Tocophobia: The Fear of Childbirth

How does fear negatively affect birth? As we have all heard, the emotion of fear elicits the fight or flight response after a surge of adrenaline. Adrenaline, however, is directly opposed to the primary hormone of birth, oxytocin. If adrenaline is present in a woman's body, her labor will either not start, slow down or stop altogether.¹ Only one hormone can remain dominant in her system and if fear is allowed control, it will take intervention to keep her in labor. Studies also show that the emotion of fear can also result in fetal distress, which is one of the most common indications for assisted vaginal delivery and cesarean sections.²

What causes fear of childbirth? Most women are concerned about one aspect of birth or another, and sometimes of birth itself. The most common fears related to childbirth include pain, exposure, death, hospitals, the unknown, and the fear of not having continuous emotional support. Considering how little women are taught about the reality of birth before their first child, these fears are to be expected. In fact, they are considered natural. Let me tell you now, there is nothing natural about the fear of childbirth. If it was supposed to be that way, adrenaline and oxytocin would not be able to contradict each other. We were designed to give birth in an environment that helps us to relax and let go.

How do you prevent or remove fear from your life? The first step is recognize where fear is present in your mind. The answer may be obvious to you, or it may not. It would help to start writing in a journal about all your feelings concerning pregnancy, birth, parenting, babies, etc. Don't think about what you are writing, just write. Eventually, you may begin to see a pattern surfacing, specific concerns or fears that you don't know what to do about. At this point, it would help to speak to someone experienced in birth or in the type of fear you are experiencing. If your caregiver is pressed for time, schedule a visit with a birth doula, a birth counselor, or a therapist. Each of them can help you to discover a solution to your fear.

Most women who fear childbirth with a dread are given the option of an elective cesarean section. Because all major surgery comes with additional risks, if you fear childbirth you would benefit from trying these treatments first, and then preparing for "the C birth":

* Learn the facts. Women were designed to give birth, most complications that occur send prior warning and can be treated before a trajedy happens, and very few women die in childbirth (13 in 100,000 ³), with many of these happening because the women did not receive prenatal care. Read up on the basics of how birth works and what you can do to make it work efficiently and make it easier for you. Knowledge creates peace and preparedness, and will dispel any fears that you have made based upon misinformation.

* If you fear hospitals in general, planning a birth center birth or a homebirth with a trained midwife may be a good alternative for you. Schedule an interview with a midwife or birth center to discuss your options.

* As for pain, every woman has a different threshold. Knowing that pain medications are available to you if you need them can help to dispel the fear, but it will also help if you come prepared with natural pain relief techniques (such as water, massage, and positioning) that you can use before taking the pain medications.

* If you are afraid of having the hospital staff see you yelling, vomiting, being naked and perhaps having a bowel movement, the best reassurance is probably something you've heard before. Although this behavior is not typical of every day life, it is very normal for that of a birth attendant. Nothing you do will shock them or make them laugh. If you are still nervous, ask your husband or birth partner to try and keep you from being exposed unless necessary. You can also seek a care provider who embraces the raw power and feminine nature of birth, since they tend to make their patients feel more normal and their behavior more appropriate.

* If you experience slowed or stalled labor, it may be because someone new entered the room, a sudden noise or movement was made, or something else startled you. The adrenaline released causes the contractions to slow or stop in preparation to defend yourself. By simulating fighting off a predator, you can start your labor back up again. This is as easy as beating a pillow for several minutes.

* Listening to women talk about their positive birth experiences, reading about them, or viewing their pictures or videos are all good ways to prepare for the work of labor. They may inspire courage and create a sense of calmness about the upcoming birth.

* If you believe in God, having complete faith that He will provide everything you need to give birth, and remembering that, can encourage you to be strong.

The most important thing may be to not keep your fear to yourself. Talk to someone who can help you, your husband, family and friends may not be able to help, but an experienced mother, doula, birth counselor, midwife, or other therapist may be able to help you overcome your fear of birth. Do not be embarrassed by it, since very few women give birth in the United States without fear. It is a common feeling, but it is not necessary at birth, and in fact, birth would do much better without it.

Sources

1 - Gaskin, Ina May. "Ina May Gaskin's Guide to Childbirth" . New York: Bantam Books (2003)

2 - Wolf, Naomi. "Misconceptions". New York: Doubleday (2001)

3 - Stobbe, Mike. "Childbirth Death Rate Rises in U.S." Associated Press August 24, 2007In our day and age, there are so many different types of sources on information about childbirth that it is no wonder women can become flustered, confused, nervous, anxious, even fearful of childbirth itself. Few women witness a birth before their own time comes, and so their reference points on the challenge of labor is based on impersonal sources that women have difficulty trusting. They are left with questions unanswered, such as will I be able to handle the pain of contractions? Will I be left exposed to strangers? Or even, Will I die in birth? Most of society has ignored these conflicting feelings within women because regardless of their emotions, the baby will be delivered and the professionals will make sure everyone is healthy in the end, or at least that is the presumption. We now understand, however, that fear itself can have a negative impact on a woman's birth experience, and she will benefit greatly by learning to recognize her fears and to address them prior to labor.