do you dread delivery?

10 ways to reduce your anxiety about labor

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My friend Tina couldn’t even watch TV’s fictional Murphy Brown give birth. “From the time I was young, I was absolutely terrified of giving birth,” she says. Ninety minutes into her all-day childbirth-education class, Tina became so upset that she had to leave the classroom. “I just lost it—I started to cry and couldn’t get control of myself,” she recalls.

Julie, another woman who feared labor, developed heart palpitations, dizziness, shortness of breath and a racing pulse in her sixth month of pregnancy. It turned out that Julie had been in a near-constant state of hyperventilation brought on by her fear of childbirth.

While just about every woman feels some anxiety about labor and delivery, 6 to 10 percent of pregnant women suffer intense fear. This dread can manifest itself in such symptoms as nightmares, physical complaints and difficulties concentrating, according to studies by Terhi Saisto, M.D., Ph.D., a researcher at Helsinki University Central Hospital in Finland. But fear and its associated stress can also cause more serious problems which, over time, can contribute to both early and late deliveries, smaller babies and a higher risk for emergency Cesarean section.

What’s more, frightened women may actually experience more discomfort during childbirth than calm women do, according to Alice D. Domar, Ph.D., a Harvard Medical School expert on stress. Prenatal distress also is associated with postpartum depression and problems with a mother’s ability to bond with her child, says Saisto.

The good news is that there are ways to reduce your fear of childbirth. Here are 10 of them.

1. Track the source of your anxiety

Certain experiences can trigger an intense fear of labor; these include a history of abuse or rape, a past miscarriage or stillbirth, guilt over an abortion, a previous difficult delivery and excessive exposure to traumatic labor stories. Tina, for example, grew up hearing about how painful her own breech birth had been. Understanding why you’re so afraid is a first step toward easing that fear.

2. Don’t wait until labor day

Deal with your fears at the beginning of your pregnancy, not the end, recommends Heather Kleber, a certified childbirth educator and doula in Littleton, Colo. “Think about what your fears are and work through them early,” she says.

3. Consider therapy

In one of Saisto’s studies, women with an intense fear of labor who underwent cognitive (talk) therapy had shorter labors and fewer unnecessary C-sections than those who didn’t. “If a woman feels that her fear is taking over other aspects of her life, such as her intimate relationships, I usually suggest that she see a therapist,” says Margaret Plumbo, C.N.M., an instructor in the Nurse-Midwifery and Women’s Health Care program at the University of Minnesota School of Nursing.

4. Learn relaxation skills

Practicing self-hypnosis, meditating and doing breathing exercises throughout pregnancy can help calm you during labor. Tina’s childbirth instructor, Wendy Dubin, director of The Relaxation Center in Kingston, Mass., made guided-relaxation tapes describing Tina’s “peaceful place”—a mountaintop in Aspen—that she listened to throughout pregnancy.

5. Share your fears

Don’t hesitate to tell your doctor that you’re afraid; just talking about it may help, and she may have ideas about how to reduce your anxiety. If your physician doesn’t seem to listen or lacks compassion, consider finding a new doctor.

6. Address your fears in your birth plan

Write a one-page birth plan that includes your desires about medication, laboring positions, fetal monitoring and an honest explanation of your fears. Share it with your doctor during a prenatal visit and have a copy ready to give to the nurses on the big day.

7. Use a midwife and/or doula

A trusted midwife or doula can help you cope with your fears before and during labor. “She understands you and will stay with you,” says Bonnie B. Matheson, a doula and the CEO of Childbirth Solutions Inc. (www.childbirth

solutions.com) in Marshall, Va.

8. Shut out negative stories

Don’t watch scary TV shows about childbirth, read horror stories or listen to friends recount the gory details of their labors, says Dubin, who believes that fear of delivery has become more widespread since the advent of sensationalized depictions of childbirth.

9. Be open-minded about drugs

Knowing that effective means of pain relief are available can help lessen your anxiety. Talk with your doctor beforehand about medication and other options and include your intentions in your birth plan.

10. Know your options

Some women fear the typical hospital childbirth experience. Choosing alternatives, such as having your baby in a homelike birthing center that permits women to deliver in different positions, can often allay such fears.

When Tina arrived at the hospital to have her baby, everything went according to the plan she’d discussed with her doctor. As soon as she was admitted, her doctor administered an analgesic to calm her. As her labor progressed, Tina listened to her Aspen tapes, and when the time was right, she asked for an epidural. A few hours later, she delivered a healthy daughter.

“My labor and delivery were pleasant and enjoyable,” Tina says. “It was awesome. I actually look forward to having another baby.” Pretty amazing for a woman who couldn’t even watch Murphy Brown give birth.

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