Feel the Fear and Birth Anyway

http://keepcalmandloveon.wordpress.com/2011/08/09/keep-calm-and-fill-in-the-blank/

This is just a little post to ease me back into the blogging world (thesis finally submitted). As usual, the content is in response to a reoccurring issue and discussions with mothers and midwives. And I welcome your experiences and comments on this topic…

In a backlash against the medicalisation of birth women are beginning to reclaim birth (yay!). Partly thanks to the availability of information via the internet, a counter culture has emerged. Movies, images and stories of empowered birthing mothers circulate through social media – women birthing in beautiful calm environments (usually in water, surrounded by candles), looking like Goddesses whilst gently and quietly ‘breathing’ their baby out. Women are able to see how birth can be, and many are inspired and driven to create a birth experience like those they watch.

Whilst these images can assist in building self-trust for mothers as they approach birth, they do not tell the whole story.

Fear, losing control, and the birth process

Labour is hard work – hence the word ‘labour’ (and I know some people don’t like the word… neither do I). But the work is not just physical, as women birth their babies, they are journeying through a life changing rite of passage into motherhood. At this time a woman is at her most powerful, and her most vulnerable. Historically and globally, childbirth is a time of danger for both mother and baby. Rituals are enacted in an attempt to ensure the safety of mother and baby. The nature of these rituals reflect the culture in which they are enacted. In medicalised cultures these rituals are technological and medical, focussing on surveillance and intervention (Davis-Floyd 2003) – which often create danger but that is a whole other post/s. Regardless of attempts to ensure safety, deep down, like our ancestors we know we step into the unknown during birth. Fear is a normal part of birth. It is normal to fear for yourself and your baby. It is normal to fear the changes that will come when this new person enters your life. It is normal to fear how you will cope/are coping with the enormous physiological changes and sensations in your body.

It is unusual and unhelpful to be extremely fearful throughout labour, and prolonged high levels of adrenaline can reduce contractions and placental blood flow. However, most women experience a point in their labour where they feel out of control, frightened and overwhelmed. Some call this ‘transition’, and it is usually a sign that birth is close. Victor Turner (1987, p.9) described the middle phase of a rite of passage as an ‘undoing, dissolution’ and a ‘decomposition’ [of the self] which is accompanied by the ‘processes of growth, transformation, and the reformulation of old elements in new patterns’. I think this is a good description of the transitional phase of labour. In addition, Michel Odent suggests that the intense fear and sense of ‘losing it’ experienced near the end of labour facilitates the physiological process of birth. You can read more about the phases of the childbirth rite of passage in Chapter 4 and 5 of my Phd thesis.

Most women will verbalise their fear, reaching out for reassurance, becoming loud and/or angry… often later apologising for their behaviour. Others remain externally calm, and those around them are oblivious to their turmoil. I have previously written about how women are judged by how they behave in labour. Women who manage to remain calm and serene whilst birthing are admired for maintaining control. In contrast, those who are loud, and appear to ‘lose it’ are considered to be out of control. However, appearing calm, and feeling calm are entirely different things. Only the woman knows what is going on inside her head – and body.

We have created a culture (and birth culture) that seeks to avoid and minimise extreme emotion and pain, and encourages being in control. We use medications and/or skills, methods and techniques to remain in control and dampen the emotions – or at least the expression of those emotions. In some cases women are told that they should not experience fear, or pain, during birth… that these are conditioned feelings that can be controlled. I think it is a shame that this powerful aspect of the birth experience remains hidden and suppressed. Birth movies rarely include footage of women visibly ‘losing control’ (are these scenes edited out?). Women rarely share with others their experiences of feeling fearful and out of control – possibly they are worried about being judged, or think that they are unusual.

Getting real – acknowledging fear

I realise that my perspective/suggestions go against many childbirth preparation programs which aim to give women skills and techniques to control their fear (and behaviour). Whilst these techniques can be helpful… particularly during early labour… they are unhelpful for some… particularly during the intense transitional phase of labour. Women have told me they felt like failures because the techniques stopped working for them and they ‘lost it’. One woman recently told me that the practitioner who taught her various techniques informed her she had not done them properly because she felt pain and fear! In addition, suggesting that the baby suffers long-term emotional issues if fear is experienced during labour is unhelpful (seriously, women are told this).

An alternative approach is to open up the discussion about fear and losing control during birth.  Rather than trying to eliminate fear, it seems more helpful to acknowledge it is part of birth (for most) and to embrace it. Some suggestions:

During pregnancy

  • Explore fear – What are you afraid of? Is there anything you can do to help alleviate specific fears (eg. researching, talking, planning)?
  • Reinforce that it is OK if fear surfaces during birth… even if you think you have ‘worked through’ a specific fear during pregnancy it may resurface.
  • If you want to, learn relaxation/coping techniques – these may help, particularly in early labour – but don’t rely on them to work throughout (they might if you are lucky). Also don’t be persuaded that you need to master particular skills to birth well… you already have everything you need within you.
  • Create/plan a safe birth environment where losing control and feeling fear will be OK. Anyone who you plan to have in your birth space should be able to ‘be with’ your fear, and support you through it. You should feel comfortable about losing it in front of them without being judged.

During labour

Get on with birthing – as fear arises let it come, feel it, accept it, and deal with it however you need to (be loud, be angry, be quiet, reach out for reassurance, shut yourself in the toilet, breathe, whatever). It will pass, and you will birth.

About midwifethinking

independent midwife, lecturer and student of all things birthy
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113 Responses to Feel the Fear and Birth Anyway

  1. birthguru says:

    Excellent reading as always and so true . I realised along time ago that teaching pain control techniques in hypnobirthing was wrong so decided to go wherever the couple needed support with fear anxiety grief or trauma whatever . As a midwife I see this out pouring in labour and welcome it , once the woman is done with expressing her panic and worry she can settle and concentrate. I have heard women in my consulting room say the midwives said I looked calm but it was the most awful experience of my life , so when I am with someone who appears calm I know this may not be the whole truth . The body and labour will usually give up its own information and we can then talk about how she is and if she needs anything . When women are noisy many of my colleagues make unnecessary comments and question my midwifery ability and there is a difference between ” healthy” birthing noises and “scarey fear based screams ” but in any way its a case of continuing the support in the best possible manner . Thanks for raising topic .

  2. Jacky says:

    The realism of birth can sometimes slip away when radicalism is needed to reclaim natural birth. Thank you for this realistic view of healthy fear and pain during labour.

  3. laura innes says:

    Thank you for this. x

    Sent from my iPad

  4. joyce says:

    Beautiful post, thank you!

    Joyce Hoek-Pula 06 18 29 39 41 http://www.embracingbirth.nl

    doula, zwangerschapsbegeleiding, babymassage ________________________________________

  5. Denise Hynd says:

    I would add “In pregnancy – if needed explore what you know and believe about how other women have birthed before you, your mothers and sisters through the ages.
    “In labour when the fear comes try to stop and connect with your baby, how are they feeling, behaving? Take your cue from her/him to work with them in this labour respecting your body which created this baby has the capacity to birth positively.

    • Thanks Denise – I agree :)

    • Melissa says:

      I love this comment so much! I had given birth twice before I ever stopped to wonder how it might feel from my baby’s perspective. It was so new, and awakening to really try and connect to my next baby when I was in labor. I had very deep feelings for my first two children upon seeing them, but I felt so much of a connection with my third when I looked at him and said, “Yes, I know. That was difficult for you too.” I was already giving of myself when I birthed, but when I stepped out of myself and into his shoes, it really opened up a new facet of birth for me. I’m a little sad now that I was so “selfish” before in my other two births. It is in the past now, of course, but I could have made it more pleasant for my first two sons, I think, if I had birthed with them instead of merely birthing them.

