Fear Factor: Coping with the Worries of Pregnancy
By William Camann, M.D., and Kathryn Alexander, M.A.
For most people, stress is just a part of everyday modern life, but pregnant women often experience stress that is specifically associated with their pregnancy, on top of all of the other day-to-day stressors. Although pregnancy-related stress is very common, and very normal, it is understandably troubling to women, most of whom are striving to have a positive pregnancy and childbirth experience.
If you find yourself worrying about pregnancy, childbirth or impending parenthood, you may find it helpful to see how common these fears are and learn some ways to manage your fear and stress levels in anticipation of giving birth.
Managing Your Fears
If you are worried about labor pain: Prepare yourself by reading books on childbirth (since you are reading this now, you’ve already begun to use your coping skills). Investigate the childbirth preparation courses at your hospital or birth center. Talk about your concerns with your childbirth educator, your caregivers, your partner and other supportive people in your life. Let othersreassure you. Learn and practice relaxation techniques most suitable to you. They will help with your anxiety and can benefit you during labor. (See Know Your Options When It Comes to Labor Pain Medication)
If you are concerned about whether you will actually be able to “do it”: Since most births in the United States occur in a hospital setting, most women have never seen or been a part of another woman’s childbirth experience, and as a result many women have a hard time picturing how they will be able to meet this challenge. Childbirth does not require previous experience. The fact that you have not given birth before does not mean you will not know how to. If you are a first-time mom you may need reassurance that your body is designed to facilitate moving the baby from the comfort of your womb to the outside world.
If you are worried that there may be “something wrong” with your baby: Most babies are born without complications. Many women have had a variety of tests during their pregnancy that have already ruled out a number of significant complications. It may allay your fears to remember that you are giving birth in a setting where you are surrounded by professionals who are ready to handle any unforeseen complication.
If you worry about modesty or the possible loss of dignity: Most people don’t relish the idea of being completely exposed to a roomful of strangers, even if it is for the purpose of delivering a baby. Many women are concerned that their privacy or sense of modesty will not be respected, or that during the strain of labor they may be unable to “control” themselves and may behave in a way they would not under ordinary circumstances. It may be hard to believe right now, but as labor gets under way, you may find that you worry a lot less over issues of modesty, and your very desire to stay “in control” may change significantly as you adjust to the physical demands of labor and delivery. Ask your caregivers about this. They will most likely tell you they have seen and heard it all while supporting women during childbirth. (See 10 Things Every Mom-to-Be Should Know)
This is not to minimize the importance of having your privacy respected or of needing a sense of control over your own childbirth process, but if you are giving birth in an environment where the labor professionals are attentive to the needs and concerns of birthing mothers, these worries will likely subside once you begin labor.If you are fearful of injury to your body during childbirth: Your body is capable of giving birth, and the pain most women experience during childbirth does not mean something is wrong. This, however, does not suggest that you therefore must tolerate the pain, but you do not need to fear that it is an indicator of anything other than the process of labor.
Some women are specifically worried over the possibility of having an episiotomy (a surgical cut from the vagina to the rectum) during birth. The trend toward giving women routine episiotomies is changing in most hospitals. Physicians are taking a more conservative approach to this procedure, due to an increased recognition that episiotomies can result in a far more painful recovery period for women and, in some cases, may be associated with more tissue and muscle damage than the vaginal tear it was meant to prevent.
Physicians and midwives can use various methods to avoid an episiotomy. Encouraging women to assume a sitting or side-lying position, or to get into a hands-and-knees position, can help them avoid overdistension (tearing) of the perineum (vaginal and rectal area). Other techniques used to avoid an episiotomy include prenatal massage of the perineal area, controlled and slow delivery of the baby, and perineal support and massage with the use of warm compresses treated with nonfragrant oil as the baby is born.
If you have concerns about the possibility of an emergency Cesarean delivery: Find out your hospital’s C-section rate. Is it at or below average? (The national average is currently approximately 25 percent of all births.) If your physician or hospital handles a large number of women who are considered high risk, the Cesarean rate may be higher than average. Ask what your particular physician’s C-section rate is and factor this in when determining where to give birth and with whom.
If you have a fear of dying during childbirth: Fortunately, the U.S. maternal mortality rate is significantly lower than that of most of the rest of the world. In the last century, the risk of death from complications for pregnant women has decreased by nearly 99 percent.
What You Can Do
Speak up. You may feel uncomfortable at the thought of talking openly about your fears of childbirth with your caregivers. Sometimes women experience a sense of shame about their own negative feelings toward childbirth and are reluctant to reveal these feelings to others. If your physician or caregiver has not specifically addressed how you may be feeling regarding the pain involved in labor and delivery, you may have to raise this issue yourself. We encourage you not to conceal your fears from your doctor and caregivers; instead, talk honestly and openly about these emotions.
You may also find it reassuring to arrange a meeting with an anesthesiologist. He or she will be able to inform you of the medical options that are available for pain relief during the various stages of labor, and can describe how you will be involved in the decision-making process. If your preference is to avoid the use of drugs, you may take comfort in contacting other women who have had a medication-free birth. Ask them about the pain-management techniques they used and how they managed to cope with their own labor pain.
