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What do YOU Fear?
A List of Very Common (and Very Normal!)
Fears of First Time Moms
Studies have shown that first time moms report more intense fears of childbirth than women who have previously given birth. If this is your first time around, it may be helpful to see what tops the list of women’s worries, in anticipation of their first trip to the maternity unit. Caregivers will tell you, whether it is your first or your sixth baby-it is not uncommon to feel a peculiar mix of ecstatic joy, excitement, wonder, and anticipation, combined with feelings of vulnerability, anxiety, and fear. But, here are some things to help you keep things in perspective:
If this is your first childbirth, your fears may typically focus on:
• worry about labor pain
• concern over whether you will actually "be able to do it"
• fear there may be “something wrong” with the baby
• worry over loss of dignity
• fear of injury to your body during childbirth
• concern over the possibility of an emergency cesarean delivery
• fear of dying during childbirth
How You Can Manage These Fears
If you are worried about labor pain: Prepare yourself by reading books on childbirth. Investigate the childbirth preparation courses at your hospital or birth center. Talk about your concerns with your childbirth educator, your caregivers, partner and other supportive people in your life. Let others reassure you. Learn and practice relaxation techniques most suitable to you. They will help with your anxiety and can benefit you during labor.
If you are concerned over whether you will actually be able to “do it”: Since most births in the US occur in a hospital setting, most women have never seen or been a part of another woman’s childbirth experience, and as a result many women have a hard time picturing how they will be able to meet this challenge. Childbirth does not require previous experience! The fact that you have not given birth before does not mean you will not know how to. For many first time moms, it’s hard to believe, (since you’ve never put it to the test) but your body, of course, is designed to facilitate moving the baby from the comfort of your womb to the outside world!
If you worry about modesty or the possible loss of dignity: Most people don’t relish the idea of being completely exposed to a room full of strangers, even if it is for the purpose of delivering a baby. Many women are concerned that their privacy or sense of modesty will not be respected, or that during the strain of labor, they may be unable to “control” themselves and may behave in a way they would not under ordinary circumstances. It may be hard to believe right now, but as labor gets underway, you may find you will worry a lot less over issues of modesty, and your very desire to stay “in control” may change significantly as you adjust to the physical demands your body will make on you during labor and delivery. Ask your caregivers about this. They will most likely tell you they have seen and heard it all while supporting women during childbirth! This is not to minimize the importance of having your privacy respected or of needing a sense of control over your own childbirth process, but if you are giving birth in an environment where the labor professionals are attentive to the needs and concerns of birthing mothers, these worries will likely subside once you begin to labor.
If you are fearful of injury to your body during childbirth: Know that your body is very capable of giving birth, and that the pain you experience does not mean something is wrong. This, however, does not suggest that you therefore must tolerate it, but you do not need to fear that the pain is an indicator of anything other than the process of labor. Some women are specifically worried over the possibility of having a tear or an episiotomy during birth. Tears can occur when the baby is being pushed out even with the use of massage, however, most physicians and midwives make every effort to avoid tearing. The trend toward giving women routine episiotomies has been replaced in most hospitals, by a more conservative approach, due to an increased recognition among caregivers that episiotomies and tears can result in a far more painful recovery period for women, for the first few days and weeks following childbirth.
If you have concerns about the possibility of an emergency cesarean delivery: Know your hospital’s Cesarean section rate. You can find out by asking your obstetrician or childbirth educator at your hospital. Is it at or below the national average? (approximately 25%) If your physician or hospital has a large number of women who are considered “high risk,” their cesarean rate may be higher than those physicians or hospitals who see women who are “low risk,” and are less likely to have health conditions which might lead to a cesarean delivery. Keep things in perspective: first time moms have a 12 to 13% chance of having a cesarean delivery. Ask what your particular physician’s cesarean section rate is and factor this in when determining where to give birth and with whom.
If you have a fear of dying during childbirth: Fortunately, the maternal morbidity (death rate) in the United States is significantly lower than that of most of the rest of the world. In the last century, the risk of death from complications for pregnant women has decreased by approximately 99%, from approximately 850 maternal deaths per 100,000 live births in 1900 to 7 in 100,000 live births in the US today. By comparison, the chances of women dying due to a pregnancy complication is approximately 1 in 48, in many underdeveloped countries.
If you are worried that there may be “something wrong” with the baby: This is another common fear that you may be better able to keep at bay if you consider the statistics. Most babies are born without complications. In the US it is estimated that 4% of babies born are born with some type of birth defect, and the infant mortality rate (which tracks mortality rates not just for newborns but for babies up to one year of age) is 6.9 per 1000 live births. Many women have had a variety of tests during their pregnancy that have already ruled out a number of significant complications. It may allay your concern to remember you are giving birth in a setting where you are surrounded by professionals who are ready to handle an unforeseen complication.
According to Dr. Diana Dell, MD, obstetrician and psychiatrist at Duke University, “Obstetrical care providers are quite accustomed to providing reassurance to women who are fearful of childbirth.” And she offers some reassuring words of her own: “If women don’t have at least some fears or concerns about childbirth, they are probably not adequately prepared. For centuries, in fact, until fairly recently in our history, women often died during childbirth; it is likely that fears associated with childbirth are somehow hardwired into our DNA!”
Excerpted with permission from Easy Labor,
Every Woman’s Guide to Choosing Less Pain and More Joy During Childbirth, by William Camann M.D., and Kathryn J. Alexander, M.A.,
Ballantine Books 2006
www.easylabor.net
Childbirth Connection, a not-for-profit organization working to improve maternity care for mothers, babies and families since 1918 has released the findings of their second national survey of mothers. Listening to Mothers II reports what mothers across the nation said about planning for pregnancy, labor and birth, being home with a new baby, physical and emotional health after birth, and opinions about choice, control, knowledge and decision-making in childbirth.
The Listening to Mothers survey was carried out in partnership with Lamaze International and with the support of a multi-disciplinary National Advisory Council of representatives from key organizations and the Centers for Disease Control and Prevention. In January-February 2006, Harris Interactive surveyed women who gave birth in U.S. hospitals in 2005.
According to the survey’s findings, women are generally not requesting
c-sections without medical reason. In fact, 10% reported that they felt pressure from health professionals to have a c-section without cause.
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