Fear of Labor
One phrase that I repeat to my students more than any other is "Labor is a Mind Game." I want them to walk away from my class understanding that their attitude, what they think and feel about what is happening to them, has a tremendous impact on how they labor.
Dr. Grantley Dick-Read was the first to write about the connection between a woman's thoughts and her ability to labor unhindered. He coined the term Fear-Tension-Pain Cycle to describe the overwhelming impact fear can have on a labor.
Many women and educators understand that fear of pain in labor can hinder a woman, but what is often overlooked is the fear that can occur after labor starts. A mother who is not afraid of the pain of labor or the labor process may still struggle with fear during labor.
What fears come up in labor?
Is my baby ok?
When there is an unexpected situation, most mothers' first thought is about the safety of the baby. In some instances, the fear is based on actual concerns about the welfare of the baby, but in others it is simply a misunderstanding on the part of the mother. A discouraging look or comment from a health care provider can easily be seen as an indication that the baby is not doing well.
A mother who fears for the safety of her baby may become panicked and suddenly seem to have lost her focus. Some mothers who are concerned for the safety of their baby appear to be laboring well, relaxing and working with their contractions. Yet their thoughts are doom, gloom and problems they believe are happening.
This isn't what I expected!
Some mothers who thought they were prepared for labor were not adequately prepared for a challenge that faced them. Such a challenge may be a back-labor, policies that require them to be induced or a very long or intense and short labor. When a mother feels that she was not adequately prepared for the reality of labor, she may begin to be fearful of what lies ahead for her during labor. She may begin to give up, feeling that she was somehow deceived or that she was not as strong as she thought.
Nobody's listening to me!
A mother who feels that she is does not have any control over what is happening to her may begin to feel fearful. She may have tried to explain how she wanted things handled to a less than receptive caregiver, or she may have been caught off-guard by orders given by her health care provider. This fear may exhibit itself by the mother no longer voicing opinions or easily giving in to procedures and interventions she had felt strongly about avoiding.
How can you overcome fear during labor?
Begin by assessing the situation. What recently happened that may have affected the mother. What has changed, who has she spoken with?
Once you understand what the mother may be struggling with, begin reassuring her and encouraging her in the opposite direction. Unless her fear is based in the reality of failing health in the baby, tell her the truth about the situation to help her overcome her fears. (She should still be told the truth if the baby's health is failing, however this will not help her to overcome her fears. In this case, it may be impossible to overcome her fears.)
Don't try to "reason her out of it." She doesn't have the energy to argue with you. Simply offer her a different way of seeing things.
For example, if the mother is accepting procedures she didn't want, remind her about her birth plans. Ask her if she gave a copy to the nurse and remind her that she has the option to accept or refuse any treatment. Remind her of her options. Give her ways to regain control such as telling the nurse when she is ready instead of waiting for the nurse to say it is time.
By paying attention to the mother's mental state, the labor support person can help even the most prepared mother overcome the challenges of fear in labor.