Helping Mothers Face Birth Fears
Most moms are anxious, even scared, to give birth. Midwives need to understand some important fear factors, if they are to truly help women face their fears.
Although birth anxiety is often dismissed as nothing more than fear of the unknown, it will have a direct physiological effect on the woman; evidence suggests that fear may delay the onset of labour, increase the amount of pain the mother feels, and lead to higher rates of elective Caesarean, pre- or post-term delivery, low birth weight babies or neonatal breathing difficulties.
And yet, midwives can make a tremendous difference. By getting to the root of the fear itself, you can help moms to achieve a better, faster, less painful, more empowering birth experience.
Choose your words wisely
Something that may seem like a harmless comment to a midwife or doctor could really change a woman’s birth experience. One of the best ways to reassure a woman during birth is to keep her fully informed about her labour progress and the different choices she has, without scaring her further. If you do have any actions or interventions you feel strongly about, explain why you feel this way, but allow her to make the final decision – unless, of course, this could endanger her or her baby’s life.
Even a comment as seemingly harmless as “Wow, you have a big baby!” could fill women with doubt about her ability to birth naturally and terrifying images of vaginal damage, when all you really meant is that her baby is developing well. If an expectant mother is upset by a colleague’s comments, take it upon yourself to reassure and comfort her.
Friends and family
In her book Ina May’s Guide to Childbirth, Ina May Gaskin re-quotes Stephen King: “Believe me: if you are told that some experience is going to hurt, it will hurt. Most pain is in the mind, and when a woman absorbs the idea that the act of giving birth is excruciatingly painful – when she gets this information from her mother, her sisters, her married friends, and her physician – that woman has been mentally prepared to feel great agony.”
How very apt. When a woman is repeatedly told horror stories about birth, she is more likely to focus on these than the many positive possibilities. Gaskin advises that the best way to overcome this negativity is to repeatedly tell empowering and positive stories. Remind her that each birth is unique and that we have an evolutionary instinct for giving birth, and provide her with constant reassurance and encouragement.
The bad birth cycle
Often, repeated fear during pregnancy or of birth is linked to a fundamental distrust either of the healthcare system, or of a woman’s own body. The latter is especially true if she has a history of miscarriages; if her body failed her with those pregnancies, why not with this birth? How can she become excited, or be filled with expectation, if her dreams may yet again be dashed? And if a mother feels that she was left to fend for herself in labour, or that staff didn’t really support her during her last birth, she may be worried she’ll experience the same neglect this time around. Mothers also often feel guilt or remorse about their last birth, if health professionals, or she herself, have not made the best decisions, whether they were not evidence-based or simply did not respect the unique emotions of birth.
Often, simply talking about her previous birth experience will help a mom to work through her emotions. She will realise just how much she learned from her previous experience, and that she now knows what to do differently. Remind her that a new, positive birth experience can help heal the wounds of previous negative ones.
Birth’s depiction in media and movies
Although it is unlikely that a woman will be scared after watching a birth scene from a movie, it is likely that she will have misperceptions about her upcoming birth. Movies are filled with misleading birth clichés, and you may need to explain to a mom that when waters break, they don’t necessarily splash on the floor ‘all of a sudden’, that labour takes place in four stages and is not instantly painful, and that birth is actually far better and less painful when done in a standing position.
If a woman has ever been sexually abused, it will affect her entire life – including birth. Sexual abuse is one of the most common causes of long-term emotional and physical stress, and will manifest as post-traumatic stress disorder (PTSD). Women with sexual abuse also often struggle to trust people; a sexual offender is usually someone they trusted – an uncle, a family friend, even a father. These trust issues will be worse if she did tell someone about the abuse, and that person refused to believe her.
Because of all this, the expectant mother’s relationship with you may be compromised, and yet, she needs to be able to trust you enough for you to guide her through her pregnancy and birth. Midwives need to make sure that they know how to approach women facing these particular fears.
If an expectant mother confides in you about previous sexual abuse, it can be very difficult to know how to respond. Don’t pity her, recoil in horror, or say anything that could be misconstrued as being judgemental or dismissive. Rather admire her for her courage and determination, and ask if she has received, or would like to receive, professional counselling, which you could help her access through:
Focus on the positive
Pregnancy and birth can, in fact, be an extremely positive experience for women. As the person she turns to during this time, your attitude can have a direct influence on whether her birth only deepens her fears and wounds, or whether it heals and empowers her like no other experience could. A positive birth can have a ripple effect that lasts for generations; the confidence and self-esteem boost a woman experiences after a birth she feels good about, will have a positive spin-off on almost every aspect of her life. A woman is the hub of the home, so this will affect her family, too, leading to more emotionally secure children, and a happier family all around. You cannot change the past, but you can influence the future of this mother and child.
Downe, S, 2008, Normal Childbirth – Evidence and Debate: Second Edition, Churchill Livingstone, Edinburgh
Gaskin, IM, 2003, Ina May’s Guide to Childbirth, Bantam Books: New York
Heli, S, 2009, Confident Birth, Pinter & Martin: London