  6. Jenna Monro-Argent says:

    There is so much liberation in letting go, I really respect and celebrate any woman who can be herself in her body. Control is counterproductive to instinct. Fear drives instinctive behaviour. You make perfect sense once again! A pleasure to read and a pleasure to ponder.
    Thanks

  7. Kate says:

    Thank you for another beautiful post. This one really resonated with me; I’ve been exploring a lot of the fears I had in my last birth, as I approach my next birth in a few months. I too have noticed that some birth preparation books insist there is no room in labour for fear, that you must eliminate all of your fears before you can push your baby out. How can anyone eliminate all of their fears, particularly with a deadline (the birth!) looming? It seems to me a much gentler approach to acknowledge fears, process them as best as you can, but not expect to be fear-free in birth. I find this a much more empowering idea – that fear is normal and can be handled/released in labour – rather than putting unrealistic pressure on myself to become enlightened before I give birth!

  8. Ann Higson says:

    OMG. As a dedicated follower of your blog I am left frustrated and annoyed by this latest post. Fear has no place within labour. In fact fear causes labour contractions to become painful as outlined in the Kindle book ‘Pain Free Labour’. There is a logical physical explanation to why fear and adrenalin mess with a normal labour. Telling women that it is OK to feel fear in labour is setting them up for a long painful labour, what is the point of that? Do you even understand the anatomy and physiology of labour? The first stage of labour was never designed by nature to cause the sensation of pain. We make the contractions painful by spreading the idea of fear into pregnant women. I never thought I would see the day when midwifethinking added to the stupid social construct that labour was meant to be painful. I am going away now to cry. Ann

    • Katie says:

      Ann,
      I was taught exactly what you are saying, that labour was not meant to be painful and that we need to breathe away all fears and there won’t be pain only pressure. But what I wasn’t told is what would happen when my baby turned posterior. That wasn’t regular contractions (I was fine with the pressure of those). I was suddenly in intense pain and there wasn’t a calm breath in the world that would take it away. I battled on through a relatively textbook and short labour but fear crept up in me when I felt the pressure of her head coming down. No matter how hard I tried to remain calm and let go of the fear I was completely overcome. Yes, maybe my baby would have been born an hour earlier had I been able to let go of that fear but what your kind of teaching did for me, the way it failed me was by teaching me that if I did feel fear and pain I hadn’t done birth right, the way it was SUPPOSED to be. As a result I am now suffering PND. I think the point of this post was to acknowledge that its ok to be afraid and its ok not the be some perfect serene goddess… By letting go of any sense of how we SHOULD feel or act to be doing it correctly we are more likely to have a fearless and pain free birth anyway! Feeling the fear and/or pain and working through it and then allowing ourselves to let it go or ebb and flow naturally is much more constructive than flat out denying it or creating expectations for ourselves. It’s all just a matter of perspective that’s all.

      • Lauren says:

        Ann,
        Of course extreme fear can increase the sensation of pain. Wouldn’t it be lovely if we could eliminate all fear from childbirth? Of course, but it’s just not realistic for everyone. Even when a woman thinks that she has let go of all of her fears during pregnancy, they often come to her while in labor. Having the expectation that she should not have these fears just sets her up for feeling like a failure if she does feel them. If we acknowledge that most women do have some amount of fear in labor, we can help them move THROUGH the fear instead of denying it exists. That way she can feel EMPOWERED by her birth experience. As a mother who gave birth by cesarean two years ago I have gone through a lot of self blame for what happened and I think much of that stems from my midwife suggesting (after lots of early labor) anti-anxiety medication and trying to get me to “relax” more during contractions. When I wasn’t able to labor exactly as she suggested, I felt like a failure and stopped thinking for myself (leading to a cascade of interventions and surgical birth). Yes, I was anxious, but what I really needed was some reassurance and encouragement, not someone sending me the message that I should not be feeling the way I was.

    • Midwife thinking said the place for fear was at transition and yes this is a scary time, when you just want it to stop and you’ll do it tomorrow, or go home (oh dear, I am at home – what now?) this ties in with the physiology positive role of adrenalin and Fergusson’s reflex as the head passes through the cervix. I think the fear is physiological (if emotions can be physiological – why not?) transition is the point of no return, quite simply the baby must now be born, the fear is a way of mobilising the mother to make sure that he is born. Yes, I don’t think labour contractions are always painful, though some are and I think of pain as a signal to do something, relax, change position, ‘rub my back’, whatever. But it can be an exciting sort of fear as in “OMG, this is it, help” a joyful sort of fear that galvanises you to action and prepares you to get out of the dreamy state and be ready to receive your newborn.

    • Ann – this post is in response to the many women who express the same sentiments as Katie and Lauren… a lot of my work with women antenatally involves unpicking their previous birth experiences and discussing feelings of failure. I agree feeling relaxed and minimising reduces pain… but most women can’t sustain this all the way through their labour.
      As for anatomy and physiology – I hope I know it as I spend a lot of my time teaching it to university students. I’m happy to explain the physiological basis for pain in labour… but might save it for another post. I’m sorry you are upset by my perspective.

    • julitownsend says:

      Ann, I believe that nature needed to send us a very powerful message to let us know we are about to give birth and undergo an amazing transformation, way before we had doctors giving us ‘due dates,’ and pain is very difficult to ignore.
      However, although I agree that fear doesn’t help us labour well, it is something that is absorbed by mothers from the society they live in, and it’s great to acknowledge that some women will experience this, tell them it’s okay and offer them advice to help.
      I think this post does a great job at that.

    • Sara r. says:

      In all honesty I was less fearful in my second birth, yet the birth was more painful, perhaps because of the baby’s hand/arm being up by his face. His birth was much more intense than I was comfortable with, and I had some moments where I really felt out-of-control and I was much more verbal than in my first birth. I don’t understand how it helps to make sweeping generalisations like “fear makes birth harder and without it birth is not painful”. Many women would disagree with you there.

    • Sandra says:

      Ann,
      What a disparaging comment. I think women like you and your ideas are why I felt (and feel) so sad and confused and alienated after my “all-natural very fast homebirth” which also happened to be very scary and painful and did a lot of damage to my body too. Sad . . . please rethink your theories. They have hurt lots of women like me that were told if they had fear they weren’t doing it right. Thank you for this wonderful blogpost. It brought tears to my eyes.

    • carissa says:

      I must say I disagree with your position. I have four homebirthed babies including twins. With my first I felt no fear about the process, believing i would only feel pain if I was afraid. I was extremely shocked at the pain of labor and became terrified thinking I had been lied to about this BS I was naive enough to believe. With my second I was scared of the pain I thought would come, however it was an easy labor and delivery, that I later described as a “walk in the park”, the twins were also easy, though not painless. I think it is a huge disservice to women to sell them the idea that to feel pain during childbirth is abnormal, because it is not, but I will say some things do intensify pain and fear, which is why my mom wasnt there for the second birth and I found a midwife I resonated better with.

  9. Steph says:

    As my lecturer at Uni and a big role model to me- yes MidwifeThinking does know the ins and outs of the of the anatomy and physiology of labour more then anyone I have met!! I think the point she may be trying to make is that it is in our human nature to experience fear during labour and instead of seeing it as a bad thing…embrace it and accept it and work through it. Yes of course we know that fear = a rise in adrenaline which = a decrease in oxytocin….but MidwifeThinking is thinking outside the square and making a point that it is ok to have these fears and acknowledging them….better that then to deny them ;) Telling a woman it is NOT OK to feel fear in the birth room is a very negative thing and will only make women think they are doing things wrong…..no one has any right to take away anything from a woman in the birth room ….not even her fears…they are hers. Help her through them of course ;)

  10. Eirinn says:

    You have stolen the title of my birth story! After two caesareans (the second was a homebirth transfer), I had moved from a place of trusting my body, to a place of fearing that I just couldn’t do it. Reading through discussions in natural birth forums scared me further; if fear is so detrimental, how was I ever going to birth a baby naturally? I discussed my fears all throughout my third pregnancy with my midwives and doula, and I told them I was going to feel the fear and do it anyway. Like Kate, I found acknowledging the fear more empowering than trying to eliminate it. I had a HBA2C six weeks ago, and it was a wonderful, straightforward labour where fear played no part.

