Although a certain amount of fear of childbirth is perfectly normal, there is a lot of fear around childbirth in our society. I am writing this article in the hopes that you will challenge yourself and ask yourself important questions regarding what your fears are and where these fears come from.
Asking yourself these questions and educating yourself on why it is important will not only promote your personal well-being, but it can greatly impact your experience while giving birth!!!
This is because...
As mammals, our bodies are built to prioritize our safety and the safety of our babies. Now imagine for a moment, you are in labour and there is a tiger in the woods.
Your body is going to enter ''fight or flight'' mode, which means your body will release adrenaline and nor-adrenaline, which are in a family of stress hormones called catecholamines. This will cause many changes to occur.
Your body will send less oxygen to your uterus and more to your extremities to prepare you to ''fight or flight'' and protect yourself and your baby. This means that labour will most likely stall (unless you are about to push or are already pushing- more on that latter.)
Your baby will also release catecholamines to help them cope with a lower oxygen level. Your body is thinking, ''I know my baby is safe in here. I don't know if my baby will be safe outside the womb, so I should stall labour until I am sure there isn't a threat.''
What makes things so much more complicated for us as humans, is that there are many more things that can cause stress and fear than real or perceived danger.
Causes of fear of childbirth include:
-fear from stories from others/deep rooted societal fears
-fear of pain
-fear of tearing
-fear of having a cesarean
-fear of interventions
-fear of ‘’Failure to progress’’
-fear of pooping in front of others while pushing
-fear of complications
-fear of unwanted people in the room and unwanted disturbances (lights, noises, interruptions)
-fear of failure
-history of sexual trauma/abuse
-fear of losing control
-fear that a special someone will miss the birth (sometimes labor stalls for hours and minutes after the arrival of a loved one the baby comes in minutes!)
-fear of not being a good parent, or ‘’everything will be different now’’ ‘’I am losing my independence’’
-fear of not being strong enough because of a previous miscarriage or cesarean
-fear of the postpartum period due to lack of support
-fear of losing inhibitions
-fear of disappointing partner/family members (*natural birth/pain medications, decisions not being supported)
-fear of the future (quality of life, climate change, war ect)
Here is a little bit of background on my own journey through fear of birth. Up until I became a Doula, I believed that birth was how movies depicted it; terrifying, dangerous, painful, and needed to take place in a hospital.
I grew up with the idea that I would have an elect cesarean when I had babies just like my mom did, because vaginal birth would be too painful.
As I got a little older I realized that an elect cesarean might not be necessary for me, but I would definitely get an epidural. (I would like to make it clear that there is nothing wrong with getting an epidural or a cesarean, but the fact that we are so afraid of birth makes many people, like I did, feel that there is no other option, and that just isn't true!)
When I became a Doula I was applauded by how different my views of birth growing up were compared to this new information I was learning. My own mother hadn't in fact needed a cesarean with all three of her children because birth was dangerous and that we all could have died otherwise; it was because she and my dad were young and didn't know she had any other options, and more importantly, they didn't know that what the doctor recommended could be anything less than necessary.
The current cesarean rate in Canada is 29%, more than double what the World Health Organization deems safe or necessary. Obstetricians, who are trained in complicated childbirth and possess life saving skills, are the care providers for approximately 93% of births in Canada. The truth is they are overworked and are not trained to provide care for normal births, creating a cesarean rate that is only rising. The high c-section rate can cause many people in our society to believe that birth is inherently dangerous.
I have since learned and witnessed with my own eyes that childbirth is not often dangerous and is not always painful. It is beautiful, sacred, and our bodies were made for it. I have learned that everyone's relationship with pain is different, and that some people feel incredibly empowered birthing without pain medication, and others have a relationship with pain in such a way that birth might be traumatic for them without some kind of relief. For these people, laughing gas or an epidural can give them the comfort and sense of safety necessary for birth.
I have also learned that associating pain with childbirth is inherent in our society, and that an unnecessary amount of fear is not healthy, under any circumstance. There are risks, yes, but we view childbirth as an illness that needs the help of a doctor in order to go smoothly, and we view the pain as unbearable, and it is not uncommon for people who give birth without medication to be labelled as 'crazy'. Our society has forgotten that our hormones are working with us, and that by staying as relaxed as possible you are allowing your hormones to create uterine contractions, natural pain relief, and a 'trance like' state to help you through labor.
Remember the 'tiger in the woods' we talked about earlier? Have you heard of a story from someone who's labor stalled for hours on end? (I highly recommend reading stories in books such as 'Spiritual Midwifery' and 'Ina May's Guide to Childbirth' that have countless accounts of situations where when the birthing person was asked if something was bothering them during a stall in labor, their labor picked up again after giving voice to their fears.)
