November 15, 2012

How Fear Affects Labor and What You Can Do About It

During a recent yoga class I was taking, my teacher discussed our natural reaction to fear. She explained that students tend to make their poses smaller and constrict themselves when they are fearful of doing the pose. For example, they are afraid to shift their weight forward off their feet and into their hands for arm balances. Or, they keep their arms close to their head for wheel poses instead of letting the pose have some space. By getting physically smaller in the pose, we decrease the chances of successfully manifesting the actual posture.

I started thinking about how this concept relates to childbirth. In my last blog, “Breathing For Labor”, I talked about the body’s reaction to fear. It goes into the ‘fight or flight” mode, releasing adrenalin into the blood flow and reduces the function of oxytocin, halting labor. The laboring mother is constricting, becoming small, when the exact opposite is needed for labor. The mother needs to focus on getting big- a big open cervix! I once had a doula client repeating the mantra “I can open so big” (referring to her cervix).

The well known midwife, Ina May Gaskin, refers to this phenomenon as the “Sphincter Law”. She explains that the sphincters in the body don’t respond well to pressure or fear. Instead of opening up, they close up even tighter. Think about it- If you were told to have an orgasm on the spot, would your body be able to relax and open, or would feel pressured, smaller and tighter? Likely the second. That is the sphincter law. The cervix is a sphincter and does not respond well to fear or pressure.

Knowing this basic law of physiology, what are some ways to help remove fear from the birthing equation?

First and foremost, it is important to help build the mother’s confidence in her body and ability to birth. A woman’s confidence is enhanced or hindered by those around her. If the people she chooses to be part of her birth experience believe in her abilities, she will feel more supported and believe in herself. Here are some additional thoughts to help reduce fear:

1. Choose your “posse” well!
Knowing that those around can influence how the mother feels about her experience, consider the people involved. Are these people supportive of the choices you are making for your birth? Will they be telling their own stories about their birth experience, or be open to seeing and listening to what is happening in the present moment? Will they help empower you? Are they knowledgeable about the birth process and can they help alleviate stress or fear should it arise?

2. Choose Your “care provider” well.
I once attended a birth of woman going through a natural delivery. She had just moved into the depth of active labor and was working to find a pain management technique she could use. The doctor said out loud- “I don’t know why you are going through a natural birth! I want an epidural for my yearly pap smear.” This kind of statement can be undermining for the woman trying to work through the birth process. It is important to find a provider who is aligned with your birth philosophy.

Another point to consider when finding a care provider is their specialty. If the care provider mainly works with high risk women, they will likely follow those protocols. If you are low risk, you likely do not need the same amount of intervention. It may feel overwhelming to have a very medicalized birth if it is not necessary.

3. Choose the right place to birth
This follows the same idea as choosing the right care provider. Does the hospital have very high rates of cesarean births or labor inductions? Does that seem overwhelming or frightening to you? If so, you may want to consider a place that practices with fewer routine interventions.

4. Read positive birth stories and stay away from scary TV shows.
The media is packed with TV shows that portray birth as a dramatic, scary event. If you stumble upon those shows, CHANGE THE CHANNEL! The same goes for listening to unpleasant birth stories of friends and family. While I was pregnant, my mother-in-law loved to tell me about how hard it was to birth my husband’s broad shoulders. This did not help my confidence leading up to my birth. in a recent survey, women were asked to rate their fear of birth before reading positive birth stories, and again three weeks after reading birth stories. Participants reported an average of 33% less fear after they read empowering stories (Midwifery Today pg. 31 Winter 2007).

For some positive birth stories, you can read the first part of “Ina May’s Guide to Childbirth” or visit www.prenatalyogacenter.com and read wonderful stories from our community.

Happy birthing!

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