Overcoming Childbirth Fears

by Barbara L. Behrmann, Ph.D.

Which statement most accurately describes your feelings about giving birth?

  • Why bother with labor at all? I'd rather have a scheduled C-section.
  • I'm terrified. Thank god for drugs! I want(ed) an epidural as soon as I feel (felt) that first contraction.
  • I'd like to try for a natural birth, but I will trust my doctor or midwife's judgment about what is best.
  • I trust my body to do what it was designed to do and am ready to embrace the experience even though it might hurt.

Overcoming fear of childbirthIf you're afraid of giving birth, you're not alone. In fact fear seems to permeate the culture of birth today. The mere fact that in the U.S. almost 1 in 3 women give birth via major abdominal surgery sends the message that our bodies may well be defective, that they are unable to do what they used to do naturally. And it's not that C-sections have improved overall outcomes. They haven't.

For decades, women in the U.S. have given birth in a culture that promotes insecurity and plays on our fears. We have been conditioned to believe that birth is something that happens to us, not something we actively do. For over 50 years, asserts Marsden Wagner, a neonataologist, perinatal epidemiologist, and former director of Women's and Children's Health for the World Health Organization, women have been told how dangerous and terrible childbirth is. "Doctors convince women that their bodies don't work. This insecurity then carries over into breastfeeding. If we can't trust our bodies during childbirth, how can we expect them to adequately feed a baby?

A fear of pain is huge. But there is good pain and bad pain. Psychologist and doula Lauren Korfine compares giving birth to running a race. You reach a point where you don't think you can go anymore. You're exhausted, your legs are aching and you're gasping for breath. If someone were to drive up and say, Hey, you're in pain. You're out of breath. Hop in the car and I'll drive you to the finish line. You'll still finish the race, but without any more discomfort, would you do it? Perhaps. But would you feel the same sense of accomplishment? The same rush? The euphoria? Not likely.

Let's extend that analogy. Back up and resume the race. Think about how it would feel if people surrounded you with criticism. You're crazy! they tell you. What are you trying to prove? You can't finish the race. Just get in the car! But you don't want to and you continue running. Only you can't stop for a drink of water and you can only run at one pace. You can't slow down or speed up. And the folks around you say, If you don't get in the car you run the risk of hurting yourself. In fact, you may not be able to run another race. As the pressure mounts, that car begins to look more appealing after all.

Now, let's replay the scenario. You're back in the race but the people around you are cheering you on. They are there to boost your confidence, help you achieve what you have been preparing for all along. If you're thirsty, they give you water. If you have a cramp, they give you a quick massage. If you need someone to lean on, they support you. And all the while they never lose faith in your natural ability to cross that finish line. In fact, only in rare cases is there even a car there as a back-up. Are you more likely to finish the race and feel triumphant? You bet.

Substitute the process of giving birth for running a marathon and you get a new way of thinking about pain, a new way of thinking about how people at your birth can either support or undermine you.

The common phrase used in hospitals today is "active management of birth." This means that instead of supporting the natural process of labor, your cervix is supposed to dilate at a certain rate, and if it doesn't, you will begin to receive interventions designed to speed things along.

But one intervention typically leads to another -- a cascade effect -- and before you know it you may experience pain that is harder to cope with, your contractions may become less effective, and the stress you feel elevates your adrenaline levels which suppresses the production of natural oxytocin, a hormone that actually helps you cope with labor. And your baby experiences the stress, too. All of these factors contribute to the skyrocketing C-section rate we're seeing today

But if you labor within an environment in which birth is treated as a natural and healthy process rather than a medical crisis (though at times, of course, such crises do arise) your body is allowed to do what it is meant to do. And both you and your baby will benefit.

If you're afraid of giving birth, or if you are putting all of your trust into your health care provider, remember that you have a say in what happens to you. Consider reading about different ways of approaching birth. Where you give birth (in a hospital, birth center, or at home) and with whom you give birth (an obstetrician, a family physician, a nurse-midwife, or a trained home-birth midwife) can have a huge impact on what happens to you during your birth, how you feel about yourself and the experience, and the well-being of your baby. It can also affect your future birth choices as hospital protocol is making it harder and harder for a woman to have a vaginal birth (vbac) after having had a previous C-section.

Remember the words of this mother in Colorado, who, in reflecting about the messages she received growing up, says: Never did I hear that birthing is empowering, that it takes strength, that a woman's body is beautiful and resilient. Never did I hear anything about breastfeeding, that a woman's ability to produce this incredible liquid is miraculous and should be honored and revered. We can pump iron and build up our muscles, but the strength of our bodies and the unique things a woman's body does aren't acknowledged. But after birthing and nursing two children, she adds, Birth and breastfeeding have empowered me in ways that no career or educational experience has done. Giving birth taught me that my body has a wisdom all its own and has strength and resilience.

So does yours.

Barbara L. Behrmann, Ph.D. is a writer, researcher, and author of The Breastfeeding Café: Mothers Share the Joys, Secrets & Challenges of Nursing, University of Michigan Press, 2005. She is a frequent speaker around the country and is available for talks, readings, and conducting birthing and breastfeeding writing circles. The mother of two formerly breastfed children, Barbara lives in upstate New York. Visit her website for more information.

Copyright © Barbara L Behrmann. Permission to republish granted to Pregnancy.org.