Pregnancy, Childbirth, & Anxiety, Part 1
This topic was another one mentioned by a reader in a recent InstaGram post, and I thought it was amazing timing as I’d just been reading a research study on issues contributing to fear of birth, including ways anxiety contributes to this. This post is the first part of a two part series; today I’ll address the big picture issues about anxiety in pregnancy, and next time I’ll talk about a few more practical things you can do in your third trimester and in labor to help reduce anxiety.
In the study (available here), researchers found that “pain catastrophizing and intolerance of uncertainty to be…contributing to childbirth-related fear, anxiety, or worry.” If you have anxiety already, this can be a pretty heavy stacking of worry-inducing issues! And as I’ve talked to women experiencing their first pregnancies, I often sense these issues… anxiety already present, fear of childbirth pain (which society does not help with), and stress about the unknown (birth remains one of the things we don’t have an illusion of complete control over). It’s a trifecta that is hard on so many women.
1) Pain Catastrophizing ~ As the study put it, “… the tendency to exaggerate the negative aspects of pain has been associated with higher ratings of both anticipated & experienced pain during childbirth.” Basically: when we are extremely afraid about what pain will feel like, we have a harder time anticipating it and we actually feel it more. Ouch. Literally.
How can a mother cope with this? First of all by assessing childbirth pain in a smarter fashion than society expects her to. Do we think of training for a 5K as something beyond what we can do? What about hiking? Working a physical trainer to get stronger? We associate pain in these areas as being worthwhile: we know there is an end in sight, we know there are tools to help cope with the pain (more on the birth tools later), and we celebrate the final outcome for a women. When we hear a woman is training for a marathon, we don’t tell her: “ugh, I did that, and I almost DIED!” We encourage and support her in this endeavor. In the same way, birth (for most women, of course there are exceptions), will definitely have pain, but there are built in rest moments along the way, and they make a difference. Helping a woman compare the pain to other physical exertions instead of implying it will be as bad as a battle scene from a Mel Gibson war movie is really important. So, if you know someone who loves to share scary birth stories, please ask them to stop. You can even share this graphic with them. ;)
I wrote more about this topic in my post on Rhea Dempsey’s wonderful book ~ check the post out here, as it has to do with raising pain tolerances ~ such a fascinating topic!
2) Intolerance of Uncertainty ~ Again, quoting the study: “Since being pregnant inevitably means being in a state associated with uncertainty, individuals experience as highly distressing are likely to experience some degree of anxiety relating to pregnancy and childbirth…” ~ One wise older woman once told me she thought women aged more gracefully than men because, though pregnancy, we’ve already gotten very intimate with the knowledge that we can’t control our bodies. We learn this in pregnancy, but it’s harder to accept it in childbirth.
My advice for childbirth planning, then, is not to create the perfect bullet-point birth plan (they can help, certainly), but to a) Know & Trust Your Providers, and B) Be Educated About All Your Options. Spend some time asking, “If this _____ unexpected happens, what am I comfortable with for this next step?” Or: “What are the things that matter the most to me in this birth?” DUH, of course it’s a healthy mom and baby! But healthy goes beyond heartbeat alone, so take the time to sort through your priorities and ask yourself why you want certain things. That way you will be able to think about the big picture as plans change. “If I can’t have this _______, what else can I do to achieve my big picture goal?”
3) One of the best things you can do to help with anxiety? Hire A Doula. I know, this is a doula blog, of course I’m going to recommend that. You don’t have to trust only me on this, though. Time and time again doulas have been shown to reduce a mother’s pain & anxiety in childbirth. Our massage techniques help boost natural oxytocin. The March of Dimes recommends doula services, the ACOG recognizes doula support as something that helps with “improved outcomes” in labor, a Cochrane review found that doulas were beneficial, and one study too recent to be included in that review specifically found “a doula's presence has positive significant effects on labor pain and anxiety reduction; also, doula-supported mothers reported considerably lower pain and anxiety compared with those experiencing physiological delivery (without doula)…”
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