The early weeks of pregnancy are fragile—and confusing. Here, the answers to your questions.
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Do you lie awake imagining a painful, protracted labor? Are you afraid something bad will happen to your baby or you? Does the whole prospect make you want to sign up for a quick Cesarean section? Nearly every pregnant woman feels some anxiety about labor and delivery, especially if it's her first time, but some women are so nervous that it interferes with their pregnancy.
"When a woman is anxious, it gets in the way of her enjoying the pregnancy," says Shari I. Lusskin, M.D., a reproductive psychiatrist at New York University School of Medicine. "It also can interfere with her adherence to prenatal care and her relationships with her partner and other children, as well as increase the risk of postpartum depression."
Substantial anxiety during pregnancy also can contribute to insomnia, eating too much or too little, headaches, high blood pressure and lowered immunity. Women who experience very high levels of anxiety or stress are more likely to experience labor and delivery complications and, perhaps, to schedule medically unnecessary C-sections. They are also at an increased risk of premature delivery and having a low-birthweight baby.
What makes women afraid?
The number of women in the U.S. who suffer from a substantial fear of childbirth—called "tokophobia"—is unknown. In Sweden, however, studies show that it affects some 10 percent of pregnant women there.
There are many possible causes. "Some women have increased fear because of what they've heard or read or seen on television," says OB-GYN Elizabeth Eden, M.D., a clinical assistant professor at New York University School of Medicine. Horror stories from friends, television and the Internet can be particularly anxiety-provoking because they dramatize and overemphasize the pain and risk of childbirth.
Fear of childbirth is also more common among certain groups of women, according to a 2008 Danish study published in BJOG, an international OB-GYN journal. It found that women who were young, unemployed, less educated and less connected to other people were more likely to fear childbirth, as were women who smoked or had poor overall health. Also at risk are women with a past history of anxiety, depression or sexual abuse, marital problems and low self-esteem, Lusskin says.
Dealing with your concerns
The first step in overcoming fear of childbirth is to figure out what you dread. You can do this by keeping a journal or talking about your fears with a trusted friend or therapist. Then you can take action to restructure, or turn around, your anxious thoughts. Here's some advice on overcoming the most common childbirth fears:
Solution: Breathing exercises and other relaxation techniques can help you cope with pain, so sign up for a Lamaze, Bradley Method or HypnoBirthing class. But there's no shame in taking pain-relief medication. If pain scares you, "Look to deliver in a facility with 24-hour, in-house obstetric anesthesia staffing," Eden suggests. "That way, there will be no delay in receiving pain relief."