  11. Katie says:

    THANKYOU so much for this beautifully written post. You brought tears to my eyes because I am one of the women who is still struggling with ‘mother guilt’ for getting fearful and losing-it during my labour (which included 4 long hours of transition in a hospital with no air conditioning turned on!). I have suffered from anxiety in the past but coming into my birth felt amazingly sure of myself, I was prepared, I did CalmBirth, I was in control and then I was in labour and it all changed! I had an 8 hour labour (+24hrs early labour) completely drug free and birthed my baby in water, pulling her up onto my chest myself. It was magical at that final moment and was a text book ‘perfect birth’ but during transition and pushing I was an absolute panicked mess and as a result in the days, weeks and months after have seen the return of my anxiety and PND due partly to my intense personal criticism of my behaviour during labour. Finally I feel like someone has released me from the burden of those feelings. Everyone around me told me and still tells me I did a wonderful job and although I know it to be true on some level. I have struggled with really feeling it until I read your words. THANKYOU again xx

  12. AJ says:

    I gave birth a month ago – first home birth after a couple hospital births – and was shaken by the fear and ‘losing control’ feeling I experienced during the last hour. Especially shocking was that my MW and husband afterwards commented about how beautifully I’d done, how smoothly and easily the birth happened. How could they not have felt any of that pain and fear I’d just gone through – it was so huge! Now that I know that this is what an unhindered, natural birth often looks like, I don’t feel ashamed that I did not maintain perfect control through the entire process. And I read the words of Mary shortly before she delivers Jesus and I understand them completely – “Oh, I wish I had died before this and was in oblivion, forgotten.” (Quran 19:23)

  13. Amen Steph!
    I am a midwife and HypnoBirthing proponent and am all about educating women about peaceful gentle birthing and giving them tools for coping with the extreme sensations associated with labor and birth. I also believe that to try to claim there should be NO pain would be a dis-sservice to women.
    What would we say to the woman who is going through an experience of labor with a baby in a persistent direct OP position WITH a compound fetal arm up next to the babe’s head as each surge of labor causes intense knife-like back pain and a fetal elbow is jabbing the lower uterine segment? She is NOT doing anything wrong if she is expresses fears or loudly in complaining of PAIN, yes pain!.
    On the other hand, I have seen women with extremes of irrational fear become completely incapacitated in early stages of labor (< 3 cm dilated) by that fear. I recognize what media-driven or abuse-related irrational fears can do to a woman's coping abilities and the associated real physical responses. An extreme catecholamine response can be harmful, and counterproductive but for some women, it is their reality. Education about birth and giving tools for coping is most often helpful, but not in all cases. Even women with a healthy attitude toward birth, with all the coping tools to be had can have an extremely painful experience and it is not necessarily because of a fear-induced catecholamine response.
    I don't believe pain in labor is a stupid social construct, sometimes it just IS painful.
    Thanks again, Rachel, for a thoughtful and well-written post.
    Merideth

    • Katie says:

      THANKYOU Meredith for acknowledging that labour sometimes just IS painful! Especially for us Mummy’s of Posterior babies!!!

    • Steph says:

      Yeah totally agree with you too – a huge disservice to women by enforcing that fear is not ok! And I also agree that pain is not a stupid social construct…it’s real!!

  14. Sadie says:

    Another excellent blog Rachel. When I had my first child I did not attend antenatal classes, did not have any scans, hardly saw a doctor because I had grown up seeing home-birth and listening to my Mother’s friends. Therefore, in 1979 I just went with my body. I had no fear – and I birthed my baby after a 6 hour labour. Fear is without doubt the enemy of women in childbirth. Hurrah for blogs like yours.

  15. Comadrona says:

    Wow, Ann Higson, have you watched a few hundred women give birth and have you done it yourself? This sort of judgement is just the kind of rubbish I was fed many years ago, when I was birthing one of my babies, by a God-bothering midwife who basically said I was feeling pain because I didn’t surrender to the Lord or some such. I’ve midwifed quite a few women – at home and in hospital -some had great pain, some had almost none. Some were deathly afraid and some had what I would say is a normal amount of trepidation for the great unknown journey they were embarking on. Pain is real and fear is real for some, if not all, birthing women at some stage. Fear and pain don’t have to be crippling and disempowering, however, but can be signposts to prompt the mother to make some sort of change and, with loving support, mothers tend to move through the fear and birth their babies just fine. The minute we place value judgements and decide “what” or “how” women should be feeling and acting in labour, we are part of the problem.

    • Jennifer says:

      Interesting, because the bible itself tells us that we will feel pain during childbirth. So, to say the woman isn’t giving herself to God and that’s why she is feeling pain is absolutely bogus.

  16. Christa says:

    I love what you are trying to say here but I feel that in your effort to acknowledge fear as a normal/healthy part of birth, you’ve inadvertently “bashed” childbirth prep courses, the “tools/techniques” they teach and the idea of addressing fears before the birth. It IS important to address fears before the birth, try to process them and even move past them if possible. But of course it’s ok to feel fear during the birth too! It’s sad that some childbirth educators are saying crazy things like there’s a “right” way to birth, but I hope they are the minority.

    “Feel the fear and birth anyway” is a fantastic attitude but a woman still needs some tools/techniques to fall back on in order to process those feelings and move past them during the birth. Whether she learns them in a class or just draws on inner resources she had already developed, it doesn’t matter.

    “We have created a culture (and birth culture) that seeks to avoid and minimise extreme emotion and pain, and encourages being in control. We use medications and/or skills, methods and techniques to remain in control and dampen the emotions – or at least the expression of those emotions.”
    I’m uneasy with comparing “coping techniques” or “comfort measures” to medication. They are not the same in purpose and are certainly not to “remain in control and dampen the emotions or the expression of those emotions”. Their purpose is to give a woman some tools to to help her tune into her body and follow her natural urges – whether that is to make noise or go within. Their purpose is to help a woman FIND her primal self, not to teach her to act a certain way or to not acknowledge her feelings.

    I’m not sure how else to explain it but something just felt a bit off with this one xxxx

    • Briohny Taylor says:

      I think the comments about the coping techniques made me feel a little squeamish too – prior to my second labour I read Birth Skills and found some of them to be incredibly helpful in keeping me calm and not too focused on the peaks of contractions. I wasn’t quiet, I wasn’t afraid, I did feel pain, and nevertheless I had a very quick birth and felt amazing afterwards, and I attribute this mostly to my coping strategies. There was one moment (in transition?) when I said something like “I really don’t want to be here anymore” and then out she came.

      But I do agree with this post overall, I feel like there is a lot of pressure on women to birth a certain way, and to feel certain things, and as a new mum I really don’t think we need any more pressure, from others or from ourselves! Some lovely ideas from MT and the other comments.

      Congratulations on finishing your thesis Rachel!

      • Christa and Briohny

        I’ve made some small edits based on your comments as I can see my post has been interpreted as implying coping techniques are a bad thing. They can be a good thing for some women… it depends on how they are presented and her expectations of them.

        I think medication (opiates) and some of the techniques women are taught are similar. Both work by relaxing the woman = reducing perception of pain … and making her look less fearful or in pain from the outside – sometimes the outside does not match the inside in both cases.

        I understand that some women like to learn skills and benefit from them in labour. But I also want women to know that the don’t have to have a set of skills to birth… or even to help them cope with fear.

