Fear of childbirth has become a modern day epidemic amongst pregnant women.
More than ever, women are frightened about birth and what ‘might’ possibly go wrong. Childbirth is a natural, normal, life changing event and while sometimes intervention may be required in order for a safe outcome for you and/or your baby, birth is not automatically a medical event the moment you fall pregnant.
If you were to ask a woman who is scared about giving birth as to why she feels that way, she’d probably tell you that she is simply worried things will go wrong, she wont cope during labour and birth will be a stressful event.
Given that this is a very common feeling amongst pregnant women, coupled with ever increasing intervention rates, something isn’t quite right. Perhaps it’s a reflection of the lack of support, education and exposure we have to pregnancy and birth – a far cry from our once communal ways when pregnancy, birth and breastfeeding were seen as a normal, everyday event. Or, perhaps it’s the way we care for pregnant women in this day and age in Australia – or a combination of all of these things.
With a caesarean rate amongst the highest in the world, we are the ones who need to do something about it. It’s important we find the right sources of support, information and education to give us the best chance at the best birth possible. Below are the 12 top fears in labour and some tips and reassurance to help deal with them.
Below are the ‘Top 12 Fears in Labour’, as collated from a discussion with BellyBelly Forum members.
All responses to the Top 12 Fears have been by written by Brenda Manning, MIPP (midwife in private practice) who has almost completed her PhD thesis on womens’ fears in labour.
#1: Episiotomy (Surgical Cut To The Perineum)
Routine episiotomy is now very unusual practice in hospitals. It is only usually done to hasten birth in an emergency. This is because the baby or mother are becoming distressed or the perineum is so tight that it is delaying the birth. If forceps/vacuum extraction is required to complete birth then it is usual to perform an episiotomy but not compulsory. As the mother, you must consent to any procedures carried out on you or your baby during labour or birth. If you do not give consent then the person performing the procedure are liable for assault. You can always just say NO!
#2: Loss Of Sexual Enjoyment Due To Episiotomy Or Tearing
There does seem to be a high incidence of women who experience pain during intercourse for months following perineal trauma requiring suturing. This is caused by many factors. We encourage women to speak to their Obstetrician, GP or Midwife in the early period (6 weeks following birth) if they experience problems as there are many ways they can be assisted. The longer the concern is left unaddressed, the harder it is to treat. The biggest hurdle is getting women to seek help with painful sexual issues, however help is very effective once sought.
#3: Death Of The Baby During Birth (Stillbirth)
Almost every mother has this fear at sometime in her pregnancy. It is a normal apprehensive response to the unknown in a situation beyond their control. A lot of women report vivid, sometimes distressing dreams during pregnancy; this is normal and not a negative thing. It is healthy to explore all possibilities, to discuss them with our partners and to think of how we’d cope with the outcome should it occur. Having thought our way through the possibilities prepares us for the event should it arise. When we dwell on the fear or become obsessed about it then we create a negative, stressful mindset. I would suggest consulting a psychologist to help put fears into perspective if they became overwhelming. But certainly some sort of anxiety is absolutely normal and not to be confused with a premonition.
According to the perinatal data collection unit in Victoria, in 2005-2006, there were 69,550 births. The percent of those births that resulted in a stillbirth was a low 0.52%. The chances of complications from unnecessary interventions is higher than this number.
#4: Accidental Bodily Function (Bowel/Bladder)
It is a completely normal thing to do when pushing out a baby, that whatever is in front of the babies head will need to come out first.
This is simple normal physiology. Should it happen, it wouldn’t bother the birth attendants one bit. However if it bothers you then go and sit on the toilet in the early pushing phase. Midwives usually suggest this anyway and it can help you greatly to just let go and bring the baby down if you aren’t worried about embarrassing yourself and or your partner.
#5: Having A C-Section
Unfortunately this is a very real fear’; Australia has one of the highest caesarean rates in the world at around 30% – one third of babies is now born via caesarean section. Having a good relationship with whomever is caring for you in labour helps reduce this rate greatly.
Those women who have a doula/birth attendant supporting them at birth have consistently been found to have 50% less caesarean sections, based on studies from around the world, due to the care and support they provide. Find out more about doulas here.
Being well informed and having an open line of communication with your care giver (Obstetrician, GP or Midwife) can reduce the need for surgical birth. Confidence in your own ability to give birth is also a huge help, we are designed for it!
