Labor Pain

Fear of Labor

One phrase I use more than any other is "Labor is a Mind Game." I want women to understand 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 specific challenge that faced them. Such a challenge may be a back-labor, policies that require them to be induced or a very long or 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 she was somehow deceived or 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 family members who were not prepared to handle their anxiety during labor. This fear may exhibit itself by the mother no longer voicing opinions or easily giving in to procedures she had felt strongly about avoiding.

Courage is not the absence of fear, but rather the judgment that something else is more important than fear.- Ambrose Redmoon

Learning how to handle the challenges of labor is what drives most women to childbirth classes. Labor and birth have become so separate from our lives, very few women have actually seen a birth before their first child is trying to be born. Because of this, a normal healthy concern to be as prepared as possible is helpful for childbirth. A healthy concern can be productive, encouraging you to make the healthiest decisions for yourself and your baby. Such concern is a motivator, moving you to do the things you should do.

Yet for some women, concern becomes an unproductive fear, paralyzing them from making decisions or enjoying the pregnancy. In addition to preventing proper preparation, such fears can cause problems during a labor. The female body is designed to stop labor in unsafe situations, and the mother being in a heightened state of fear is a trigger for stopping labor.

Overcoming Fear Before Labor Begins

There are some things you can do now to help you overcome a fear of labor. Choose the tools you think will work best for you and work on them for a week or two. Then consider your fear again, do you need to make more changes or do more work to overcome your fears? Take the time to investigate any fear you have. Overcoming the fear of labor is the first step towards a natural birth.

Attitude:

Your attitude has to do with how you think about labor and your feelings about the process of childbirth. To begin, stop thinking of labor as something that happens to you. Laboring is something you do to give birth to your child. The process of labor is run completely by your body - it is your uterine muscle contracting; your body is creating that powerful sensation. Don't fight the work of your body, let it happen and work with it to the best of your ability. You may not be in control of the process of labor, but you have many options for ways to respond and through your response you can impact the way your labor is progressing. Consider your attitudes about childbirth. Ask yourself where they came from, why do you feel the way your do? The figure out what you need to do to get your attitude right.

Education:

Many times fear is caused by uncertainty, other times it is caused by misinformation. Learning what to expect from a normal labor can help reduce those fears. Learn to tell the difference between what is normal and what is not normal. Learn about the options you have, including their potential benefits and risks. Learn some techniques to handle the parts of labor you are most concerned about.

Support:

You may find yourself less frightened if you know you will not be alone during labor. Choose caregivers and attendants who will remain with you the birth process. Make sure everyone invited to your labor is supportive of the choices you have made. Surround yourself with people who provide emotional support and encouragement now, and find a way to end any discouraging or hurtful relationships you may have (either by confronting the person or avoiding if necessary). You may also want to look into hiring a doula to help you with labor.

Realistic Expectations:

Pregnant women are often the unwilling audience for women who want to complain about their labor horror stories, or extole the virtues of a specific method for removing all pain from childbirth. Although the intent to educate you is appreciated, make sure you keep your expectations of labor realistic even if that means not listening to every story you are told. Do your own research and choose options that are likely to provide the amount of relief you are likely to need during labor.

Take Control:

Just as labor is not something that just happens to you, labor is not something that is done to you. Today a pregnant woman has many options for the way she handles labor. Find out what options are available in your local community and select caregivers and a birth place with the options you want. Use a birth plan to work with your caregivers to make the best decisions possible before labor begins, and continue the working relationship in labor. Be a part of the decision making, selecting carefully how you handle unexpected situations.

Overcoming 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.