The Fear Factor

Fear. It’s something we are all familiar with. We’ve all experienced it in one form or another and know the physical effects it can have on our bodies – increased heart rate, sweating, shaking, shallow breathing, even freezing or hiding. Fear. It’s a feeling, a sense, a reaction in our body and mind designed to keep us, and our loved ones, safe from danger or threats. So what place then, does fear have in birth, if any?

Unfortunately, for many expectant mothers, fear of labour and childbirth can dominate our thoughts for many of our gestational months. As our “due date” draws near, this fear can escalate, bringing on real feelings of anxiety and making us doubt our ability to bring our babies into this world. Now I would like to be able to tell you three easy steps to birth without fear, however, if we are honest, fear does poke its little-ol’ head in every now and then. I will, however, give you some strategies to help keep the fear from escalating, but we will get to that later. Firstly, let’s talk about birthing hormones and what fear can do to them.

I think most of us know that Oxytocin, also known as the love hormone, is the hormone responsible for stimulating the surges that work to move your baby “down and out”, often referred to as contractions (although I don’t love this term myself). Now, this love hormone, only likes to come out and play when we feel safe, have privacy and are in darkness, or low light (think romance). If these conditions are maintained, we produce more Oxytocin and the surges increase in speed and length. An undisturbed labour is usually efficient, which explains why the word Oxytocin comes from a Greek word meaning ‘quick birth’. So what happens when the “romantic” or safe environment is not maintained? Like bright hospital lights, observation, and strangers. Well, our brains interpret these conditions as threats and our “fight or flight” response is triggered by the stress hormone Adrenalin. This is a primal instinct designed to stall labour to allow us to move to a safer environment to birth our baby. And this is where it gets tricky…..

As the “fight or flight” response is triggered, a labouring woman will experience the physical effects of fear – her muscles will tense up and her breathing will become shallow. This in-turn will cause her to feel more pain, as she is not relaxed. In a medicalised birth environment, a stall in labour along with increased pain for the mum will automatically cause care providers to show concern and thus increasing a woman’s fear that her body isn’t “functioning properly” or that something is terribly wrong. Adrenalin continues to pump, surges decrease and labour stalls or even stops for a period of time. And so the fear cycle begins.

So what can we deduce from the above? That the medicalisation of birth (bright lights, exams, clinical conditions), in part, causes fear, which causes the rising Adrenalin levels, which in turn causes complications that lead to medical intervention, thus normalising birth as a medical event. Or in other words, those who have only witnessed birth in a medical setting would see prolonged labours followed by medical intervention (synthetic Oxytocin, forceps, caesarean section) as common and normal. I was taught when I was younger that, when we are exposed to something repeatedly, we form a “callus” and stop being shocked or surprised by the behaviour. This is much the same. But being aware of this cycle, gives us the opportunity to avoid it, when we ourselves are in the birth suite.

This said, fear is a normal part of childbirth. Yes, you heard me correctly. Fear is actually normal. Most women experience a point in their labour where they feel out of control, frightened and overwhelmed. This is often referred to as ‘transition” and it is usually a sign that birth is close. These feelings of fear again trigger a rush of Adrenalin, and another category of hormones called catecholamines (CA’s) which give a woman the energy she needs to push her baby out. So experiencing fear during labour is not only normal, it is necessary. But it has its place and we would like it to stay firmly there. So below are some tips to help you keep the fear at bay.

  • Explore what is causing your fear of childbirth and talk it through with your care provider and / or support person.

  • During pregnancy, surround yourself with images and stories of empowered birthing mothers. Avoid the “stylized” images often portrayed in movies and television programs for dramatic effect.

  • Avoid listening to other women’s “horror stories”. Be honest and politely explain that each birth is different and you would prefer to write your own story.

  • Reinforce that it is ok if fear surfaces during birth. Don’t fear fear to the point of causing more fear. Cut yourself some slack and trust in your ability to birth your baby. If fear does come, you can accept it and deal with it.

  • Learn relaxation techniques to use during labour, such as visualisation, breathing, stamping, squeezing a stress ball, Hypnobirthing – whatever works for you.

  • Stay at home for as long as you feel comfortable to do so while in labour. Your familiar surroundings will help you to feel safe. Keep the lights low and the room quiet.

  • Studies show that having continuous support by a known midwife during childbirth greatly assists in making a mother feel safe and supported. Ask your hospital about being in a Continuity of Midwifery Carer program if you are not already.

  • If you are able to, choose a birthing environment you feel comfortable and safe in. Ask your birth team to minimize interruptions and examinations as much as possible.

So know that it is normal for every woman to experience some level of fear during labour and childbirth. Don’t pressure yourself to meet some idealistic image of the “perfect birthing goodness” – you are perfect just the way you are. However, if you feel that your fear is abnormal, talk to your care provider and support person so they can help you navigate your way through.

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