#6: Forceps / Other Intervention
Sometimes consenting to intervention is a choice we must make. Being well informed and choosing your care-giver carefully so they will keep you informed of what is happening during your pregnancy, labour and birth will help. Knowledge is power. Ignorance just makes you vulnerable to emotional blackmail. When you have the facts you can make informed decisions, ask questions and understand the answers. Use the BRAIN'D technique to help you decide which interventions to consent to.
When an intervention is suggested to you ask:
- B – What are the Benefits of this procedure?
- R – What are the Risks of this procedure?
- A – What are the Alternatives to this treatment/procedure?
- I – What does my Intuition say?
- N – What will happen if I choose to do Nothing?
- D – Can we please have some privacy to make a Decision
This is a very logical and helpful process to work through to help you decide whether or not the intervention recommended is right for you.
#7: Meconium Complications
Meconium in the amniotic waters around the baby is not always troublesome. If your carer detects its presence during labour s/he will look at the big picture (all that is going on) and then act appropriately on it. It is very important to notify your birth attendant if your waters break and the fluid is anything other than clear. You have no control over the presence of meconium, therefore there is nothing you can do except to alert your care giver/midwife of its presence and then discuss the options.
#8: Cord Around Baby’s Neck
A high percentage of babies have their cords loosely looped about their bodies somewhere. They play ‘skippy’ in there with it and use it in dress-ups as a scarf! It rarely causes any problems. On the occasion that it is so tight it is causing the baby distress whomever is caring for you will likely detect its presence. Together you then make decisions about how best to deal with the situation.
#9: Premature Birth
Premature birth can be prevented in some cases if help is sought early enough. In other cases it is inevitable. There is no blame attached to your baby being born too early in any situation. Some medical conditions imitate labour (urinary tract infections, kidney infections) and once they are treated the contractions stop. Sometimes we can stop contractions with medication if the labour is in its early stages. Sometimes we can’t. Be reassured that prem infants do very well in this present day with the high quality intensive care we have available in Australia.
Any contractions, loss of blood or fluid from the vagina, unusual backache or abdominal pain should be checked by your caregiver.
It is helpful if pregnant women can to revise their learned perception of pain. They can alter how they address it by simply remembering that the pain of childbirth is not the pain of injury. There is no damage being caused by the contractions, it is just muscles working really hard to stretch and open for a baby to be born. This is an easy concept to grasp once you cease to think of birth as being an illness. It is a state of health and birth is a normal physical process. There are always methods of pain relief available for women who require them. Choose the people who surround you in birthing carefully, they will support and help you whenever you feel overwhelmed. Positive, loving people in a calm, comfortable environment make a huge difference to how you cope with pain. There are always methods of pain relief available if you request them. Also look at getting a doula – many studies show that couples who use a doula request much less pain relief (and have much less intervention including 50% less caesareans) due to the support and help they have from someone trained and experienced, supporting them continuously, external to the hospital.
#11: Not Knowing What To Do If Something Goes Wrong
Being well informed through reading and research helps you to deal with any unexpected events. Trusting the people caring for you is vital, making your needs, feelings and beliefs known to them is very important. Once you have a good rapport established with your care providers you will be able to trust them to do the right thing for you if things are not going as planned.
#12: Not Making It To The Hospital In Time
This rarely happens with first babies, almost never in fact, unless the woman chooses to delay going to the hospital for reasons she is unable or unwilling to reveal. In fact, according to the Peri-Natal Data Statistics Collection in Victoria, 0.4% of births are BBA – born before arrival. So you have around 99.6% chance of making it in time.
It is more common in subsequent births to be ‘caught short’. These births are almost always uncomplicated and proceed normally. There is no cause for alarm because all will be well if everyone remains calm. There are many books and websites where you can read up on emergency birth. If you have quick labours it is probably a good idea to be prepared.
For a woman to receive the best care in labour she needs three things.
CONTINUOUS support from someone who is EXPERIENCED in birth and KNOWN TO HER. Unless you have your own private birth support, this is not going to happen in a hospital.
An Obstetrician is experienced and known to her, yet he/she cannot provide continuous care in labour. They generally do not attend unless there is a complication, and are called in when the birth is impending (and may even still miss the birth if they are busy).
A hospital midwife is also experienced but is not likely to be known to her due to rotating shifts and not having met before, and she/he cannot provide continuous care in labour. They will need to leave to assist other women or take breaks.
A woman’s partner is known to her, can provide continuous care, but is not experienced in birth.
Therefore, it is a great idea to hire your own doula/birth attendant or independent midwife. The studies speak for themselves for the emotional, physical and physiological benefits to mother, father and baby, and the percent difference is significant.