Afraid of giving birth

During her pregnancy, Jen Parsons found that when she started thinking about her upcoming birth, certain labour possibilities made her feel anxious. “My biggest fear was that I would have to have a C-section,” the first-time Toronto mom recalls.

Imagining a cold, bright room where her baby was whisked away immediately, “definitely kept me up at night, and even brought me to tears a few times.”

When you’re expecting, it’s normal to feel some trepidation mixed with the excitement. “You’re scared before you go on your first date, you’re scared before you go to university — with any life change, there’s fear,” says Rivka Cymbalist, a doula in Montreal and author of The Birth Conspiracy. First-timers fear the unknown, while some moms expecting a second or third baby may be wary of reliving a particular moment from a previous birth.

That said, it’s worth paying attention to those fears, and taking steps to address them. For one thing, fear hormones can slow — even stall — contractions. And fear fuels anxiety, which, in turn, ramps up pain. “If you can break that cycle and try to approach labour from a place of confidence, you’re able to relax into the process, and it actually hurts less,” notes Elizabeth Brandeis, vice president of the Association of Ontario Midwives.

The question is, how do you do that? We asked moms in our Facebook community about their biggest concerns going into the birth of their first child. Here’s what worried them most, and strategies for getting past these fears.

Fear #1: I won't be able to cope with the pain

Learn about labour: A good childbirth class or discussions with a doula or midwife can help cast contractions in a new, more positive light: Think of the “good” pain runners get when their muscles are working hard. Believe it or not, pain can provide useful feedback during labour. “It actually lets your body know what you’re doing right,” Cymbalist explains. For example, if a woman feels a pain in her left side, she will naturally want to adjust her body to ease it, likely moving the baby into a more optimum position.

Explore pain management methods: It’s a good idea to investigate a variety of options, from warm baths and massages to the resources available in your local hospital. “Just knowing that you can have an epidural if the pain really turns out to be as bad as you fear can be very reassuring,” says Lee Saxell, a midwife, director of the South Community Birth Program and program lead for the Caesarean Task Force at BC Women’s Hospital in Vancouver.

Fear #2: I'll do something embarrassing during labour

Confide in your caregiver: “There’s literature that shows that just being listened to is helpful,” says Maya Hammer, a Toronto psychotherapist who specializes in perinatal mental health. As well, your health-care provider may be able to reassure you about how a particular situation is handled in the delivery room, or how unlikely it is to actually happen. For instance, many women are mortified by the possibility of pooping in front of everyone while pushing, but if that does happen, often one of the caregivers will discreetly cover the area so no one else can see. Or you might be surprised to learn how few women actually “lose it” and start screaming. (Too uncomfortable to raise the subject? That may be a warning sign you need to switch to a caregiver you’re more comfortable with, suggests Saxell. Open communication helps cultivate trust, which is a potent fear-fighter.)

Fear #3: I will have an unwanted intervention like an epidural or a C-section

Research risk-reducing strategies: Find out whether there are any evidence-backed measures for reducing your chances of undergoing the intervention you fear. For instance, some studies suggest that avoiding induction of labour unless there’s a pressing medical need lowers the odds of Caesarean section. Multiple studies have also linked the presence of a doula with a reduced likelihood of several interventions, including epidural, vacuum or forceps delivery, and Caesarean. Taking concrete steps to minimize your chance of having the intervention that worries you will help you feel more in control, which combats fear.

Meet the enemy: While it’s natural to shy away from even thinking about something you fear, finding out more about what’s really involved in a particular intervention can be more productive. You might even discover you were mistaken about some aspect you found especially disturbing — for example, if the possibility of being separated from your baby is what bothers you most about C-section, you might find you can have the baby placed on your chest immediately after birth. And the more familiar something becomes, the less scary it’s apt to be. Some childbirth educators, like Amanda Spakowski of the The Nesting Place in Toronto, have expectant parents act out certain scenarios: A mock C-section gives both partners a preview of how many people will be present in the O.R., and what each of them will be able to see during surgery.

In the end, Jen Parsons did have a C-section because her baby was breech. But by then, with the help of some of the above strategies, she’d robbed her fear of much of its power. Knowing her partner and midwife could be present during surgery made the prospect seem far less frightening. (And when the big day arrived, “It was a warm and personal experience,” she says.) What’s more, Parsons discovered her underlying fear — that surgery would keep her separated from her baby, and sabotage bonding and breastfeeding — was easily addressed. “My partner brought the baby to me right away, and placed him on my chest soon after he came out,” she says. “It was great.”

A version of this article appeared in our Today's Parent Pregnancy Winter 2012/2013 issue with the headline "What scares you?," pp. 42.

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