        Thanks for you input and perspective. Debate is good :)

  17. robynheud says:

    Thank you so much for your amazing post. With my homebirth I spent most of my very fast labor moaning like a cow. He wasn’t posterior, but, oh, the back pain. Hands and knees and bellowing was the only way I could handle the pain. I even had double-peaking contractions, and up until labor hit, I had been preparing to just “breathe the baby out” and maybe with more practice and less denial that this was really it (I was 4 weeks early) it might have been less painful, but I doubt it. I also experienced that fear when I was in transition, telling my husband I was done and didn’t want to do it, and thinking to myself it was time to go to the hospital and get an epidural (and TBH, epidurals terrify me – the whole needle in the back thing – so my “fear” must have been pretty bad to even consider that). But the big thing was, I didn’t feel hindered. The whole labor lasted less than 3-1/2 hours from water breaking to baby being born. In spite of the fear I felt I felt free to dance around and bellow and make completely irrational statements. The title “Feel the Fear and Birth Anyway” is perfect, because fear doesn’t have to hold you back. It is not always a hindrance. And honestly, when I do something amazing in spite of the pain and in spite of my fears, I am stronger for it, as are we all.

  18. Cathy Welch says:

    As a Natal Hypnotherapy practitioner I would agree that it is important that women can approach labour having reduced their fears and built up their confidence and trust in their ability to birth their baby. During labour itself there may be times when women doubt themselves and their bodies, they may feel fear and apprehension, they may feel as if they are ‘losing it’ – and that is when the role of the supporter/midwife is so important. To hold her and help her through those times – not undermining the process and panicking on her behalf. Those adrenalin filled moments serve a real purpose (as others have said more eloquently than I can) and are part of the journey into motherhood. So, while I definitely believe that women benefit from dealing with their fears before labour starts and by keeping as calm as they can during labour, I also know that they will also experience an intense roller-coaster of emotions as labour progresses and by knowing and understanding that they, and their carers, can work together towards a positive and empowering birth experience.

  19. Wise words as ever. And completely agree that in terms of labour and birth, physiological fear can be part of it. That all manner of intense emotions can be felt, and that they are normal and will pass. In this connection, I have been surprised by two first-time mums I supported who practised hypnobirthing techniques for labour, (and absolutely reaped the very many wonderful benefits) but when it came to the more tumultuous point of labour, they both said ‘ it isn’t supposed to be like this.’ They almost seemed let-down, and certainly felt something was wrong. As a less experienced doula, I would often make the mistake of stepping in all the time, to ‘rescue’ the woman from her peak of intensity…until a wonderful midwife once touched me on the arm and urged me to resist, pause…’let her feel it, she will see that it passes, and that’s what takes it forward…’ Michel Odent and Liliana, as MT comments, also always urge this approach. This way the woman is truly letting her body take over, soaring, sometimes struggling, but then soaring again…and this is why it is a rite of passage and why my husband is envious, shortchanged even that as a Western man, there is nothing for him to go through that even comes close to this – a lesson on what it means to be alive.. But though I agree we should embrace and accept physiological fear…CULTURALLY-IMPOSED fear of birth, which is widespread and insidious, and spread by 1) turning maternity care into medicine 2) the media 3) trafficking of traumatic birth stories 4) bad birth education – DOES needs combatting, squashing flat in fact, as it is robbing women left right and centre of the experience above

  20. Thank you, thank you, thank you for writing this post! I’m a Lamaze certified childbirth educator, and what you wrote is exactly what I teach. You have expressed it much more eloquently than I could have.

    I also talk about the difference between pain and suffering. “Pain is inevitable, suffering is optional.” We have many ways to cope with the pain of labor, these are the skills I teach. I also teach that if pain should ever roll over into suffering, then a mother needs to seeks out additional pain relief, whether that’s medication, or another support person, etc.

    On to fear – I think much of the belief system is around the fear-tension-pain cycle by Dr. Grantley Dick-Read. So, many childbirth ed. programs seek to eliminate fear to break the cycle. Although fear can have an impact on birth, when we resolve some of these fears through education “Oh, I didn’t know I could push in any other position other than that lying down/semi-seated position!” (I heard that one last night…) we can help a mother to go into her birth confident. Education about the normal emotional state of transition can help her and her partner to move through it more easily and with confidence that she is progressing towards pushing.

    So, again, thank you.

  21. Stephanie says:

    My husband and I love our children and wanted a large family. (Let that sentence sink in before you get the wrong idea reading this next part.) It’s a good thing we do, because I am a childbirth junkie. Childbirth is my favorite sport to participate in or watch. I have given birth unmedicated (except for half a dose of a muscle relaxer at the very end of my first birth, which was totally unnoticed) eleven times. Ladies, I have had all these children and am passionate about natural birth, but after the first few babies I’ve noticed there comes a time in every pregnancy (normally referred to as the third trimester) when I start dealing with fear. In between births, I know and remember better than a lot of women EXACTLY what those sensations feel like. I base that statement on my earlier experiences when I only had three or four children and the pain memories faded out between pregnancies. But practice makes perfect and a grand-multip may deal with fear more than a mom of just a few. My husband says I have a love-hate relationship with labor because at some point, and it may last only a few fleeting seconds if labor is progressing quickly, there is almost always still an element of fright and the fight or flight feeling kicks in. Although I can specifically think of two of my labors where I do not remember having that feeling (In one of them there was no time. There were only five contractions.) I truly believe it is just part of the process for most labors. It’s a time when the woman just needs support and encouragement and to be reminded gently of her pre-determined goals for birth if she seems to be panicking and straying from her desires that were determined in a time when she was not under stress. As far as quiet vs. noisy laboring women, every mother should be assured that whatever level of noise she makes is completely acceptable, with the exception of high-pitched panicking shrieking. Any low toned noises, whatever the volume are fine. Silence is fine. What is not fine is tension. Clenched jaws, breath-holding pushing, and scrunched up faces are signs that the body is not working with the other muscles in a wholistic way to birth the baby. Most importantly in regard to fear in childbirth is making sure that the mother is in the environment and with the people (regardless of where and who that is) that make her feel the safest.

    • jennifer. says:

      I identify better with this than the article. To me, a mother of six, the fears all arise in the pregnancy. I work through them or remind myself of having done that before. During the labor and delivery, there is only focus and fleeting thoughts, following the body’s lead and releasing it to do its work.

  22. Georgianna says:

    lovely post. i related to every word and i’m so glad someone else thinks the same way as me. thank you for your words.

  23. Jaclyn says:

    I cannot thank you enough for this post. I have been struggling so much with the way my labor went because I felt ashamed that I wasn’t a calm birthing goddess as I had seen in birth videos. I was powerfully loud… And now I realize from reading this that I was afraid. I was surrendering to my lack of control while fighting it by using my powerful voice. I truly can’t thank you enough for writing this. I feel as if a part of me has healed. My birth experience and my pregnancy AND my postpartum period have been a source of shame and I wasn’t sure I would ever have another child. Reading this post makes me feel as if a weight has been lifted. As if, I’ve been given permission to not be a calm fertility goddess but to be who I really am. Thank you. (Did I say thanks yet? Ha!)

  24. Sophie says:

    Terrific post. As a hypnotherapist I taught a well known form of hypnobirthing for years and just couldn’t teach women any longer for exactly these reasons. I’m now a doula and teach Mindful Mamma which uses hypnosis but in a very different way. One of things we work at is giving the women confidence to express themselves without fear, to ask questions without fear, and the dads to support them by putting judgement aside. Some women are naturally calm, but others, for whom the intent of being calm masks other fears around being observed, not being compliant and not behaving in a “socially acceptable way” it’s unhelpful. Any form of psychological preparation should be about freeing the women from those types of fears to have the confidence to embrace her experience, whichever path that takes and to know that she can do it.

    If the couple are very well prepared, the mum should feel held within her space by a confident partner, free of judgement. I see fears come up at births, even if you’ve worked therapeutically with someone beforehand; birth is a psychological process in itself. As a therapist, my experience is that if someone knows that their space is held, and that their fears are held safely in this place, mindfully by whomever is there, they are able to express themselves however is right for them in that moment. This definitely makes for a more positive experience.

