Fear of childbirth

Fear of childbirth could range from mild worry to a paralysing phobia. Your partner may also feel worried and scared about the delivery. Fear of childbirth can also kick in well before it’s time to give birth – maybe right when you see the plus sign on the stick, or before you’re even pregnant. Depending on your level of worry, there are different approaches to moving past the fear. Because fear is actually a feeling that you can learn to manage, for example by understanding what it stems from and knowing what’s happening in your body.

What is the root cause of your fear of childbirth?

Fear of childbirth could be caused by lots of different things, such as:

• fear of hospitals
• fear of blood or shots
• not having enough support around you
• past experience of anxiety or depression
• fear of something going wrong during childbirth
• fear of losing control, whether of your body or of the situation
• higher sensitivity to pain and/or fear of pain
• past trauma
• a difficult delivery in the past

Sometimes it can be tough to place your finger on exactly why, but if you can identify what your fear stems from, it will give you a better starting point and something concrete to work with.

What happens in your body when you are afraid?

When exposed to what your body perceives as danger, you start to produce the stress hormone adrenaline. This is an inherited, primitive response that worked well historically, because it helped people fight or escape threats from wild animals, for example. But when it comes to childbirth, adrenaline has a less helpful effect because it blocks the feel-good hormone oxytocin, which we need to feel safe (or to provide security), to have a good labour, an easier delivery and faster recovery. However, by learning to handle your fear, you can slow the surge of stress. It’s also good to know that touch and closeness help release oxytocin – the hormone we want lots of. Hugging and skin contact aren’t just cosy; they also lower our blood pressure and pulse, reduce stress and make us feel better in general. Breastfeeding also releases oxytocin, and helps support bonding once the baby is born.

How do I handle a fear of childbirth?

If you’re afraid of childbirth, it’s good to get a handle on the fear as soon as you can, because an unprocessed fear won’t usually disappear on its own; it can actually get worse. If you are already afraid when you first become pregnant, then tell your doctor or midwife at your first appointment. As a partner, it’s also important to work on this fear, because it will be difficult for an insecure or scared partner to provide good support during labour. It’s also important to remember that you’re always entitled to your feelings; it doesn’t work to question or diminish them. Someone telling you that it isn’t dangerous or you should just try to stop thinking about it won’t help – even if their intentions are good. Instead, you need to accept the fear in order to learn to deal with it.

Depending on how severe it is, you and your partner (if you have one) might be referred to a specialist clinic that handles fear of childbirth. They will give you tools for handling your fear, anxiety, or stress evoked by thoughts of childbirth. If you don’t live near that kind of clinic, or if your therapy appointments wouldn’t be until late in your pregnancy, you can also check to see if your clinic has or can refer you to a psychologist. That way, you can ask for therapy if your concerns are becoming overwhelming. You can also look into the availability of online CBT therapy, which you can do no matter where you live, and without having to wait.

If you had a difficult childbirth experience in the past, it’s not so surprising that you would have fear now, before your next delivery. You need a chance to talk about what happened and see what can be done differently so that it doesn’t happen again, either with your doctor or midwife, or through therapy at a specialist clinic.

Tips for alleviating mild anxiety about childbirth

Figuring out just what scares you will offer a starting point to work from: are you afraid of hospitals? Do you have a fear of losing control? Does the idea of pain have you panicked?

• Maybe one of the most important factors for reducing your fear of childbirth is not trying to handle it alone. The person who will be by your side in the maternity ward and with whom you might have the strongest relationship is also the one who can give you the best support. Involve this person in the process.
• Even if you don’t go to therapy, it’s still important to get professional support from your doctor or midwife. Most are very skilled at handling fear of childbirth, but if you feel that support is lacking, then switch to someone else.
• Writing a birth plan is always wise, but it may be especially important if you are particularly worried. For example, if you’re afraid of needles, then include in your plan a request for topical anaesthetic to numb your skin before they give you a shot (or ask to avoid pain relief involving shots). If you’re not sure where to start with your birth plan, take a look at the checklist in our app, which has tips on what may be good to include.
• If you’re afraid of the pain, it can be helpful to read up on different kinds of pain relief, as well as labour pain and how you can learn to manage it.
• If your fear is related to being left alone, or of your partner or the person who will accompany you getting sick, then appoint someone else to come as backup. That might be a doula, relative, or close friend. Even if the likelihood of someone getting sick is minor, this will help alleviate the stress of having to think about it.
• Prepare for childbirth by attending some of the informational meetings that many hospitals offer. There are also classes aiming to help reduce fear and foster a more positive birth experience.
• Knowledge is power, as they say, and that’s true here as well. By learning more about what happens during childbirth, which phases you go through and what’s happening in your body, you can take control of your fear.

Please note that all information above is based on Swedish recommendations.