Listen to other women who you trust to give you a realistic account of their labor experience, what they found effective for pain relief, and how they dealt with their fears and anxieties before and during childbirth. We often hear of difficult birth experiences referred to as “horror stories,” and some people feel it is impolite or inappropriate to reveal graphic details of the pain they may have endured during childbirth. But to dismiss a woman’s account of her difficult labor and delivery as a horror story does not honor her birth experience.
One woman’s description of her difficult birth may, in fact, be your opportunity to prepare yourself by gathering information from your caregivers about all of the safe options for pain relief available to you prior to your own childbirth experience. It may also provide you with the knowledge you need in order to have a dialogue with your physician or caregivers regarding various complications that may arise and how they would handle them in a worst-case-scenario situation.
Keep in mind that some women’s reports of disappointing birth experiences are based on the difficulty they had with caregivers who did not offer appropriate “alternative” pain-management interventions and were resistant to the laboring woman’s preference to avoid epidural and narcotic interventions.
Hearing from other women about their impressions, fears, emotions, sensations and pain provides you with information and a perspective that will allow you to work with your physician and caregivers to prepare for your own unique and satisfying childbirth expérience.
Visit the hospital or birth center. Many hospitals and birth centers encourage women to tour the maternity unit or birthing suites prior to their due date. This is a good opportunity to see and hearwhat a maternity unit is all about before you get there.
During your tour you may see things that reassure you, or things that are foreign and possibly intimidating. This is why you are there! It is vital that you get a realistic view of what happens in your chosen facility to help you understand what it will be like when it is your time to give birth. If the tour itself raises any questions or contributes to your sense of anxiety, raise these specific concerns and work through them with your caregiver.
Seek professional help. If your physician or caregiver does not seem sympathetic or responsive to your concerns, or if you feel your fear and anxiety exceed what you normally experience during stressful life events, consider meeting with a different obstetric caregiver. A doula, midwife, obstetrician, social worker or psychologist can listen, provide encouragement and help you develop effective coping strategies to use during labor and delivery.
Remember, stress is a part of most major life events, even positive life events like a pregnancy. Fortunately, most women are able to adjust to the new stressors associated with their pregnancy.
More from Parenthood.com about CHILDBIRTH
This article, reprinted by arrangement with The Random House Publishing Group, is excerpted from the book Easy Labor: Every Woman’s Guide to Choosing Less Pain and More Joy During Childbirth, by William Camann, M.D., and Kathryn J. Alexander, M.A., Ballantine Books, 2006. For more information, see www.easylabor.net.
For most people, stress is just a part of everyday modern life, but pregnant women often experience stress that is specifically associated with their pregnancy, on top of all of the other day-to-day stressors. Although pregnancy-related stress is very common, and very normal, it is understandably troubling to women, most of whom are striving to have a positive pregnancy and childbirth experience.
If you find yourself worrying about pregnancy, childbirth or impending parenthood, you may find it helpful to see how common these fears are and learn some ways to manage your fear and stress levels in anticipation of giving birth.
Managing Your Fears
If you are worried about labor pain: Prepare yourself by reading books on childbirth (since you are reading this now, you’ve already begun to use your coping skills). Investigate the childbirth preparation courses at your hospital or birth center. Talk about your concerns with your childbirth educator, your caregivers, your partner and other supportive people in your life. Let othersreassure you. Learn and practice relaxation techniques most suitable to you. They will help with your anxiety and can benefit you during labor. (See Know Your Options When It Comes to Labor Pain Medication)
If you are concerned about whether you will actually be able to “do it”: Since most births in the United States occur in a hospital setting, most women have never seen or been a part of another woman’s childbirth experience, and as a result many women have a hard time picturing how they will be able to meet this challenge. Childbirth does not require previous experience. The fact that you have not given birth before does not mean you will not know how to. If you are a first-time mom you may need reassurance that your body is designed to facilitate moving the baby from the comfort of your womb to the outside world.
If you are worried that there may be “something wrong” with your baby: Most babies are born without complications. Many women have had a variety of tests during their pregnancy that have already ruled out a number of significant complications. It may allay your fears to remember that you are giving birth in a setting where you are surrounded by professionals who are ready to handle any unforeseen complication.
If you worry about modesty or the possible loss of dignity: Most people don’t relish the idea of being completely exposed to a roomful of strangers, even if it is for the purpose of delivering a baby. Many women are concerned that their privacy or sense of modesty will not be respected, or that during the strain of labor they may be unable to “control” themselves and may behave in a way they would not under ordinary circumstances. It may be hard to believe right now, but as labor gets under way, you may find that you worry a lot less over issues of modesty, and your very desire to stay “in control” may change significantly as you adjust to the physical demands of labor and delivery. Ask your caregivers about this. They will most likely tell you they have seen and heard it all while supporting women during childbirth. (See 10 Things Every Mom-to-Be Should Know)
This is not to minimize the importance of having your privacy respected or of needing a sense of control over your own childbirth process, but if you are giving birth in an environment where the labor professionals are attentive to the needs and concerns of birthing mothers, these worries will likely subside once you begin labor.If you are fearful of injury to your body during childbirth: Your body is capable of giving birth, and the pain most women experience during childbirth does not mean something is wrong. This, however, does not suggest that you therefore must tolerate the pain, but you do not need to fear that it is an indicator of anything other than the process of labor.
