An article appeared recently in Time magazine entitled ‘Why Women Who Fear Childbirth Spend More Time in Labour’.  The research findings presented weren’t particularly surprising. This study showed that women who fear childbirth are more likely to labour longer, have an instrumental delivery (birth assisted by forceps or Ventouse vacuum extraction) and have a Caesarean birth.

Those of us who approach birth from a holistic perspective understand well the influence that thoughts, beliefs and emotions have on the physical functioning of the body.  It was British obstetrician Grantley Dick-Read who, back in the 1930s, first explained the Fear-Tension-Pain cycle.  Firstly, if a woman’s personal and cultural conditioning leads her to believe that birth is dangerous or that her body is somehow inadequate for giving birth, she’s likely to experience fear and anxiety when in labour.  This fear and anxiety then causes muscular tension.  Think of how you feel at times of heightened fear – jaw clenched, shoulders hunched, every muscle in your body held tightly. Fear during labour also produces excessive tension in the uterus, which leads to increased sensations of pain.

Feeling afraid and anxious activates the the sympathetic nervous system and triggers the release of the fight-or-flight hormones, epinephrine and norepinephrine, commonly known as adrenaline.  In the first stage of labour, adrenaline inhibits the release of oxytocin, the hormone that causes the uterus to contract, thereby slowing or inhibiting labour.  Adrenaline also diverts blood flow to the limbs (so that one could either fight or flee) and away from the uterus and placenta.  Reduced blood flow to the uterus increases the perception of pain, while reduced blood flow to the placenta means less oxygenated blood to the baby.  The end result is often longer, more painful labour and a greater likelihood of fetal distress.

It isn’t only the fear that women take with them into labour that’s the problem.  A woman may enter the hospital feeling calm and confident and then become engulfed in a medicalised environment of fear and mistrust of the body’s innate ability to birth. So how can you prepare yourself to deal with both types of fear – both the ‘baggage’ you may be carrying due to personal and cultural beliefs AND the fear that may be foisted upon you by medical care providers?

Doulas use a variety of tools in our antenatal work to help clients get to the heart of their fears around birth and parenting.  Once the origin of the fear is determined, there are several techniques we employ to facilitate the elimination or at least a minimisation of that fear.  Birth Hypnosis is an excellent method of working through fears and developing the ability to drop into deep relaxation, no matter what may be occurring around you in the birth space.  Additionally, learning about your options in birth, routine interventions (and the lack of evidence supporting them) and your rights as a consumer is vital preparation for birthing in today’s maternity care environment.

So, was there anything surprising at all in that Times article?  Without a doubt, the most significant information I gleaned was from  the relatively low rate of Caesarean births in this study – 11% for fearful women and 7% for non-fearful women.  From these statistics, it’s easy to conclude that the study wasn’t conducted in a country suffering from a Caesarean epidemic with rates above 30%, like Australia or the US (let’s not even mention the horrendously high rates in many Latin American and Asian countries).  Rather the research was conducted in Norway, a country that is much more supportive of women-centred and evidence-based care.