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Fear of childbirth causes more pain!

Pregnant woman giving birth in the bathDid you see Winners & Losers last week? For those who didn’t let me recap – two heavily pregnant women go into labour. One is portrayed stereotypical of all things television and demands an epidural during her first contraction. The other remains calm, serene and confident in her ability to birth her baby. Alright, it’s a TV show they can do anything they want – but it does raise the question of why two women experiencing the same rite of passage respond so drastically different?

One explanation of this difference is what Grantly Dick-Read named the Fear-Tension-Pain Syndrome.

Grantly Dick-Read practised medicine in the early 20th century when ‘knock-em-out, drag-em-out’ obstetrics was common practise (I mean as if a weak little woman would be capable of doing something as important as giving birth!). What this meant was women were given a drug to make them unconscious then their babies were delivered via forceps by their all-powerful doctors. It was during this era that Grantly Dick-Read was called to attend to a birth where the women declined his offer of chloroform. After birthing her child he asked why she refused the drug, her reply – ‘It didn’t hurt. It wasn’t meant to, was it, Doctor?’.

This lead Grantly Dick-Read to investigate why there was so much variation in the way women experienced the pain of childbirth. As a result he developed his fear-tension-pain theory. That is, when a woman fears birth, she tenses up her body, and this in turn causes pain. The more pain, the more fear she experiences, the more she tenses up, the more pain and so on.

In other words if you think ‘contractions are going to hurt’, ‘something is going to go wrong’ ‘I don’t want to be made vulnerable’, or even ‘my bikini line is atrocious what will my care giver think’ you are setting yourself up to have a harder task than women who intrinsically believe ‘my body was designed to birth this baby and everything is going to be fine’.

These negative thoughts have the power to release the wrong type of hormones (namely adrenalin and noradrenaline). When we are anxious, scared or fearful our body jumps into defensive mode and triggers the fight or flight response. When this happens our body prepares itself to escape harm – that is, we will either gear up to fight or run away. This is a great physical response when we are actually at risk of harm – not so great when we are in labour (although these hormones do come into play just before a baby is born but let’s leave that discussion for another blog post)!

The release of these fight or flight hormones make our muscles tense up in the wrong ways which in turn often make our contractions less effective and/or more painful. When the body focuses on releasing adrenalin and noradrenalin, the release and effectiveness of the natural pain killers that it is designed to produce in labour (otherwise known as endorphins) are diminished. To make things worse, we have been programmed to believe pain = bad. So if a woman then associates the sensation of her contractions as painful (in a bad way) she is likely to fall back into this cycle of fear-tension-pain with thoughts  such as ‘something must be wrong’, ‘I’m not going to be able to do this’ and so on.

As a woman who has given birth twice I can highly relate to this theory. The birth of my oldest son was what could be described as a long, hard and complicated birth – but I was extremely confident in my body’s ability, was excited about his pending birth and felt supported by my care givers. There was a point in my labour where my husband even asked the midwives ‘What’s wrong, why isn’t she in pain?’. I’d love to be able to claim that it was a pain-free birth, it wasn’t, but the contractions were nowhere near as bad as I had been programmed to believe they would be.

Fast forward to my second experience of giving birth – despite being what may be considered an ‘easy’ birth, this experience was very different to my first. I perceived my contractions to be agonising and felt completely out of control – I was scared. For a number of reasons pregnancy had left me feeling nervous and anxious and these feelings quickly floated to the surface as my labour progressed. I knew I had to get ‘out of my head’ but I couldn’t seem to achieve it. On top of the baggage I had taken into the room I also felt unsupported by the midwife who was present which made me feel more anxious.

While each pregnancy, birth and baby are different, I will never again underestimate the importance that being in the right mindset plays in how a woman feels during her labour.

So how can you reduce your experience of ‘pain’? Here are a few of my favourite tips for preparing yourself in the lead up to the birth:

  • Identify any fears or concerns you have and work through them. Talk to your care provider and seek counselling if necessary.
  • Learn about the physiology of labour – that way you will understand what your body is actually doing each time you feel the sensations of labour.
  • Surround yourself with stories of women who have had positive birth experiences. This may mean politely telling a ‘well-meaning’ friend you are flattered she has decided to share her birth story with you, but that you have chosen to surround yourself with stories that will empower rather than frighten you.
  • Learn relaxation techniques and practise them regularly – these will help you turn down your adrenalin production if you do start to feel anxious or fearful during labour.
  • Choose a birth support team that make you feel comfortable and respect your choices.

Now back to discussing the birth experiences on Winners & Losers. Bec seemed calm, confident and unhurried. Even when things weren’t going to plan she seemed relaxed in the knowledge that her body was doing what it was supposed to. When her friend started to stress out, Bec basically told her she either needed to shape up or ship out – she knew that her having the right attitude in her supports was vital in being able to keep her level of fear reduced. Bridget – well she had one contraction, screamed at the top of her lungs and then raced out the door to go to hospital…

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2 comments so far -

  1. There’s no way I’d say labor isn’t painful I have gone through it 4 times no epidural, my first I was worried and stressed and found that labor the most prolonged and stressful – I had poor midwife support also. Forward through the last three, yes they were tough but I was so relaxed and strong minded I felt fine and calm and had a much smoother and happy labor experience! I agree with the article

  2. Pingback: Fear of Childbirth Causes More Pain « perinatalwellness.com.au

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