You hear stories from friends and you read accounts online, but what’s really going to happen in the L&D room? As an OBGYN, Dr. Kenosha Gleaton discusses these topics with patients all the time and is here to share some of the most common fears and concerns around birth, what’s actually true, and ways you can mentally prepare for the big day.
We’ve all heard the stories. Childbirth either goes unimaginably perfect while the heavens open and angels sing, or it goes unexpectedly wrong and horror movie scenes come to mind.
So it comes as no surprise that many women harbor a fear of giving birth. In fact studies suggest that one in five women is affected by a fear of childbirth—a condition known as tokophobia.
And despite alarming statistics highlighting notable opportunities to improve maternal outcomes in the US, pregnancy and childbirth for a vast majority of women is still very safe, with favorable outcomes.
Studies show that confident, self-assured women get through labor and delivery more easily than their scared, fearful counterparts. So let's take a proactive approach, address common fears, and better prepare you for the journey ahead.
Concern #1: Not getting to the hospital in time
This concern often ranks highest on the list and despite our best efforts, labor remains unpredictable in timing and duration! Statistics are on your side in this instance since most labor averages at least four to eight hours, which leads to ample time to settle into your desired birthing place.
To reduce the risk of a highway delivery:
- Pack your bags in advance (before 36 weeks) and keep them in your car.
- Have a solid plan for childcare or petcare—and pack those bags too!
- If you live more than 45 minutes from the hospital, notify your OBGYN at the first signs of labor.
- If you’ve been triaged in the hospital and are discharged due to early labor, consider remaining in close proximity to the hospital for a few hours to ensure active labor isn't imminent.
Concern #2: Labor will be unbearably painful
If this were Family Feud, I’d say, “Number one answer,” in my Steve Harvey voice. There have been multiple studies to show that concerns regarding uncontrolled pain and its severity are directly related to the amount of fear women associate with childbirth.
The best course of action is to arm yourself with knowledge, which leads to empowerment. Remember, you were made for this! Women have been giving birth since the dawn of time—and most of them without epidurals! Draw on the strength of the amazing women before you, who are the reason you are here today.
I highly recommend research pain-reducing techniques that are acceptable to you and involve your support person. These may include relaxation techniques, aromatherapy, acupressure, positive confessions/affirmations, sterile water injections, IV pain medications, or epidural.
Concern #3: Pooping while in labor
Well, we all know poop happens! And in the obstetrics world we consider this a badge of honor, indicating that you are using the correct muscles to push! From our toddlers years, we know to intrinsically hide and poop, so to think of pooping in front of a room full of strangers can be quite unnerving.
During my labor, I was literally fixated on not pooping on my fellow colleague. But honestly, at the end of the day, no one even remembers, except you. I’ve delivered thousands of babies, and I have no recollection of which patients pooped and which didn’t. It’s like remembering which patients had a vaginal tear and which didn’t; it's impossible and just a normal part of the process.
I’ve delivered thousands of babies, and I have no recollection of which patients pooped and which didn’t.
It is extremely common to poop in labor, and it will probably happen to you. I highly recommend freeing up that mind space for more important things!
If you’re still concerned, consider Natalist Fiber or another natural agent to actively prevent constipation in the weeks prior to birth.
Concern #4: Tearing
Over 50% of mom’s will have a vaginal tear or laceration of some sort, and this can range from first degree (minimal disruption of vaginal skin) to fourth degree (extensive, involving the anus). Fortunately, most lacreations are first or second degrees, and only one percent of births typically involve fourth degree tears.
To potentially reduce vaginal tearing, consider perineal massage starting at 36 weeks. Perineal massage is a manual technique you can perform at home by yourself or with your partner to help stretch and prepare the tissues of the perineum for a vaginal delivery. The main goal and benefit of perineal massage is to decrease the severity of perineal tearing and/or avoid tearing altogether during a vaginal delivery. It can do this by increasing the flexibility of the tissues and desensitize women to the burning and discomfort they will feel during delivery.
You could also consider using warm perineal compresses during pushing and asking your OBGYN to avoid routine episiotomy unless medically necessary.
Concern #5: Very long birth or unplanned c-section
In 2011, one in three births in the United States were via cesarean section (c-section), and although the c-section numbers have decreased recently, the average c-section rate across the US remains 23-40%. The most common cause for a cesarean delivery (35%) is a failed labor, where the cervix simply stops dilating or the baby just can’t fit through the pelvis.
Unwanted and unplanned c-sections can often induce maternal anxiety, guilt, feelings of inadequacy, and occasionally, regret and depression. While I encourage you to own your birthing process, it helps to accept that there are certain aspects that are simply beyond your control. Respecting the labor process and trusting your body to know what's best helps with that acceptance. Learn about c-sections beforehand, so you are best prepared if that’s the course your birth experience takes you.
Remind yourself that despite your best preparations and verbalized desires, your birth journey may take a detour, and that’s okay. Try to remain focused on the ultimate destination—which should be a healthy mom and healthy baby.
Ways to mentally prepare and empower yourself for giving birth
Birthing a human is a very big deal! It is totally normal to have fears or concerns, but don’t let them take over your empowered birth experience. Learn as much as possible, and stay focused on the goal. Here are a few other tips to preparing for birth:
- Tell your doctor or midwife about your fears and identify coping measures and solutions
- Talk about it with a partner, friends, or a support group
- Take a birthing class
- Consider centering pregnancy (group prenatal care)
- Create a birth plan
- Work with a doula
Remember, fear can be a natural reaction, but childbirth is also natural—and one of the many tasks your body was created to do. When you find your mind racing with self-defeating, fearful thoughts, recenter, refocus, and replace those thoughts with faith in your desired outcome, your body's ability, and your healthy baby! After all, your thoughts are the one thing, in this unpredictable setting, that you absolutely can control!