  25. I could agree more!!! Thank you so much for everything you write!!Fear is so natural during birth, like it’s pain.

  26. abuela says:

    I loved this post and felt that my ideas about how to support women during transition (or whenever they are overwhelmed or fearful) were reinforced beautifully. I see how this point of view is very valuable for those of us who work with laboring women and also for women who are processing their experiences after giving birth. What I wonder about is how to communicate this understanding to pregnant women who are preparing for birth. I’m afraid that in teaching “feel the fear and birth anyway,” we can create fear of the fear. I’m not saying that it shouldn’t be taught. I’m just interested in others’ ideas about how to communicate this message without adding one more thing for women to fear.

    • I think just warning women (and their birth partners) that there’ll probably be a time at transition when they’ll want to give up but that this is a sign that they are about to have their baby is probably enough

  27. Mary says:

    Spot on :-)

  28. zo - maman sf says:

    Rachel, merci infiniment pour ce post aux propos incroyablement justes ! Une nouvelle fois, j’ai eu beaucoup de plaisir à découvrir un nouvel article du blog ! Hâte de continuer ! zo (french mother & midwife)

  29. Reblogged this on Learning Motherhood and commented:
    I love this post from Midwife Thinking on pain and fear in labor. I’ve been hearing a lot lately about how labor isn’t supposed to hurt. I haven’t found that to be true for either my own births or those of the vast majority of women I have been with in labor.

  30. Thanks everyone for your comments. I knew I could rely on you to generously contribute to the post with experiences and opinions. When I direct students and mothers to this site I always tell them to read the comments as they provide valuable insights. :)

    • AcesPlace says:

      Great reply. One of the reasons I never had any children was because I didn’t want to experience the pain and the fear. I wanted a child, and I lost 4 great relationships because I chose to not have any children, but I did get to avoid the pain, the physical and emotional damage, and the fear. What I didn’t get to avoid was the irate family members who have no grandchildren, the lost engagements and relationships, and the loneliness that now has set in since I am over 50, single and childless. I just could not see myself coping with the pain and the fear without long-term debilitating physical and emotional damage. As a depression sufferer, I fully expected to suffer from post-partum psychosis. So I spent a lifetime lying to everyone, telling them all I didn’t like children. Those of us who are cursed with deep fear of childbirth and who suffer psychological damage from pain could benefit from information contained in this article. There are more women like me than you might imagine. They privately tell me they understand when no one else is around to listen. They are too embarassed to admit it, or they are too afraid of their family’s reaction to the decision to be childless, but they–we–are there in droves. Thank you for a great article. Maybe it will save some younger women.

  31. Guinevere says:

    Thank you for this great blog. Since my 3rd baby’s birth 6 months ago I’ve been thinking a lot about birth videos – exactly as you say, when you watch a video of a very relaxed mum birthing calmly, you tend to assume that she is feeling totally calm. I was very relaxed and not fearful during my son’s birth but I was certainly feeling pain both during and in between surges (unlike my first two labours) – I was working with this in my head all the time and it wasn’t easy, but when I saw the photos afterwards I looked completely relaxed like the women in the birth videos! So I guess what I’m saying is sometimes the videos don’t give an accurate impression of the woman’s experience, and perhaps this is contributing to an ideal of what birth ‘should’ be like – birth stories that tell what the woman was feeling are perhaps more helpful in giving a rounded picture.

  32. Mel Cameron says:

    Nice one Rach! Yes it is painful , yes it is scary and to deny women their fears is as patriarchal as wanting to control childbirth in a technocratic environment. Childbirth is not owned by anyone but the woman who is experiencing it. What she feels is hers; to deny her of her emotions is doing a great disservice to women.

    • Stephanie says:

      Well said!

      • Melissa Pate says:

        Thank you! This is exactly how I have felt. I have labored 4 times. The first three ended in c-section. The third was a homebirth turned hospital transfer. That was the most damaging. A homebirth midwife I trusted to hold the space for me tormented and traumatized me physically and emotionally. Her patriarchal approach was the hardest to deal with because I trusted her to be different. I feel that to deny a woman her feelings no matter what they are is to blame her for even having them. I had fear of being judged for having fear. The happy ending is that I found an amazing, supportive, loving, accepting midwife to attend me at home with my fourth child and gave birth in my bedroom after 3 c-sections. I know I could have never done this without her complete acceptance of all of my responses to pain in labor including fear.

    • HERE HERE!! no good replacing one control with another

  33. amelia says:

    restrictive and inaccurate definitions of what “fear” is have conditioned womens perceptions of fear in labour – “fear” in the context of childbirth is not a linear logical psychological process alone – it is a compression and an expression of the essence of woman and its presence at that pivitol time in labout provides her with a choice and the opportunity to let go to surrender to give herself her energy and her body fully into the birthing of the baby. Education about “fear” in labour needs to change and i congratulate midwife thinking for writing about this subject.

    • amelia says:

      PS – I have given birth 6 times and each time brought its own unique experience –
      The birth of my second child was a classic perfect birth – lol – not an ounce of fear felt at any stage. My 3rd child was born in a posterior position and I can tell you during that labour there were times when fear played its part. And it was perfectly acceptable for this to be so!
      Fear is but another emotion or feeling that like many others is transitory in labour – it comes and it goes – fear should not be feared – it can be as helpful as any other feeling but it is the one feeling that typically “is not allowed” to be expressed in the labour process.
      My 5th child was a home birth and as the second stage was progressing I could feel that the baby was not descending like my others had – this was the hardest work I had ever done and I felt the baby was stuck – did I feel fear – you betcha – was that wrong or inappropriate – no way – it was a normal response in those circumstances – part of the purpose of fears presence in this specific instance was to alert me and to alert my midwife – I needed to be doing something very different to what I had been doing – and I did – my son was born some time after that in a calm and peaceful space at home – he was 12 pounds 11 ounces ( 5.75kilo)

  34. Tamrin says:

    thank you midwifethinking, your post is 100% spot on..!
    I loved watching videos of people giving birth when I was pregnant. Many of the women in the videos gave birth silently and without seeming like there was much pain happening at all (although I know now that that is not true). I thought the couple of women who made some noise and commotion while giving birth were just silly as I had made my ignorant little primip mind up to give birth just like the ‘silent and in control’ looking mothers. Well, when it came time for me to give birth…I thought that the bad period pain for eight hours was a breeze until these intense huge tightenings overtook my whole body for the next 6 hours until my son was born…it was like my perfect little preconceived idea of birthing was hit head on with a double decker bus!!!…I am a very expressive person and remember thinking that I needed to let some freaking sound come out of my body as I was not in a good place for myself trying to ‘hold it all in’…when I apologised to my midwife for making such a horrendous noise, she was perfect and just whispered to me that it was ok and I could make whatever sounds I needed to. Well!..you think I would have already known that?….I was in my own home for goodness sake!..but because I had this silly idea of what birth should be like In my head I was fighting back who i really was and so I wasn’t getting anywhere. As soon as she spoke those tender words….I felt free and got on with birthing my son….loudly and intensely!!
    After my birth I remember thinking that I needed to burn all those DVD’s that I had watched…I couldn’t though, as they were borrowed!!

  35. jennifer. says:

    But… What of us that truly have no fear in labor? There is nothing frightening in transition, there is only a doorway to pass through. A change in the physical body that ushers in the next stage. It’s not a moment of fear for me, it’s a decision to continue to follow the body’s lead as the body changes directions. From opening, one reaches the top, the climax, and dives into the time to bear down. Sometimes, this climax is greeted with a pause, a time of reflection and almost like a short walk to the end of the high dive so that the final act can begin. Other times, there is just the change and the bearing down begins without control.

