Fear of Childbirth Prolongs Labor

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When I was little, I would constantly ask my mom about childbirth: Is it really as painful as they make it seem on TV? My mom confirmed that it was the most painful thing she ever experienced. Of course, she said, I’d do it all over again because my babies are so special. My eyes were wide in disbelief – I don’t think my siblings and I were ever that special.

The idea of giving birth to a child has always been incredibly scary to me, and now, with more knowledge on the subject, the idea is scarier still. Just thinking about contractions, tearing, and a head coming out of my vagina is enough to make me pass out.

Unfortunately for me, researchers recently found that such fears only draw out the labor process.

Fear of Childbirth Only Prolongs Childbirth

Norwegian researchers published a study in BJOG, An International Journal of Obstetrics and Gynaecology, that found women with a fear of childbirth spend an hour and 32 minutes longer in labor than women without fears of childbirth.

Even after researchers adjusted for other factors that could contribute to the duration of labor, such as having given birth before and instrumental vaginal delivery, women who feared childbirth were still in labor 47 minutes longer than those with no fear.

In addition, labor-fearing patients tended to be more likely to deliver by instrumental vaginal delivery or emergency cesarean delivery than women who were more comfortable with labor.

Stress Hormone May Prolong Labor

Researchers from Akershus University Hospital, The Health Services Research Center, and the University of Oslo, Norway are not exactly sure why women who fear childbirth get to experience the joys of labor for a longer period of time, but some point to stress hormones.

Samantha Salvesen Adams, co-author of the research, shared two theories:

“First, stressed women have higher stress hormones during pregnancy, and high stress hormones may weaken the power of the uterus to contract. And second, we think that women who fear childbirth may communicate in different ways with health care professionals during pregnancy,” which could impede proper assistance for a shorter labor.

Oxytocin and Catecholamines

The hormone oxytocin is released in large amounts during labor, causing the uterus to contract regularly, which is why the name was derived from the Greek word for “quick birth.” Oxytocin has also been shown to increase trust and reduce fear, a happy result for fearful mothers-to-be.

The secretion of oxytocin, however, is repressed by catecholamines, or the fight-or-flight hormones, epinephrine and norepinephrine. Catecholamine levels can rise when a woman feels frightened, and labor can be suppressed.

This is fine at the beginning of the delivery – no need to start contractions too early, catecholamines are even important for the fetal-ejection reflex; but these adrenal-gland hormones can make for a long labor if they continue to inhibit oxytocin from kicking in.

How to Handle the Fear of Childbirth

Studies seem to indicate that fear begets fear, so it seems the best way to handle any anxiety is by coming to the delivery room with as little fear as possible, and that takes preparation.

If I was expecting a baby, I would take advantage of the following methods to reduce anxiety, fear, and excessive amounts of catecholamines:

Massage
Finally, an excuse to get a really good massage. Massages can help keep your head clear and your anxieties at bay. Of course, if you didn’t get your fill of massages prior to delivery, the Traditional Chinese Medicine University claims that massage during labor can significantly shorten the labor process.

If all else fails, massaging the nipples can increase oxytocin production and induce labor. You should consult your doctor prior to using these massage techniques.

Prenatal Yoga
Om.ygod. Prenatal yoga helps to reduce the stress and anxiety that can make delivery last longer than necessary. By focusing on breathing techniques, stretching, strengthening, and mental concentration, you are preparing yourself for labor.

Some studies even suggest that prenatal yoga shortens the overall time of labor, particularly the first stage of labor.

Meditation
I’m not thinking about the pain. I’m not thinking about the pain. I’m not thinking about the pain. With enough practice, you’ll learn to control these thoughts. Like prenatal yoga, meditation focuses on breathing and mental exercises, which minimize the adrenaline and cortisol levels that trigger stress.

In fact, one study found that women who practiced meditation during pregnancy reported a decline in stress and anxiety.

Communication
As Samantha Salvesen Adams stated, fear may prolong labor because of poor communication between doctor and patient. In order to mitigate delayed treatment and assistance, start building a relationship with your doctor by communicating any fears or anxieties you have prior to delivery.

Open communication can give your doctor an idea of how you may handle delivery, and the doctor may, in turn, give you advice to prepare for the upcoming delivery. Communicating early on will also allow you to feel more comfortable discussing fears and pain when you’re in the delivery room.

What Worked for You?

I’ve already made it clear that I have not been in labor, but I would be interested to learn what techniques worked to reduce your fear of childbirth.

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Elena Perez

Elena Perez obtained a B.A. in American Literature at UCLA, but a growing interest in environmental issues led her to enroll in science classes and gain lab experience at UCSD and SIO. The close link between our ocean’s health and our own well-being has spurred Elena to explore the role environmental toxins play in our growth and development.

4 Comments

  1. An affirmation, listed here as meditation, should always be phrased in positive. The word “not” should never appear. Instead of the one listed here, an affirmation such as “I can manage this pain” or “The pain is a sign that my body is opening” would be more effective. Another approach is to rename pain. Popular switch-outs include surge, work, sensation, or force.

  2. I also read Ina May’s guide to childbirth. It’s such a great book for any expecting mother. The stories are positive and inspirational. I also did hypnobirthing. While going through the classes I feared that all of my “practice” aka conditioning may go out the window during labor. It didn’t, it was the best decision I made about my birthing experience, in addition to having a doula. I can honestly say with all of those tools at my side I was actually excited for labor. I was ready for the physical challenge and to see if I “could do it”–unmedicated that is. My labor lasted 20 hours and I pushed for 3.5 hours. Yes it was painful and uncomfortable but it was also the most beautiful and empowering experience I’ve ever had.

  3. I wouldn’t say that i had a fear of childbirth, at least not much and i was in labor for 62 hrs. It actually didn’t hurt very much. It was a very easy labor even though it was long. I did a homebirth and delivered in the water. I had read Ina May Gaskin’s Guide to Childbirth and from reading everyone’s unique birth stories, it helped me to relax and not worry about all of the “what ifs” because every birth is so different. I knew i could be in labor anywhere from 2hrs to 2weeks and that it may or may not hurt a lot. Maybe if i was more fearful i would have bern inmlabor for 2 weeks.

  4. Dear Elena,
    You and all who are fearful of birth need to talk with and be with women who have had joyous births most of whom have birthed at home!
    Also I recommend Dr sarah Buckley’s book and website and Kate Evans’ book “Bump”. Know that leaving home or your nest particularly when you are going to an environment that is not set up for physiological birth (ie hospital) interrupts and stops the flow of your labour hormones thus labour is more painful and slower!!

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