, is directly involved in initiating and maintaining labour. It also peaks right after delivery, resulting in a sense of euphoria for the mother that helps her bond with her baby despite the ordeal to get there.
Unfortunately, adrenaline is like kryptonite for the “shy” hormone oxytocin. Adrenaline is released when you feel threatened or frightened, so when a birthing mother feels fear, the adrenaline released counteracts the love hormone and can slow or even halt labour.
Labour consists of three stages, and each will evoke different emotional and physical responses. Knowing what to expect, how to prepare and how to ease the pain will make all the difference to your birthing experience. But regardless of the stage of labour you’re in, there are a few basic needs women have that will help minimise the fear and encourage oxytocin to release.
Create your environment
“There is a link between environmental stressors and pain,” explains Zaahida Joel, a WOMBS certified doula and childbirth educator. “As Dr Grantly Dick-Read’s theory teaches, fear causes tension in the body, which increases pain. When a birthing woman is feeling fearful, her body and cervix will tense up and not dilate as it should.
Researchers have found that when women feel capable, confident and cared for, they feel less pain during labour. They perceive their pain as more manageable and they’re better able to cope.”
According to Ruth Ehrhardt, certified professional midwife and doula, women in labour have seven basic needs that, if met, help things go smoothly:
- To feel safe
- To leave the Thinking Brain (The Neo Cortex) switched off
- Darkness or low lights
- Not feeling observed
- No adrenaline.
There are several ways you can reduce your fear around labour, says Zaahida. Here are a few measures you can put into place to ease into labour:
Zaahida stresses that one of the most empowering things a woman can do during pregnancy is to attend antenatal classes. “This will give you the opportunity to learn about your own physiology and how it changes during labour, the different stages and the process of labour, which will help you feel less anxious and unsure, and more in control.”
Enlisting a birth team is essential to ensuring you feel surrounded by love and support during labour. Doulas, in particular, are specifically trained to make the birthing mother feel as comfortable and secure as possible throughout labour. “This is achieved through soothing touch and massage, counter pressure on the back or hips, and ensuring you stay hydrated and nourished. A doula will also assist you in moving into more comfortable and beneficial positions.”
Labour positions to try:
- Standing and rocking or swaying your hips
- Squatting on all fours on the floor or bed, or sitting on a birthing stool
- Leaning forward on a ball, hospital bed, chair or your birth partner.
- Labouring on the toilet
- Bouncing, rocking or swaying on a birthing ball.
“Bright lights, clinical smells, a crowded room, noise and restrictions in movement can all increase your level of pain perception,” explains Zaahida.
Bring on the essential oils.
Aromatherapy can help disguise the clinical smells of hospitals that can induce fear while also supporting the nervous system in managing fear, tension and anxiety which can decrease pain perception.
Use positive birth affirmations and visualisation.
These serve to remind you your body is made to birth and that each contraction is bringing you closer to your baby. Visualise your baby dropping down lower into your pelvis and imagine your cervix dilating with each contraction.
Rest during early labour.
This will help you preserve mental energy, which will help you remain calm and focussed as labour progresses. Preserving physical energy earlier on will mean you cope better with increasing contractions.
Empty your bladder.
Do this at least every hour, because a full bladder feels uncomfortable and slows the descent of the baby’s head. You can also help prevent permanent damage to your bladder if it is empty when you push your baby out.
Touch and massage.
Preferably from your doula or birth partner. This helps to relax tense muscles, and reduce anxiety and pain. It calms you and enhances your mood by stimulating endorphin production, which are natural painkillers and mood enhancers.
Use warm towels, a warm compress, beanbag or even a familiar, soft blanket to comfort and relieve pain in the tummy, groin and lower back region.
Eat a snack that’s easily digested and light.
This has been shown to reduce the length of labour by 90 minutes. Dates are a great snack since they contain a host of vitamins and minerals, prevent constipation and help to soften the cervix.
Drink water, coconut water or an electrolyte solution. This can mean you prevent the use of an IV and it will help keep your energy levels up while assisting your body in working optimally.
The active birth movement
When you’re upright, moving around and changing position during labour, gravity helps your baby’s head descend into your pelvis, and your uterus can contract more efficiently to support your baby in getting into a more optimal position.
“Using a birthing ball and squatting and kneeling helps widen the pelvic outlet and speeds up dilation and labour. The quicker you dilate, the shorter the labour is and the less pain is experienced,” says Zaahida.
“There is an abundance of studies proving that women who were in an upright position and mobile during labour had lower levels of pain, shorter labours, and were less likely to request an epidural and to have a C-section.”
The American College of Obstetricians and Gynaecologists has acknowledged care providers still encourage a lying-down position during labour, although there are known side effects, including lowering the mother’s blood pressure and increasing the chance of abnormal foetal heart rates.
Water and pain relief
“Water birth means labouring in warm water and staying in the water throughout the pushing phase, until baby is birthed.
Hydrotherapy (using hot water as pain relief) can include having a hot shower or immersing your body in a hot tub of water during labour, regardless of the position or place you give birth in. This is an effective method of relaxation and pain relief, and incredibly underused.
Even in state hospitals, there are tubs and showers available to use during labour. All you have to do is ask,” explains Zaahida.
Many studies have shown that water births reduce pain perception and requests for pain medication. Zaahida says these effects can be increased by adding Epsom salts and a soothing essential oil such as lavender to the water.
Marianne is a freelance content creator and copy editor. She has been part of the Living and Loving team in various capacities over the last six years, but since becoming a mom to a boisterous boy, she has found a special interest in parenting issues including discipline, education and early childhood development. When not running after, and negotiating with, her three-year-old, you’ll find her experimenting in the kitchen.