  36. chantelletee says:

    Thanks for posting about fear. It’s the f-word of labour. Although I’m not averse to the other f-words! I always say to women when they are in this time of intense fear (transition) that its ok to be frightened, we’ll ride it together, use your fear etc. Partners (male) on the other hand will try and stop the woman often by saying ‘don’t be frightened’ I know they mean well and are trying to make it better (don’t men, God love ‘em, always want to provide you with a solution?!) but then the woman gets confused. I’ve taken to saying to the man on the QT that she will behave like this and she just needs to know he is there supporting ie ‘it’s okay, I’m here’ etc rather than trying to negate her very real feelings.

  37. Maha Al Musa says:

    Hi Rachel
    Great piece – I agree re fear and I talk about self generated fear in my Bellydancebirth program – moving into and thru the portal of birth is similar to states of making love – to excavate into the depths of ones womb story n body holdings to peel back the layers – fear may be there and that these holdings have opportunity to rise to surface to be greeted – have no fear of fear it is part of the whole journey into knowing thyself – when I home Birthed at 46 I included footage of my deep crying breakdown during active stage and talked about the necessity to go to that place of emotional grief to face old wounding – how blessed I was to get that space n time to do so Anyway I love this and talk on this often
    Thank you xx

  38. Sandy Riley says:

    Thankyou, interesting topic I am a hypnodoula and I support your views on fear in birth!

  39. zoe says:

    Praise to sensible talk, thank you Rachel zx

  40. julitownsend says:

    This topic has stimulated some wonderful discussion. It is great to read the triumphant stories, but also sad that many women felt judged or that they failed. I have written a fictional story based on my experiences as a midwife in the hope that it would stimulate such discussions among the wider population. First, I have to get it noticed.
    I believe that as much as we prepare to avoid fear, there can be a subconscious memory that may emerge and create fear at unexpected moments. Our bodies also have a memory. As a midwife, I often observed this in action with mothers who had an earlier traumatic birthing experience.
    In my novel, Absent Children, Jessamy and Luke both experience this fear during the birth of their second baby. The birth of their first baby ended tragically, but they prepared well for the second baby and were convinced they held no fear. All went smoothly until the moment when things had gone wrong with the first baby. Then, overwhelming fear hit.
    If you’re interested, you can see what other readers are saying about Absent Children here: http://tinyurl.com/d2ze4u6

  41. Jaclyn says:

    Reblogged this on Kinda Crunchy and commented:
    I had to share this post with my readers because it touches on a subject that I am very passionate about. As you may have read in my post “I am Birthing, Hear Me Roar,” I have struggled with feelings of disappointment and shame regarding my birth experience. This post brought me closer to healing. I am so thankful that I read it! Hope you all enjoy it as much as I did!

  42. streiberts says:

    Hej,

    I just wanted to share something with you as I used Hypnobabies and it totally gave me so much. There was a small point of fear when transition was nearly over and I felt that I had to push out once again a complete baby ;-) But I had the courage to say so to my midwife and she empowered me by just saying: “Yes, and you are brave about that now and just do it! You can do it!”
    My first birth (birth center with midwife) was, even if everything went fine – not so nice for me. In the end I was only glad that it was over,I felt kind of violated trough all these intense feelings and pain and could not just love the girl I got for about two weeks.
    This was all very different with the second birth, it went so much smoother on the emotional level for me. And one additonal thing just blew my mind yesterday.

    So here is what Hypnobabies gave me:
    I will have my medical finals next week. I was with a coach who works with hypnosis to work for a calm and relaxed feeling during the finals so I remember everything and have my full potential – as it is really hard.
    So I had to find two situations where I felt the feelings I wanted to feel in the exam. Beforehand I said I wanted to be calm and in control, let it flow intuitively although I sure am a little excited. And I wanted to be totally focussed on myself. He told me (in a trance) to think about one situation for every feeling. So one of the two situations was me teaching one of my best yoga classes and the other where I felt totally self-empowered and in control while letting it flow and being focused on myself – it was my Hypnobabies birth that sprang to my mind.

    And isn’t that the most amazing thing? The situation that so many women describe as a loss of control, as being filled with fear and pain – for me (even though there was some kind of pain as I pictured the transition) it was just me coping with a situation that needed all of my strength and concentration. Where there was none but me even if my midwife entered the room and my husband was around and my mother left to pick up our firstborn girl.
    There was just the picture of me being totally calm and breathing, totally within myself in a demanding situation. Just me, everything was fine.

    I’m really glad Hypnobabies did not just help me to have abetter birth, but gave me a resource to live from for the rest of my life :-)

    Still in the end while pushing I was screaming and not breathing anything out :-D And I was fine with that as every woman birthes differently – thanks to an article of you here earlier that was very clear to me. (I did not proceed to the Hypnobabies Pushing CD – have to listen to that anytime soon to know what’s in there…)

  43. Emma Lund says:

    Thank you for this discussion. My opinion is that when women are birthing their babies it is completely natural to experience SOME anxiety, fear, stress, loss of control associated with the “fight flight freeze” response. We simply can not avoid that because some of the hormones ie adrenaline etc produced just prior to the baby being born are designed to assist with the process, and are actually necessary for the natural expulsive reflex to work and for your baby to be “ejected”. It is as much a psychological state as a physiological state. It is common for the mother to feel a sudden rush of energy and she may also experience fear, anger and excitement. Depending on many factors such as the mothers level of trust, personality, circumstances, expressive behaviours, cultural norms etc etc she will react to the activation of the fight-flight response in different ways. Some will swear, some will shout and others will experience the same sensations and feelings as the woman screaming but will look calm and internalise their emotions (like I have done three times!! and I have felt just as much intensity as others Ive spoken to who behaved differently). Just as we all behave differently in stressful situations, we will all birth differently and that is what makes us human. Accept that your behaviour, the way you cope with the experience and your interpretations of your birthing are all unique and to be appreciated. Do not judge yourself and others in a harsh way pleeeasse. Emma

  44. Welcome back! It had been awhile since I checked up on your blog, and though I’m a little late, glad to have you back. I haven’t had my first child yet, but I agree with you, I do almost “fear” childbirth. Maybe it is the unknown or the fact that none of my close friends have gone through it yet so I don’t know what to expect, but I guess when the time comes, I will cross that bridge or at least have someone I can talk to about the process.
    Thanks for the great insights!

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  46. LauraJ says:

    Thank you so much for this post. I stumbled across your blog as I have been having trouble recently coming to terms with the birth of my daughter. I too attended calmbirth and religiously practised the breathing and visualisation which did help in early labour. I was 8cm when I got to hospital but as the contractions came on top of one another, I started to panic and ‘lose it’. I was trying to remain calm, but I was terrified. I wasn’t saying anything and because of this my partner and MW thought I was coping when in reality I was too terrified to speak. As the pain got too much and the breathing was no longer helping I was convinced that something was wrong and asked for an epidural. I felt like I had failed because I couldn’t ‘cope’ with transition. I understand now that what I was feeling was completely normal. I wish I had understood or I had the support at the time to help me understand that these feelings meant my baby was close and that I didn’t need to ‘cope’ with what I was gong through but instead work with these feelings to birth my baby.

    • Thank you for sharing your experience. I wrote this post because unfortunately I hear this ‘story’ a lot and women struggle to come to terms with the reality of their birth experience. It is so important that this aspect of birth is not hidden.

  47. Angela says:

    What a great blog. Will share it with other student midwives. Thanks for taking the time to write.

  48. nicole says:

    I am so greatful to be reading this. 36 weeks with my 3rd baby, my last delivery was fast and furious leaving me nervous this time around. I am afraid of many things…not being in control is definitely one. Something about being reminded of the natural process again and how normal it is has provided comfort. Especially appreciate the reminder to have only those in the room that can deal with you under those circumstances. I think havi ng to appear tougher than I feel can be a challenge and is exhausting in its own right. So, thank u again..for the reminder that it is ok to experience the full range of emotions without shame. Sometimes just hearing something with the right wording can transpose empowerment.

