If you’re pregnant, you may have typed these words into your favourite search engine: ‘scared of giving birth’.
Most women at some stage will admit to having some or many fears about giving birth, especially for the first time.
Some women are so worried about birth that it interferes with enjoying their pregnancy.
It is estimated around 10% of women suffer intense fear of birth (tokophobia) and experts say the number is growing.
What do we have to fear about birth?
Why Do We Fear Birth?
There is a commonly held belief that birth is dangerous and we’re lucky to have access to medical assistance, because in the old days ‘women died all the time’.
Many women did die during childbirth, but it wasn’t due to some fault of their bodies. Poor health due to lack of nutrition and hygiene were often the main culprits. Childbed fever killed many mothers until it was discovered in the late 1800s that doctors were responsible, due to not washing their hands between patients (even dead ones – eek!).
You can read more about why so many women used to die in childbirth here.
In the last few hundred years, birth has moved out of the home and into the hospital. Medical intervention is the norm, even for women having healthy pregnancies and babies. Interventions are favoured over normal labour and birth. Well known birth educator and advocate, Rhea Dempsey, calls this the ‘labour bypass era’.
TV shows such as One Born Every Minute are popular but they often depict birth happening in a highly dramatic fashion. Women screaming in pain, flat on their backs with legs in stirrups, pushing until they are purple and then the doctor runs in and saves the day. “Thank goodness for hospitals and doctors!” the new parents exclaim – as do the shocked, wide-eyed viewers at home.
Most births reported in the media are shown simply for their shock value. If it wasn’t shocking and dramatic, the viewers wouldn’t be hooked on watching it (on the edge of their seats, of course). Women having babies in the car, in the backs of ambulances, at the shopping centre – the focus is on how extraordinary it is a woman gave birth without any medical assistance and how scary it must’ve been.
Even family and friends contribute to a woman’s fear of birth. If a child’s mother experienced birth as traumatic, she is likely to grow up believing this to be normal for birth. Horror stories from friends and online sources can increase fear because they over-emphasise the pain and drama of birth.
A previous experience of birth ending in intervention or trauma can also heighten fear about any future births. This is especially true if a woman experienced hostility or lack of support from her care providers.
What Is Fear of Birth Doing To Women?
Is it any surprise so many women are scared of giving birth in a culture where birth is still considered the most painful and dangerous thing ever?
Women who are fearful about labour and birth often say they would far rather be knocked out than go through a natural birth.
A 2012 study from Sweden found that women who feared birth were more likely to ask for and to have a c-section.
Fear increases our perception of pain. The same study from Sweden found women who feared birth rated their labour pain as more intense than women who weren’t afraid – even with use of pain medication. When we are in a fearful state, our bodies release stress hormones and these can alter the way labour progresses, and causes tension in our muscles. These ‘fight or flight’ responses increase the pain we feel.
Fear can also increase the length of labour.
A study published in the journal BMJ Open found fear of birth was associated with an increase in postpartum depression (PPD). Women who had no history of PPD were 3 times more at risk and those with known depression were 5 times more likely to experience PPD.
Some women experience physical symptoms of fear during pregnancy, such as nightmares, heart palpitations, dizziness, shortness of breath, a racing pulse and difficulty concentrating.
These symptoms and ongoing stress during pregnancy can contribute to insomnia, poor eating habits, headaches, high blood pressure and lowered immunity.
Women with very high levels of stress during pregnancy are more likely to schedule medically unnecessary inductions or c-sections as well as experience labour complications, such as premature birth and low birthweight babies.
Should We Be Scared Of Birth?
In a few hundred years we have gone from believing birth is a natural event in a woman’s life to fearing it like an incurable disease.
Women are so frightened by what they have been told or led to believe, they are more likely to accept interventions during labour.
This leads to having the birth experience they feared and expected.
Most likely the next time they give birth, they will have few expectations it can be any different.
Birth Support Reduces Fear
Research shows us women who have continuity of care from known midwives are more likely to have positive and satisfying birth experiences, with fewer interventions.
Having the same midwife or group of midwives during pregnancy and birth gives you the chance to develop trust in the person caring for you. You can discuss your fears and work through how to manage these fears. Your role as the key decision maker is respected and you can feel more in control during labour.
Most women give birth in hospital settings and experience what is known as shared care. Shared care means seeing a different midwife or doctor at each appointment. During labour you arrive at hospital and don’t know the staff who are assigned to care for you.
In countries where women have few choices for care or access obstetric care, interventions are likely to be higher and this helps to further the belief birth is dangerous and medical assistance is a must.
Birth Preparation Removes Fear Of The Unknown
Birth education is often provided through hospitals and tends to focus on what you will be allowed to do and not to do. There is little attention on preparing women for normal birth, rather the information is based on what can go wrong and how it can be ‘fixed’.
Independent birth classes can help provide women with information about normal birth, and about the risks and benefits of procedures and interventions if they are needed. There is generally a focus on what informed consent is and how this applies to them in a birth setting.
Knowledge is very powerful for helping women to face their fears about birth. It can be daunting to try and imagine how you will feel in a situation if you’ve never experienced it before. But by being aware of the process of birth and how important other factors are, such as choice of birthplace and carer, you can dispel a lot of myths for yourself.
For most women, the excitement of being pregnant is mixed with feelings of fear and anxiety about labour. This is considered a normal part of the experience of birth yet each woman’s anxiety may centre on different aspects. The highly medicalised approach to birth is creating further fears which often lead women to feel extremely anxious about their birth options.
There are a number of ways you can reduce the fear of birth. Be as informed as possible about how to have an undisturbed labour and choose a care provider who supports birth as a normal and natural event.
Recommended Reading: Check out the book, Childbirth Without Fear by Grantly Dick-Read.