Preparing for Birth and Common Fears

Having a baby can be a wonderful and joyful experience. Many women have strong ideas about how they want their babies to be born. Society might however suggest that some types of labour are ‘better’ then others. This creates a lot of expectations for women and can lead to difficult or even traumatic birth experiences (see our article about difficult birth experiences here).

Being prepared for your labour is a key part of pregnancy and during counselling we have seen some women want to know ‘every-single-detail’ of what will happen in the labour and some women who are more likely to avoid this in order to manage their anxiety.

We know that local hospitals will usually provide free programs for expecting parents so that they can mentally prepare for what will happen during labour. They will usually tour the labour ward, help women visualise where they will give birth and talk through the different options when women do go into labour. There are also birthing courses that you can purchase that talk through specific birthing strategies (examples of these include Calm Birth). These courses can help couples to become more informed about labour and what their options might be. It is very common for labour to progress in ways that are unexpected, and these courses can help to empower women and their partners to feel confident in expressing their wishes during the process.

Whether you choose to pay for a course or attend hospital provided courses, they aim to do several things. Mainly, the courses provide:

- Education about what to expect during labour so that you can make informed choices.

- Information about the various ways that women give birth including vaginal, with medication, in water, elective C-Sections etc, in order to normalise these.

- Education to families about the various things that might occur during labour that could become emergency situations.

- A roadmap of what to expect in the hospital, during the process of labour and in the following days.

A key message to take away from this information is that there is no one right way to birth your baby. You might have a plan that outlines your ideal labour, but it is important to keep in mind the end goal and be guided by the health professionals assisting you.

While there are specialist education programs that can help you to understand labour, sometimes this does not remove the feelings of fear and terror related to giving birth. Many women report that they fear the pain, they worry about tearing or permanent damage to their bodies, fear of specific procedures (like spinal blocks, emergency c-section, episiotomy), losing control during labour and/ or being unable to cope. Many women also fear that they will die or that their baby will not survive. Another very real fear for expecting mothers (especially in recent months) is the fear of being alone during the labour.

Women might also have a prior traumatic birth experience that is contributing to their fear about an upcoming labour, especially when there has been serious risk to them or their baby in previous labours. In cases where the birth has been particularly traumatic (prolapsed cord; unplanned Caesarean section; postpartum haemorrhage; induction; use of vacuum extractor or forceps to deliver the baby; rapid delivery; severe toxaemia; manual removal of placenta; premature birth; separation from infant in NICU; feelings of powerlessness, poor communication and/or lack of support and reassurance during the delivery) women may in fact develop PTSD symptoms which can be very difficult to manage in subsequent pregnancies if left untreated.

These fears (whilst common) can be very distressing for you especially as the due date approaches. We know that symptoms can also worsen over time and may lead to panic attacks, avoidance of people, places and things or the development of obsessive thoughts/ behaviours. It is understood however that Cognitive-Behavioural treatments (CBT) are the gold-standard in terms of treatment for these fears and anxieties about labour. Being able to talk about these worries can help you to process and understand your concerns as well as develop strategies that you can use ‘in-the-moment’ when anxiety becomes overwhelming. Talking to a perinatal psychologist who is well-versed in CBT can help you to have a greater quality of life during your pregnancy and help you to manage your anxiety once the baby has arrived.