Overview

All expectant mothers experience some level of anxiety or fear about the unpredictability of labor. Not only can it be stressful to have anxiety about giving birth, but research shows fear of birth can negatively impact your birth experience. There will always be unknowns about how your labor will unfold. The good news is that there are many strategies you can employ to overcome anxiety or concerns. Learn how to tackle specific fears, overcome general anxiety about labor, reframe your mindset, and build your confidence about labor and birth.

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Fear of Birth

Tokophobia is a severe fear of pregnancy and childbirth. Thankfully, this phobia is not common, but having some fear or anxiety around giving birth is very common. It can be frustrating when this should be a really happy and exciting time in your life, and you are stressed out about having your baby. I remember, in both pregnancies, thinking that I knew everything would be okay once I was holding my baby. Until that moment, there was always a chance that something would go wrong or a complication would arise. That was a really uneasy feeling.

There is a lot of research on the fear of birth that utilizes questionnaires to asses how mothers feel about birth. Evidence demonstrates that fear of childbirth negatively and significantly predicts the childbirth experience. Further, women who are more fearful of childbirth are found to have worse obstetric outcomes and a higher likelihood of having a cesarean.

The main elements of fear revolve around the unpredictability of how your labor will unfold. I hear from many expecting moms who have fear or anxiety about giving birth. If you have never gone through labor before, there are a lot of unknowns. How long will you be in labor? How painful will contractions be? Will you need an emergency cesarean? While you cannot know the answers to these questions, there are a lot of things you can do to build your confidence and alleviate anxiety about giving birth.

Your Feelings Are Valid

A common rebuttal to a mother who is afraid of childbirth is to tell her that her body is built for childbirth. It is a natural process that millions of women go through every year, and everything will be fine. This doesn’t alleviate fear or anxiety; it only dismisses it. Whether you feel anxious, nervous, or terrified about having your baby, how you feel is important and valid. Rather than dismissing your feelings, let’s take a deeper look into the causes of these emotions and actionable steps you can take to build confidence about meeting your baby.

Avoid Negative Influence

If you have never had a baby before, you don’t have any first-hand experience of giving birth. Your exposure to labor and birth is from movies where a mother in labor is screaming in pain or hearing birth stories from friends. Unfortunately, so many birth stories emphasize negative experiences. I have been in too many group conversations, which were like a competition for the longest labor with the scariest circumstances.

Your first step is to cut out negative influences on how things in labor can go wrong or hear negative stories from others. If you watch a movie with an intense birth scene, skip through it. If you are talking to a friend and they start telling you about their 47-hour labor, cut them off. You don’t need to be rude and can do this politely. You could say, I appreciate that you want to share your birth story with me. I am trying to focus on staying optimistic and calm about having my baby, and birth stories aren’t helpful for me right now. You are a rockstar, and I look forward to swapping birth stories with you later.

You can replace these negative influences by hearing some positive birth stories. The Birth Hour Podcast is a great resource for birth stories from mothers of all backgrounds and all scenarios. You should also be mindful of the accounts you follow on social media or the stories you consume. If you are following someone on social media whose posts don’t make you feel optimistic and excited about becoming a mother, stop following them.

Identify What You Are Afraid of or What Gives You Anxiety

Identifying your fears is the next step to building your confidence about birth. It is one thing to have general anxiety about giving birth. Can you pinpoint why you are afraid or what gives you anxiety? Start by making a list. Get out a pen and a piece of paper and brain-dump everything. Simply naming what it is that gives you anxiety can be a great start to overcoming that feeling.

Fear About Specific Interventions

If you have anxiety or fear around a particular intervention. The first thing you want to do is get more information and learn about it. You may have misconceptions about interventions you can clear up with more information. What can increase the odds of this happening or your care provider employing this intervention? Are there things you can do to decrease the odds it will happen? What are your options if you end up in a position where this intervention is unavoidable? You almost always have options if you know what those options are. Lastly, are there things you can do after birth, during the postpartum period, to help in recovery?

While I do not want to give you any new things to be anxious about, I want to provide you with some concrete examples I have helped other expecting moms with. I have heard from a lot of expecting moms who are scared of tearing during birth or having an episiotomy. I get it; the last thing you want is an injury to your vagina or perineum. Step one is to educate yourself. A great starting place is to see if there is an episode of the Pregnancy Podcast on this topic. If you listen to that episode, you take the unknown out of the equation. You know it is possible this could happen, but you also know how to decrease your odds and, if it happens, how best to recover.

Fear of Labor Pain

It is common to have fear about the pain of labor, especially if this is your first baby. There are some anecdotes about pain-free births, but there is some pain for most expecting mothers. There is an episode on reframing labor pain so you are not terrified going into the experience, have a better idea of what to expect, and understand why birth can involve pain. The good news is that you also have access to pain relief in the form of an epidural, nitrous oxide, or other pain management options. Even if you are planning an unmedicated birth, you can utilize tools like a TENS machine or hydrotherapy.

I had a listener reach out who was scared she would miss her window to get an epidural. The window of opportunity to get an epidural is until your baby’s head is crowning. It is doubtful, especially if this is your first baby, to reach that point quickly. If you know you want an epidural the second you get to the hospital, ask for one. You also have the option of the anesthesiologist putting the catheter in place and waiting to start the medication when your labor becomes more active. Once I explained this, she talked to her doctor about getting an epidural as soon as she was admitted, and her fear about this was gone.