  49. Hannah says:

    Hi Rachel,
    I just wanted to comment and say that over the last few months I have read your whole blog and I have been hugely inspired by it! I started reading when I made the decision to follow my lifelong dream and apply to train as a midwife. Reading your blog has given me absolute conviction that not only do I want to work as a midwife but that I want to follow your lead by always thinking about and thoroughly researching ‘standard practice’ in order to find the safest, kindest and most empowering way to help each woman give birth. Thank you for your accessible yet well-reseached and intelligent posts, I look forward to reading more!

    Best wishes,
    Hannah

  50. Thank you for this post. We at “Birthing From Within” have been teaching this for decades, and it’s, in fact, a core piece of our childbirth classes. It can be an unpopular stance (as demonstrated by some of the comments here), and we’ve had a bit of an uphill battle as well, trying to normalize, expect, and even embrace the “darker” side of birth: the fear, doubt, freak-outs, and loss of control. When we neglect a part of birth (and life!), we are ignoring a part of what it is to be human, and to go through an initiation. To feel as if we might be shattered, out of control, or even dying is not something to be avoided but rather accepted as a part of bringing a baby into the world and being born as mother. This is the true meaning of holistic– being whole– acknowledging and embracing every possible part of an experience. As doulas and midwives and educators, we can help take the “shame” out of birth, and instead of avoiding doubt, pain, fear, help women (and their partners) prepare for it (emotionally and practically) and to love themselves even when they find themselves acting or doing something wild to get their baby out! Thank you!

    • That’s why I like the Birthing From Within approach. I have a good friend (Pernille) who has completed your education and provides brilliant preparation for birth sessions… and debriefing sessions too. :)

  51. cm says:

    GREAT post. We talk so much about getting rid of fear in birth but sometimes fear roars up in laboring women and if we let it come up it’ll move on. I was a birth last month where the nurse said to the first time mom at the end of transition when she was unraveling a little bit, “No crying! Mommies don’t cry!” [shudder] At a similar birth last week mom was sobbing at the end of transition but no one told her to stop. She said, “I don’t know why am I crying.” I told her, “you’re crying because you’re in transition and it’s a big transition and it brings up a lot of feelings. Let them come up and they’ll pass through you.” And sure enough they came up and they moved on! It’s fascinating to see fear come up like that. The tears almost seem like the fear coming out of your body and I suppose in a way they are.

  52. ImHereYoureNot says:

    I’m 52 years old, and I intentionally never had any children because I can honestly say I never saw or heard of a childbirth experience that I would want to have to remember the rest of my life. I can easily understand the earlier post where the writer said she didn’t love her new baby for two weeks. I can easily see myself not loving the baby ever. I don’t do things that scare me because I end up resenting the people and the experience. I think this is a great post because women should read it and think about how the fear is going to impact the rest of their lives. I know I did the right thing by not having a child, because I would without a doubt resent the child and despise the experience. We would have better quality mothers if the right women became mothers. I am not one of those people, and more power to those of you who are. The experiences look and sound horrendous, and I don’t know how you can do anything but hate the memory for the rest of your lives.

  53. Robyn says:

    I think the birthing woman’s partners influence is also a crucial factor. He/she needs to trust fully in them. Sometimes it’s not the partner it’s the mother or mother in law. But whoever it is if they start doubting this is picked up by the birthing woman and often escalates interventions. The importance of the role of the support person cannot be underestimated because they have a lot of power which if negative can be detrimental to the birthing woman who may already be battling their own internal fears and doubts.

    • Robyn says:

      I should also add the influence the midwife/doctors have on the woman at this vulnerable time as well but I guess that kind of goes without saying.

  54. Heidi Hodder says:

    good timing for me to read this as I’ve been going through a lot of intense emotions processing the birth of my third child who is now 9mths old.

    My second experience giving birth was ecstatic and completely pain-free and I expected number 3 to be easy at the very least . . I was shocked at feeling intense pain, some fear, need for reassurance, etc.

    I qualified as a HypnoBirthing practioner recently, something I’d thought about doing for years (I read a book on it while I was pregnant with number two) but was spurred on by the desire to offer something more tangible than advice to my sister who is expecting her first child. But I do have issues with the ‘black and white’ way birth is portrayed by some, & this is something I really feel I need to resolve if I’m going to be teaching childbirth education.

    There are lots of factors involved in why two of my births were painful & entailed ‘losing it’, and why the middle one was pure bliss. But was one birth preferable to the others?? Of course I would choose bliss if I had the choice . .but getting what we want is different to getting what we need . . Each birth was what it should be, what it needed to be to teach me about myself, it is still painful for me to admit that, painful to look back & see how deluded & egotistical I was, but there is nothing wrong with pain

  55. There is fear and then there is “fear”…. One is a primal human response to change, one that moves one forward to completion if we respond and work with it. The other is a socio-political stance. It is actually a resistance to feeling authentic fear and it is responsible for all the shutting down of birth in the contemporary global birth culture. We so often confuse the two.

    Ironically, I think the same political “fear” behind the medicalization of birth is the very same fear commenter-Ann has that, if a woman admits to feeling fear, the establishment will be proven right – that birth is a frightful and dangerous thing.

    The problem with this is that birth IS a frightful and dangerous thing…. and that’s ok. And while it is also many other things, maybe we don’t need to “fear” its dangerousness. Until we are ready to accept ourselves and acknowledge that birth is different for every mother and every baby, that birth is deeply unsettling and amazing and that it is powerful, intense… we will be stuck in a fractured denial.

    The terrifying exhilarating and motivating fear of a baby’s head passing through the threshold of birth is the stuff of mythology, of deep transformation, of transmutation into mother-ness. Let’s start honoring it and standing up for the real truth of birth, not the one that provides the fastest route to what we want ~ even if it’s birth freedom.

    Thank you for for honoring the precious and nearly extinct ability of humanity to be whole. ~ Krista

    “Fear is a natural reaction to moving closer to the truth” ~ Pema Chödrön

  56. Myrna says:

    this article took me back to my last birth. I was induced by AROM and no more interventions were needed… but I got to that stage in transition where I panicked. I just remember my husband ( who was holding me through all the contractions) just whispering “its nearly over” and that was enough to get me through the panic and focus on my body again. He was right…
    but that leads into care providers and support people and having someone there you can trust during birth to help you deal with the fear. I still am upset about not being able to have a home birth with one on one care that I needed emotionally.

  57. Sarah Egan says:

    This was a great article. There is a reason why support during birth is so important and you have pointed it out in this article. If birth was so easily controlled and painless then there wouldn’t be a need for doulas or other labor support! I am currently certifying to be a doula and I’ve had a hard time figuring out how to balance the positive aspects of natural birth and building a woman’s confidence in her ability to birth her baby with the reality of what natural birth entails. I want the women I support to know how wonderful of an experience natural birth can be but I also don’t want them to be surprised by the elements of birth that you have mentioned or feel as if they did or are doing something wrong when these moments arise.

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  60. “Also don’t be persuaded that you need to master particular skills to birth well… you already have everything you need within you.” This is how I teach my childbirth classes. It’s about discovering what’s already there and using your skills in a new way.

    Fear is a powerful motivator, and it could be either negative or positive. It is real, needs to be acknowledged and allowed to move on. Thanks for this post.

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  62. Cristina says:

    I personally find the article to be very negative and discouraging. I’m expecting my first in 10 weeks or less and was pretty calm and accepting about things until reading this. I’m having a home birth and your mentioning that birth is a dangerous time for mother and baby is just downright negative and fear inducing and i don’t appreciate it. Birth is not a dangerous time unless complications arise and many of those can be predetermined. Basically
    the women I’ve spoken to and seen birth cramp, feel pressure, some pain then feel
    like they’re having a huge bowel movement then the baby is there. Sounds pretty basic and natural. Not dangerous. (barring complications of course). Anyway, thanks bringing fear back into birthing.