I like to imagine a world where we all grow up with the belief that physiological birth is normal, it is not something to fear, and it is not always painful, and when it is needed, we have the best medical care in human history available to us. Imagine a world where when you voice fears of tearing, interventions or cesareans, and were told that tearing heals faster than an episiotomy and that more than a 1st degree tear only occurs in 3% of vaginal births, and that relaxing your mouth and perineum can reduce your chances of tearing.
I wish it was common knowledge that unnecessary interventions can be limited with the right choice of caregiver and informed decision making, that pooping during birth is normal and will be scooped up from the pad beneath you so discreetly that you won't even notice. I wish it was common knowledge that every other fear can be made a little easier by voicing your worries to trusted people, and that that can make a huge difference.
Whether you are preparing for birth or trying to reconstruct the way you feel about birth, it is important to educate yourself, nourish yourself, and surround yourself with supportive people. Choose books and videos written by people who believe that the female body is beautifully made to give birth. This can help you enter labor feeling prepared, empowered and relaxed, which can help you release oxytocin.
Oxytocin is released from our pituitary gland during sexual activity, orgasm, birth, breastfeeding and when we are in physical contact with people whom we love and feel safe with. We even release oxytocin when we are sharing a nice meal. Oxytocin creates rhythmic uterine contractions and a latter surge benefits pushing. Around the time of birth, oxytocin will be in the highest peak of the birthing person’s life. (More than 1000x the normal amount.)
Epinephrine and norepinephrine (also known as adrenaline and noradrenaline) are hormones from a family called ‘’catecholamines’’ and are responsible for our ‘’fight or flight’’ responses and are released when we feel stresses such as hunger, fear and cold.
Although a surge of stress hormones can stall labour ealier on, naturally the levels of these hormones gradually rise and are helpful during the pushing phase when an extra energy surge is needed. This happens especially with nor-epinephrine which has been referred to as the ‘’fetal ejection reflex’’. This happens between the first and second stages of labor (usually between transition {nearing full dilation} and the pushing phase) and will help the birthing person feel alert and usually want to be upright.
There may also be feelings of fear, anger and excitement which at this point during labor will increase the level of oxytocin, creating a harmonious balance of hormones.
This surge of catecholamine’s and oxytocin will only occur if the birthing person feels safe and undisturbed. Once again, If there is a catecholamine rise from stress or fear earlier in labor, it can cause labor to stall or even stop. By staying as relaxed as possible and voicing your fears or concerns with your support people, you can keep your catecholamine levels in check, your oxytocin high and you beta-endorphins in balance (which help with natural pain relief.)
Catecholamine levels also rise in the baby while labor progresses to help the baby cope with the lack of oxygen when the birthing persons contractions are the strongest. This happens by keeping blood flowing to the heart and brain and helping all of the baby’s tissues be more tolerant to low oxygen levels. Just as these catecholamines help your baby stay safe during a ''fight or flight'' response, they help keep your baby safe during the pushing phase.
It can be a comfort to many knowing that your body produces natural pain relief. Sadly the natural flow of hormones is seriously compromised or ''shut off'' if you have an epidural or if you are induced by Pitocin (synthetic oxytocin, which shuts off your natural production of oxytocin.) But remember, you need to make the right choices for YOU, and what you feel is best for your labour as every person and every labour is unique.
Birthing without pain medication is not the best way for everyone, pain medication can be there if you want it and believe that you will have a better experience with it. It does not make you weak if you want pain relief, and it does not make you weak if you have a cesarean. It has become radical to birth without pain medication or intervention because so many people have forgotten that its not only possible but can be enjoyable. 25% of people experiencing childbirth without pain medication or pitocin have an ''Ecstatic Birth'' or ''Orgasm Birth.'' I highly recommend the documentary, ''Orgasm Birth''
‘’People who are in denial about the possibility of sexual feelings during labor forget what happens in the body during a good kiss. Blood rushes from the thinking part of the brain, the neocortex, to the vaginal tissues, and this is precisely what causes the swelling that enlarges the vaginal opening enough to make painless penetration possible. Oxytocin and beta-endorphin levels soar. When a woman gives birth, she has- if anything- an even greater need for such swelling to take place. When labor can proceed in a way that allows the release of high levels of oxytocin and beta-endorphins, the optimal swelling of her vaginal tissues can then take place. As mentioned earlier, the release of the hormones explains why some women- as strange as this may seem to anyone who hasn’t seen or experienced it- experience orgasm during labor or birth.''
-Birth matters, by Ina May Gaskin, 2011, Seven Stories Press
I want people to know what their bodies are capable of, what is possible, because so many people will tell you otherwise. Remember that you and your baby are working together. Remember that your body knows what to do. Remember that you have choices, and that no one else should decide how you birth. Educate yourself, trust yourself. The important thing is that its your body, your baby, your choice, and you intuitively know the best way to birth.
Thank you for reading <3
This article was written by Jaz Wilson, Certified Childbirth Educator and Birth Doula located in Campbell River BC