Building Your Confidence

You can do so many things to build your confidence about your labor and birth. Building confidence involves educating yourself, understanding your options, and creating a supportive environment.

Have a Birth Plan

You should have a plan for the birth you want. When you create a birth plan, you have a concise sheet of paper with your requests. More importantly, everything you do leading up to that final printed piece of paper will set you up for success. Creating your birth plan will lay the foundation to prepare you for the scenario in which everything goes exactly as planned and for what should happen if things do not go as planned.

The Pregnancy Podcast has a lot of resources for creating your birth plan:

• 10 Steps to Craft Your Birth Plan
• Get a copy of Vanessa’s birth plan
• Your Birth Plan book
• Become a Premium Member for access to the entire back catalog of episodes ad-free and a copy of the Your Birth Plan book

Have a Plan B

A common fear is that your birth does not go as planned. This could mean a cesarean if you plan a vaginal birth. If you want to have your baby at home or a birth center, it could mean a transfer to a hospital. I encourage you to make a backup birth plan for any alternate scenario that you are nervous about. There is always the possibility your birth will not go as planned. Having a backup birth plan for cesarean birth or a hospital transfer will make the difference between navigating that possibility with confidence or feeling overwhelmed and like everything is out of your control if your birth does not go as planned. Remember, you always have options if you know what those options are. Educating yourself and having a plan B removes many unknowns, which are a massive driver of fear.

Take a Birth Class

An evidence-based intervention to decrease the fear of childbirth is to take a birth class. Research shows women who attend a birth class have lower levels of fear and, as a consequence, a better childbirth experience. The main function of a birth class is that it will prepare you for what to expect and give you tools and techniques to navigate the challenges of labor. This could include hypnobirthing, breathing techniques, or labor positions. A birth class takes away some unknowns and gives you tools to control how you cope with labor.

Stack Odds in Your Favor

You can do so many things to prepare for the birth you want and maximize the likelihood that your birth will go as planned. Some of these tools or techniques may not make a big difference on their own, but when you stack small things together, they add up. Some examples are setting up your birth environment to be a calming and safe space or utilizing tools like a birthing ball or a rebozo. The more tools you have in your toolbox, the better you will be able to navigate the different stages of labor.

Things to Keep in Mind

You don’t have a crystal ball and cannot know exactly how your labor will go. I know that can be frustrating to hear, but it is the reality. At some level, you have to come to peace with the fact that some elements of your labor and birth are out of your control. That being said, there are a few things you should remember that may help put your mind at ease.

You Aren’t Doing This Alone

You have to remember that you have a team of people and professionals who will be with you and are working to ensure you and your baby are healthy. You work closely with a doctor or midwife who has extensive training in pregnancy and birth and is trained to manage any complication that could arise safely. Your primary care provider also has a team of people to support you. Depending on where you have your baby, you could also have nurses and specialists like anesthesiologists or neonatologists.

You may also consider including a doula. There is substantial growing evidence that doulas positively impact births. A Cochrane Review found that women with continuous support were more likely to have a spontaneous vaginal birth, less likely to use pain medication, have an instrumental vaginal birth, a cesarean birth, or a baby with a low five‐minute Apgar score. Continuous support was also associated with shorter labor and more positive feelings about the childbirth experience. There is even evidence that the emotional support provided by doulas can reduce anxiety and stress during labor. For more information, see the episode: Do you really need a doula?

Another support person who will be with you is your partner. If you do not have a partner present, hopefully, you have a friend or family member who can be by your side through pregnancy and birth. You do not have to worry all by yourself. If you have concerns, fear, or anxiety, please share it with your partner or support person. Even if they do not have a solution, simply having someone to talk to and share your feelings with can help. There are a few episodes of the podcast for dads and partners that cover what they should know and how they can best support you:

• Pregnancy Crash Course for Dads and Partners
• Your Partner’s Role in Pregnancy, Birth, and Postpartum
• Preparing Your Partner for Birth

Reframe Your Mindset

It is easy to go down a rabbit hole of worry that can quickly spiral out of control. If you constantly tell yourself that you are worried, stressed, or anxious, it will make those feelings more pronounced. Can you swap anxious or any other adjective you may use for excited? Becoming a mother is one of the most amazing journeys you will ever embark on. You should be excited to be a mother and meet your baby. Focusing on your excitement may not alleviate your anxiety, but focusing on the positive is always better than focusing on the negative.

Talk to Your Doctor or Midwife

One of the best resources to talk to about any fear or anxiety relating to your pregnancy or birth is your doctor or midwife. Due to their expertise and experience, they are in a unique position to help you navigate through any worries you may have. They can go through different scenarios and discuss how they would handle certain situations or complications. They can also discuss your options. In some cases, they may be able to completely alleviate your specific fears. I encourage you to bring up any concerns with your doctor or midwife.

Keep Your Eye on the Prize

Anytime you worry about things that are out of your control, remember that at the end of this, you get to hold your beautiful baby. I know this may not alleviate all of your concerns, but there is a finish line. I promise that any worries or anxiety you have right now will all be worth it. You will gain more confidence about your birth as you navigate your pregnancy and educate yourself. In some ways, this is the perfect introduction to being a parent. Worry, fear, or anxiety about your child is something every parent will experience, and you gain confidence as a mom as you go.

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