Some women are specifically worried over the possibility of having an episiotomy (a surgical cut from the vagina to the rectum) during birth. The trend toward giving women routine episiotomies is changing in most hospitals. Physicians are taking a more conservative approach to this procedure, due to an increased recognition that episiotomies can result in a far more painful recovery period for women and, in some cases, may be associated with more tissue and muscle damage than the vaginal tear it was meant to prevent.
Physicians and midwives can use various methods to avoid an episiotomy. Encouraging women to assume a sitting or side-lying position, or to get into a hands-and-knees position, can help them avoid overdistension (tearing) of the perineum (vaginal and rectal area). Other techniques used to avoid an episiotomy include prenatal massage of the perineal area, controlled and slow delivery of the baby, and perineal support and massage with the use of warm compresses treated with nonfragrant oil as the baby is born.
If you have concerns about the possibility of an emergency Cesarean delivery: Find out your hospital’s C-section rate. Is it at or below average? (The national average is currently approximately 25 percent of all births.) If your physician or hospital handles a large number of women who are considered high risk, the Cesarean rate may be higher than average. Ask what your particular physician’s C-section rate is and factor this in when determining where to give birth and with whom.
If you have a fear of dying during childbirth: Fortunately, the U.S. maternal mortality rate is significantly lower than that of most of the rest of the world. In the last century, the risk of death from complications for pregnant women has decreased by nearly 99 percent.
What You Can Do
Speak up. You may feel uncomfortable at the thought of talking openly about your fears of childbirth with your caregivers. Sometimes women experience a sense of shame about their own negative feelings toward childbirth and are reluctant to reveal these feelings to others. If your physician or caregiver has not specifically addressed how you may be feeling regarding the pain involved in labor and delivery, you may have to raise this issue yourself. We encourage you not to conceal your fears from your doctor and caregivers; instead, talk honestly and openly about these emotions.
You may also find it reassuring to arrange a meeting with an anesthesiologist. He or she will be able to inform you of the medical options that are available for pain relief during the various stages of labor, and can describe how you will be involved in the decision-making process. If your preference is to avoid the use of drugs, you may take comfort in contacting other women who have had a medication-free birth. Ask them about the pain-management techniques they used and how they managed to cope with their own labor pain.
Listen to other women who you trust to give you a realistic account of their labor experience, what they found effective for pain relief, and how they dealt with their fears and anxieties before and during childbirth. We often hear of difficult birth experiences referred to as “horror stories,” and some people feel it is impolite or inappropriate to reveal graphic details of the pain they may have endured during childbirth. But to dismiss a woman’s account of her difficult labor and delivery as a horror story does not honor her birth experience.
One woman’s description of her difficult birth may, in fact, be your opportunity to prepare yourself by gathering information from your caregivers about all of the safe options for pain relief available to you prior to your own childbirth experience. It may also provide you with the knowledge you need in order to have a dialogue with your physician or caregivers regarding various complications that may arise and how they would handle them in a worst-case-scenario situation.
Keep in mind that some women’s reports of disappointing birth experiences are based on the difficulty they had with caregivers who did not offer appropriate “alternative” pain-management interventions and were resistant to the laboring woman’s preference to avoid epidural and narcotic interventions.
Hearing from other women about their impressions, fears, emotions, sensations and pain provides you with information and a perspective that will allow you to work with your physician and caregivers to prepare for your own unique and satisfying childbirth expérience.
Visit the hospital or birth center. Many hospitals and birth centers encourage women to tour the maternity unit or birthing suites prior to their due date. This is a good opportunity to see and hearwhat a maternity unit is all about before you get there.
During your tour you may see things that reassure you, or things that are foreign and possibly intimidating. This is why you are there! It is vital that you get a realistic view of what happens in your chosen facility to help you understand what it will be like when it is your time to give birth. If the tour itself raises any questions or contributes to your sense of anxiety, raise these specific concerns and work through them with your caregiver.
Seek professional help. If your physician or caregiver does not seem sympathetic or responsive to your concerns, or if you feel your fear and anxiety exceed what you normally experience during stressful life events, consider meeting with a different obstetric caregiver. A doula, midwife, obstetrician, social worker or psychologist can listen, provide encouragement and help you develop effective coping strategies to use during labor and delivery.
Remember, stress is a part of most major life events, even positive life events like a pregnancy. Fortunately, most women are able to adjust to the new stressors associated with their pregnancy.
More from Parenthood.com about CHILDBIRTH
This article, reprinted by arrangement with The Random House Publishing Group, is excerpted from the book Easy Labor: Every Woman’s Guide to Choosing Less Pain and More Joy During Childbirth, by William Camann, M.D., and Kathryn J. Alexander, M.A., Ballantine Books, 2006. For more information, see www.easylabor.net.