Fear, childbirth and overcoming it
Switch on the television, you will see how birth is depicted. Suddenly a woman drops her shopping and yells ‘the baby’s coming’ all of a sudden. Its then all systems go as she suddenly starts panting, waters break all over the floor, the poor father is flapping around trying to find his car keys and they barely make it to hospital in time before the poor mother screams and strains her baby out through sweat and tears. How do we overcome fear in childbirth?
This is how the majority perceive childbirth, however neither Aristotle nor Hippocrates who were early leaders in general medicine many centuries ago, wrote of pain and hysteria during natural uncomplicated childbirth. In fact Aristotle wrote of the mind-body connection and emphasized deep relaxation during childbirth. Over time this attitude towards birth has slowly changed and as we enter a society that is becoming more and more medicalised, unfortunately so is childbirth.
Negative Birth Stories
Everyone has a birth story to tell and most stories you will hear of heard of are horrendous negative stories of 5 day labours, emergency caesareans and 100’s of stitches. Why don’t you hear of the wonderful straightforward births so much? It is the nature of human beings to create an exciting story. Discussing normal straightforward birth is boring because it’s well…… normal. I have a sister who has recently had a baby. When she was around 21 weeks pregnant and she was advised by a friend to just opt for an epidural, a strong opiate mixed anaesthetic that is injected into the spine. Her friend was giving advice based on her own bad experience. This is the type of advice pregnant women are hearing all the time, albeit with good intentions.
In the early 19th century, women feared dying in childbirth. Women died from unsanitary conditions in hospitals and complications arising from long labours. Long labours potentially caused by the sympathetic nervous system. Ultimately fear causes adrenaline to be released to prepare muscles to jump into action incase of a need to fight or run. In labour this is useless and just hinders the production of the hormone oxytocin which is needed by the uterus to contract effectively. Subsequently labour slows down or stops. This is usually the case when you get the so called 5 day labour. As time has evolved, medicine has too and is great for those who genuinely need it when real complications arise during or after birth. The problem is that some interventions are being performed unnecessarily and are actually causing problems rather than solving them!
Fear Tension Pain
In the current day is the misconception that childbirth must bring awful pain that instils fear into many women complicating their births. This is called the ‘Fear-tension-pain’ theory. So who exactly started the theory about ‘Fear-Tension-Pain’?
In 1913 on one dark and bitterly cold night, a young medical intern cycled resolutely through the mud and sleet of the east end slums of London’s White Chapel district. At around three o’clock in the morning, he arrived at a lowly hovel near some railway arches. He found his way to a small, dingy apartment where his patient was lying, covered only with sack cloths and an old black skirt. He asked permission to put the mask over her face and perform chloroform. Her empathetic refusal took him by surprise. He stood back and watched as she birthed her baby with little more than gentle breathing. When he asked why she refused the chloroform, she answered these words that will remain with him: “It didn’t hurt. It wasn’t supposed to, was it Doctor?”(Summarised from Mongan, 2005)
The year was 1913, and the name of the intern was Dr. Grantly Dick-Read. This incident made a huge impact on Dr. Dick-Read, and after observing similar cases of seemingly painless, natural child-birth, he decided to investigate the matter. Over time it became apparent to him that the answer lay not in what these women brought to their labours, but rather what they didn’t bring, namely fear.
We must bear in mind the nervous system and how it’s closely connected to the body’s ability to birth with ease or hindrance.
The Automatic Nervous System
The Autonomic Nervous System (ANS) is the body’s communication network, and functions on impulses that are not under our conscious control, and therefore involuntary reactions. ANS is divided into two subsidiary systems, namely the
The Sympathetic system is triggered when we are frightened and stressed. This system that causes the ‘fight, flight or freeze’ reaction in the body. When it is in motion, the pupils dilate, the heart rate increases, and the body goes on defence. Activities such as digestion get suspended. Most important, it closes the arteries to the organs that are not essential for defence such as the uterus. This is a result of adrenalin being released in preparation for fight or flight.
The Parasympathetic system keeps the body in a state of harmony and balance. This system maintains the body functioning in a state of calm, slowing the heart rate, reducing stimulation, allowing the body to release endorphins, the body’s natural pain reliever and oxytocin needed to help the uterine muscles tighten, and generally keeps us in a state of well-being.
So what can be done to overcome these fears and work toward a positive birthing experience?
Here are some suggestions:
- Rest and focus on your baby. It’s good for you and your baby if you can relax, so don’t feel guilty about it
- Talk about it.
- Eat well.
- Take exercise such as walking, swimming or yoga
- Prepare for birth
- Complementary therapies
- Birth Affirmations
- If people around you speak negatively of birth, remind them that you are pregnant and would only like to hear positive things!
- Yoga, swimming, gentle exercise and a healthy diet. This is physical and mental preparation. When you are confident your body is healthy and strong, this will prepare you better and give you more confidence in your body’s ability to birth well.
- Birth relaxation and hypnosis are well renowned for teaching amazing techniques to ease the birth process. See Http://www.nowbabylive.co.uk for more info.
Knowing your midwife. Having a midwife you know and trust has been shown to have higher positive birth outcomes. Unfortunately this is not something offered by all NHS trusts
Remember, the type of birth you experience is usually dependent on three factors (outside of medical anomalies that may occur during pregnancy)
Generally the more children you have birthed naturally, the more likely it is for you to have a quick, smoother delivery. Second and subsequent time mothers are usually more relaxed as they know what to expect.
The position of the baby
The baby’s head should be in a flexed position for an optimal birth. If the baby’s head is in an odd position, this can cause a prolonged labour and may even cause interventions.
Women who are fearful and anxious during their pregnancy may stall going into labour. Fear & anxiety during labour can prolong the process.
Read more about the NHS guidance on complementary therapies in pregnancy here: https://www.nhs.uk/chq/pages/957.aspx?categoryid=73&subcategoryid=107