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A pregnant woman in a birthing pool holding hands with her partner

Keeping calm during labour

Probably every woman is a little afraid of childbirth – after all, if it is your first baby, you have the very natural ‘fear of the unknown’. Many worry about the health of their baby.

Nowadays, with so many tests carried out in pregnancy, most abnormalities are identified before birth, and the remainder are very, very rare. Very few babies now have any problems around the time of birth, and 7 out of every 10 of these are pre-term. So if you get to full term (37-42 weeks), the chances of your baby getting into difficulties are very, very low, particularly if you are cared for by a midwife or obstetrician during pregnancy. You can also reduce this risk by not smoking, and by eating healthy food and exercising regularly so that your weight gain is normal. That’s one anxiety that you can put out of your mind.

Some women are afraid of dying in pregnancy or labour. This is extremely rare in high income countries – about 6 out of every 100,000 births. When you realise that about half of these deaths are due to road traffic accidents, cancer, heart problems or suicide, you will realise that dying from actual pregnancy complications is extremely rare and is less than your chance of dying in a car accident in your lifetime.

Fear of the actual birth, however, affects all women at some stage and about 1 in every 10 women, in many countries across the world, have an intense fear of childbirth that interferes with their daily life. If you are so worried or anxious about childbirth that you wake up in the night, or have bad dreams about it, or constantly think about labour every day, then please talk to your midwife or obstetrician and ask for help. Women with such worry or anxiety can be helped by having talking therapies, as well as by working through the tips below. If you have had a traumatic experience in the past, this may be affecting how you feel about this pregnancy and birth, so please seek help now.

If you are one of the other 9 out of 10 women, who have varying levels of fear about childbirth, here are some tips to try:

  1. Remember your body knows what to do, your own oxytocin will make it all happen, and your job is to keep as calm as you can to let the oxytocin do its work. As oxytocin levels increase near the end of pregnancy, the hormone will calm and relax you so that, even if you are fearful now, you will feel better as time goes on.

  2. Perhaps you watched an ordinary woman, a bit like you, run a mini-marathon and thought ‘I could never do that!’ But if you talk to her, she will tell you how she thought that too, until she decided she wanted to run a mini-marathon and started training for it. You have taken the first step in preparing for birth by taking on this course, and the information and exercises you do during the course will help you to be ready for birth also.

  3. Set yourself the challenge of learning all you can about whatever makes you most afraid about childbirth. Is it fear of pain? Fear of losing control? Fear of damage to your body? Very often, once you face the fear and find out more information about it, you will see that this problem occurs very seldom, not usually to women like yourself, and is also manageable using some techniques or skills that you can learn. For example, you can learn about lots of ways to relieve pain in Steps 2.8, 2.9, 3.8, and 4.11, and you will learn how to avoid or minimise damage to your vagina during birth in Steps 4.12 and 5.6.

  4. Avoid listening to, or watching, scary birth stories or scenes. Many TV programmes on childbirth are sensationalised, as that makes good television. I remember watching one a few years ago that included lots of shots of women grimacing, moaning, shouting and crying during labour. All had forceps or caesarean section births. Then there was a three-minute piece showing a woman labouring quietly and calmly in a birthing pool, birthing her baby and turning quickly round in the water to hold and cuddle her baby. Even though one third to one half of all women have normal vaginal births, the television programme presented birth as a difficult and uncomfortable experience that required medical assistance. Watching programmes like this will only feed your fear and give you an unbalanced view of birth.

  5. Think about having a well-prepared birth partner who will support and care for you in labour. You might like to employ a ‘doula’ if you can afford it, or ask a friend or your partner to really study and learn about ways to help you. (See Steps 2.5 and 4.9 for more information).

  6. Learn relaxation or self-hypnosis as soon as you can and keep practising the techniques until they are second nature to you. In particular, use pain as a trigger to relax. Get a partner to squeeze your hand more and more strongly, while practising how to relax even more, the stronger the pressure is. Use your relaxation tapes or music when you are in labour. (See Steps 2.8, 2.9, 3.5 for more information). Acupressure or massage are also useful (see Step 3.8).

  7. Choose a birth setting that suits you. Some women fear the medicalised nature of modern birth, and would prefer a home birth, birth centre or midwife-led unit. Others would like to be in a hospital, and feel safer there. Explore these options to find what is best for you. Sometimes you can combine parts of each of these places to suit you; for example, some hospitals will let you bring in your own portable birthing pool. Most will let you bring in your own bedcover, music, light projection, snacks and drinks etc. (See Steps 2.2, 3.7 for more information).

  8. Have an advocate. This is someone who knows exactly what you want in labour, and will speak up for you so that you can concentrate on ‘going into your zone’ in labour. This may be your partner, or your birth partner or doula.

  9. Above all, when you are in labour, concentrate on you. In between every contraction, rest and relax; don’t think about the time, or what else is going on outside the room, or how much longer your labour will be. Rely on your birth partner to remind you to drink every half hour, or to encourage you to change position. Remember, every contraction is bringing you closer to the birth.

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This article is from the free online course:

Journey to birth

Trinity College Dublin