    • I’m sorry that you found the article negative. You state that ‘birth is not a dangerous time unless complications arise’ – my point is that birth is dangerous because it can become complicated. Statistically for a healthy mother having a physiological birth this is unlikely… but still possible, hence our natural fear surrounding the process. I am pleased that the women you have spoken to and seen birth have experienced the births you describe. As a midwife who has attended hundreds of births the experience you describe is rare… Birth is ‘pretty basic and natural’… it is also powerful and challenging. I’d love to hear how you experience birth, if you want to come back and let us know.

      • cm says:

        As a childbirth educator I just wanted to chime in on this– I’ve been following this thread and love this post. I think some educators and birth advocates/classes really focus on the positive aspects of birth and it’s very appealing. But I think one risk to this is that we don’t acknowledge difficulty as a part of life and transformation and that is, I think, a disservice to us all in many ways. The more I age and mother and work with new parents the more I feel determined to talk about struggle and challenge in a way that normalizes it. When we want to erase and take away all pain and fear, we sound a lot like people pushing epidurals, no? (Not that I have anything against epidurals!) I had a second baby at home with a certified nurse midwife and a hospital down the road (I live in NYC) and my mother who had 4 babies (two at home in the UK in the 70s) and there was NO FEAR in the room. We all trusted that this would work and if complications came up, we had plans galore. I felt very calm in my labor but it was a huge challenge and between transitions contractions I did not say, “this is so beautiful” I said, “it’s just so awful.” In all, it was the most glorious experience: to have something feel difficult, overwhelming, brilliant and outstanding and normal. And to be cared for by people who let me feel whatever I had to feel, and didn’t care if I swore and moaned. They just let me at it and held my hand.

    • T says:

      To Cristina, acknowledging risk is neither negative nor fear inducing. No matter where you plan to birth, you need to be prepared for and educated about possible complications.

  63. Nancy says:

    Just stumbled on this after deciding to give natural childbirth a try again (I’ve done natural and epidural in the past). Learning to not panic with each contraction or to fear what is happening is very powerful for me . At the same time, when I discuss natural childbirth with my friends it almost feels taboo to use the words “pain” or “fear”. I get the concept of injury pain verses what our uterus is doing in labor. It’s beautiful, and allowing my uterus to contract without letting the rest of me tense up really helped, but, it seems silly that I am supposed to use gentle words like “pressure” that don’t really cut it. I had some powerful meditative and even spiritual moments during my contractions, but, during the very end of transition, the only ttrue words to describe it wouldbe “terrifying pain”. I am so glad to have read this so I no longer have to feel like I have to mince around that. And, oddly, it makes me feel . . . less afraid of the fear. I suppose that sounds silly, but what is empowering to me is to know I can meet it and push right through. I’m a marathoner. The experience is beautiful and rewarding, but nobody would expect me to say I didn’t hit walls. But the grandness comes not just in never hitting them, but in pressing through them. That’s empowering. I don’t feel like you are telling women to embrace debilitating terror. I feel like you have told us, or at least me, to not fear the fear. I like it. Thank you so much. I actually feel much more in control now thani did when I felt like I was doomed if I let a spot of nervousness creep in. It’s ok. It might be there, but I can wade through it.

  64. Hi I am seeking permission to reprint this article in a newsletter for a Not For Profit organisation called CARES Incorporated. Could you please email me at cares.sa.org@gmail.com.

  65. Mary@edmondson.me.uk says:

    Brilliant. Currently thinking about normality for My Msc. Thank you for articulating your thoughtsxx

  66. Perdita says:

    This is interesting. At my very pro-natural ante natal classes, and online, I have read about how if you “don’t shout” and have a “quiet place” it will hurt less and be quicker. This has always struck me as slightly “victim blaming”… because maybe women who shout and swear just feel the pain more anyway hence they shout!
    It is one of my real ‘issues’ with some approaches to encouraging natural birth (in the United Kingdom). Certain books and videos do the rounds suggesting if the mum makes the right choices birth will be serene. Then if it isn’t, the mum feels a failure.
    This idea if YOU hire the right midwife, if YOU do the right classes… it won’t hurt and you’ll be all candles and music. They won’t even say the word ‘pain’ at all at my classes!

    Strikes me as odd. As you put in your title, I know it will be scary, hard work and painful. I’m going to prepare. I might well shout or swear who knows.
    I don’t actually want to be like the woman in the video my class was shown, who just breathed out the baby without any reaction on her face. For some reason I feel the urge/need that it will be hard work: the need for effort. I don’t know why.

  67. Thank you for the awesomeness of this article! And most of the comments were fantastic too :) I’m about a month away from my second birth, and I’ve felt so much pressure to purge ALL my fears out, otherwise I wouldn’t be able to birth “right” or “effectively” … but I’m finding that a really hard task, especially with all these lovely hormones making me batty. I don’t really have fear surrounding labor (except of course for fear of a bad complication), but I do have fear about becoming a mom of 2 when I barely have a handle on mothering 1, and she still needs me A LOT. Now I feel as if it’s okay and natural to still have some fear going into birth, I’ll face down my demons as I bring my son into the world, just like I did with my daughter! My first birth was hardly perfect and according to plan, but it was beautiful, and primal, and yes, painful, and SO empowering! It was worth every second of the 41 hours it took to bring my sweet girl into the world. And I think if I had been denied permission to expect and prepare for PAIN and fear, I would have actually been a lot more terrified. Knowing that those things may very well crop up let me mentally prepare, and when it happened I felt more like “oh, okay .. this isn’t as horrible as I was expecting, I can do this!” I think fearing the process is what can become unhealthy, and knowledge combats that fear. Having strong emotions, even fear, during labor, is just part of the journey. We have to acknowledge that birth is both mentally and physically taxing, and that’s okay, that doesn’t take away it’s beauty or power. Perhaps it even adds to it.

    Anyway, now that I’ve rambled … lol, once again thank you for a great article! I was able to use it to compile a list of “affirmations” I’d like my husband to read to me when things get tough, one of those being giving myself permission to feel the fear and birth anyway ^_^

  68. Priscilla Norris says:

    Thank you for this post, it’s amazing to hear things that often swim around in my head but is never addressed.

    I am thankful for those that voice well what I believe is truth.

    Birth is a wonderful/amazing/hard and at time fearful process, your right, it changes you forever,

    I have had three very different labours and some I would not want to do again. But have learnt through it to listen to my body and am thankful for learning those lessons.

    I do hope your thoughts get spread well to prepare more ladies, that we are able to better equip those about to embark on this amazing journey that babies arriving into our lives brings.

    Thanks again. Blessings Priscilla

  69. mel says:

    Thank you. I experienced this 100%. And completely felt like I let myself down. I broke down because transition was brutal on me and inwardly broke down more because of shame that I had broken down in the first place. Never mind that my tiny frame had a 9 lb+ baby to push out. Then with my next I was terrified of birth because no matter how much I had prepared the previous time it wasn’t good enough…. I sucked at it. That one was more painful… my baby was malpositioned and every contraction seemed like it was trying to blow my hips off during transition. But I didn’t try so hard to be that stoic birther and that gave more room for my midwives and husband to encourage me which really made it a much better experience. If there is a next time I will totally keep this in mind.

  70. Nerida Hopkins-Arnold says:

    Great read, thanks.

  71. Nicole says:

    I’m in the 28th week of my first pregnancy and planning a home birth. Thank you so much for this encouraging, empowering, and wonderfully honest message about birth! Felt like it was meant for me :)
    Controlling my fears and emotions (by way of research, deep reflection/relaxation, yoga, and planning for every possible scenario) has been at the forefront of my birth preparation. While I have gained some great self understanding and the comfort/power of knowledge, none of it has ever felt like it’s quite “enough.” But in the 5 minutes I read and received this message, this permission to “freak out and break stuff,” to give into this natural feeling, to “fear and birth anyways”, I have been given more relief and freedom than all of the hours of specialized prep, reading, and planning. Truthfully, I will probably continue researching, yoga, planning, but I will now carry this message with me: any bit that I’m doing is “enough.” I Am Enough.

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