Anxiety can influence a woman's experience during labor. I was quoted in this article regarding how stress and worry can impact a woman's delivery and how to manage their anxiety. by Rheyanne Weaver |
It’s common to fear to some extent painful experiences we aren’t familiar with yet, such as childbirth for soon-to-be mothers. However, a new study found in BJOG: An International Journal of Obstetrics and Gynaecologysuggests that women who fear childbirth tend to actually be in labor for longer than women who aren’t fearful of giving birth.
A news release on www.ScienceDaily.com stated that 2,206 women were included in the study. These women were only giving birth to one child vaginally, and 7.5% of these women were determined to be fearful of childbirth at 32 weeks into their pregnancy. The report estimated that between 5% and 20% of pregnant women generally fear childbirth.
For women who feared childbirth, the average labor time was about 1 hour and 32 minutes longer than in women without as much fear. When other factors were considered, the women with fear of childbirth still took 47 minutes longer for labor than women without the same amount of fear. Women who feared childbirth were also more likely to need intervention during labor, such as instrumental vaginal delivery and emergency Caesarean section. However, most women who feared childbirth were still able to have a successful vaginal delivery.
The study added that there are different factors that cause women to fear childbirth, such as having a baby for the first time, being a young mother, having little social support, having a history of abuse, and suffering from psychological issues. Other experts share their professional opinions on the causes of fear of childbirth and what women can do to decrease that fear.
Julie Hanks, a licensed clinical social worker, the owner and executive director of Wasatch Family Therapy, LLC, and a mother of four children, said in an email that she believes fear of childbirth is actually quite common in our society. “I think it is common for women to fear childbirth because it has become so medicalized in our society,” Hanks said. “Instead of viewing childbirth as a natural process that women’s bodies were created to do, it is viewed as a scary, painful, ‘out of control’ experience that needs medical intervention.”
She said that some women who have gone through specific painful experiences before might be more likely to have a fear of childbirth. “In my clinical practice I have seen a link between childhood sexual trauma and fear of childbirth,” Hanks said. “Since childbirth and sexual abuse involve the same organs, it is often emotionally tied together. Additionally, feelings of helplessness and of being controlled by a man may emerge during the childbirth process (often a male OB).”
General anxiety could also lead to fear of childbirth. “Certain mental illnesses, like anxiety disorders, may predispose certain women to anxiety about the childbirth process, especially with first-time moms,” she said.
The stories of other women who have had bad experiences with childbirth could also add to the fear for first-time moms. “Women may fear childbirth because of family stories surrounding their mother or sister’s childbirth experiences,” Hanks said. “Additionally, women tend to share their birth ‘horror stories’ more frequently than they share uncomplicated birth stories, playing into a cultural fear of childbirth. I think this can impact mental health in general.”
The whole concept of becoming a mother can bring up a lot of issues, not just childbirth itself. “Taking on the new role of becoming a mother is also emotionally loaded and may bring up a woman’s own fear of inadequacy and self-doubt about whether or not she will be able to provide the nurturing that this helpless baby requires,” Hanks said. “If a woman has emotional neglect, abuse, or other unresolved issues with her own mother, those ‘left over’ emotions may surface as a woman now faces becoming her mother.”
There are even more mental health issues that can be associated with pregnancy and childbirth. “Hormonal fluctuations may impact emotional health relating to childbirth,” Hanks said. “Also, family pressures, relatives coming into town to celebrate the birth of a new baby may add to the overall stress of childbirth experiences.”
If physical health is impacted, then mental health is also not far behind. “Eating disorders or distorted body image may play into mental health issues, anxiety, and obsessions around childbirth,” Hanks said. “The physical changes that often accompany pregnancy and childbirth are often frightening to women who have built their self-worth around their appearance.” Hanks shared her thoughts on helping women overcome any fear they may feel in relation to childbirth. She said, “I believe that a cultural shift in viewing childbirth as a normal, natural process that generally doesn’t require intervention would really help women embrace the process without fear. Also, sharing positive childbirth stories openly may help shift women’s views.”
Dr. Ingrid Rodia, an OB-GYN and associate professor of obstetrics and gynecology at Geffen School of Medicine at UCLA, said in an email that some women are more anxious in general, and others do have a higher risk in regard to childbirth, so these can both lead to issues with fear. She added that the most common fears women have in relation to childbirth are pain, concerns about the baby coming out “normal,” and concerns about surviving childbirth. “Women might fear childbirth because they are already overwhelmed and wonder how they are going to deal with the additional demands,” Rodi said. “Women who did not plan the pregnancy, and especially those who did not want to be pregnant, are particularly at risk for anxiety and depression. Those women with a pre-existing mood or anxiety disorder are at increased risk of anxiety and depression, not only during the pregnancy, but also post partum … Psychological issues before the pregnancy can lead to more fear of childbirth.”
Financial issues, a poor relationship with the father, and psychological issues can add to fear of childbirth as well. “Basically, in order to decrease the fear of childbirth, the pregnancy should be desired, the woman should feel financially and personally supported, and she should have medical and psychiatric problems identified and treated prior to pregnancy,” Rodi said.
Nerina Garcia-Arcement, a licensed clinical psychologist and clinical assistant professor at NYU School of Medicine, said in an email that pain and negativity associated with childbirth tends to be exaggerated in the media and among family and friends, adding to a fear of childbirth. “The media’s portrayal of childbirth with women screaming in agony makes it understandable why women might fear childbirth,” Garcia-Arcement said. “Rarely are stories of childbirth portrayed as calm and peaceful, where women are in control of the experience and the pain. Some women have heard negative stories of long and difficult labor from family and friends. If this is their first child, fear of the unknown is common. Women worry about what might happen, what might go wrong and how they will react to the pain of childbirth. This is an experience perceived as out of their control, which can be scary.”
Women who have mental disorders and have certain personality types might fear childbirth more than others. “Women that are already experiencing anxiety and depression symptoms prior to pregnancy are likely to have those symptoms exacerbated by things like a difficult pregnancy or worry about what to expect during childbirth,” Garcia-Arcement said. “Individuals that like to be in control of their experiences will likely worry about childbirth, an experience that cannot be dictated by a mother but can be managed.”
Women do have real concerns in regard to pregnancy, because each pregnancy and childbirth experience is different, and some women do require C-sections, endure more pain, and have complications with delivery, adding to that fear. However, Garcia-Arcement does have several tips for women who may fear an upcoming childbirth experience.
- Become informed about what will happen during labor and childbirth. She said, “Childbirth itself might not be within a woman’s control, but how she reacts to it is. Being informed can be empowering. Avoidance of what is feared will only make it worse. Becoming an informed consumer will help women feel they can make better choices during childbirth. Women ought to learn about what typical labor medical procedures and medications are used.”
- Choose the doctor or midwife who is right for you, and plan to use the hospital or birthing center that matches your beliefs about childbirth.
- Create a birth plan and discuss concerns and wishes with your medical provider. This is your baby and your body, so don’t be afraid to ask questions before and during labor.
- Learn how to use deep breathing techniques, muscle relaxation exercises, and imagery of a safe peaceful place to reduce anxiety.
- Plan to use distraction with positive self-care activities.
- Seek support from other women, whether in a group setting or online.