When we ask our clients how they’re feeling about giving birth, we’re pretty likely to hear one of these phrases (or something close to it):

“I’m excited to meet my baby, but I feel really nervous about giving birth!”
“I feel really scared when I think about what’s going to happen- or what might happen.”
“I just hope that I can deal with the pain and avoid anything going wrong!”

Notice how each phrase contains a fearful word. It is so common to feel nervous about giving birth- particularly if this is the first time you’ll do it! It’s a hugely transformative event in your life. But, let’s talk about what effects this fear can have on your body, your mind, and ultimately, on your birth experience.

In the late 1800s and early 1900s, two obstetricians- Dr Jonathan Dye and Dr Grantley Dick-Read- were researching why their poorer, less educated patients experienced significantly less pain and complications in childbirth than their more affluent counterparts whom routinely required anesthesia and more medically managed births.

Ultimately, the doctors concluded that because their poorer patients did not have the same levels of fear around labour and birth, they had better experiences and healthier outcomes. They reasoned that the more fear a person had about labour, the higher the likelihood of complications and a painful experience. They called this the fear-tension-pain cycle.

It works like this: When you’re feeling fearful, anxious, or unsafe, you’re activating your body’s fight or flight mode and your bloodstream fills with adrenalin. Your body reroutes blood and oxygen away from vital organs, and sends it towards the extremities to help you escape your threat (this is flight mode). You may start breathing heavily, sweating, and your heart rate will increase. It’s an automatic and primitive response to fear, and it’s not always something you can control.

Fear Tension Pain cycleThe fight part of this response causes you to tense up your entire body in anticipation of pain or threat. Your muscles hold tension, your shoulders rise, your fists and jaw clench, and there’s not a single relaxed muscle in your body. You’re ready to fight your threat (and in this scenario, your “threat” is the pain of labour). However, when your muscles are tense, everything hurts much, much more- including your contractions.

So what happens when this occurs during labour? Imagine this: you just finished a contraction, and it was the hardest one yet. You’re starting to really work hard through your contractions, and you’re beginning to feel afraid of the intensity of your labour. Maybe your support team doesn’t pick up on this, and you’re starting to feel panicked because your coping tools suddenly aren’t working anymore. You’re dreading the next contraction, because the last one was so intense. The doctor said you’re 5 centimeters dilated and making “good progress”, but you know you still have some work to do and you’re tired. The first voice of doubt creeps into the back of your mind. “What if I really can’t do this? What if this goes on for hours?” Your heart rate increases, your breathing quickens, and your body starts to tense up. All of a sudden, the next contraction begins. “Wow!” you think. “This is even harder than the last one! I can’t do this! The next one will be even worse, and I still have so long to go…”

You’re trapped in the fear-tension-pain cycle, and it’s a hard place to be in during labour. When you get stuck using (or trying to use) your rational, logical, “thinking” brain, you’re much less able to tap into your body’s instinctual knowledge (yes, you have it!) and your body’s hormones (and the natural pain relief that oxytocin and endorphins provide). Instead of surrendering to the process and staying calm, the fear-tension-pain cycle (and the fight-or-flight response) tells you you’re in an emergency and that you need to mobilize to stay safe. It causes you to fight each contraction and your progressing labour, potentially causing you to feel overwhelmed, panicked, or afraid.

Here are some tips to avoid this cycle during your labour:

1. Education is key. The more you know about what to expect during labour and delivery, the less room there is for fear and “what ifs” to creep in. When you understand the way birth is designed, how your body works, and what’s going on, you’ll feel much more confident about your labour. (Pro tip: our childbirth education classes are a great way to get the education you need!)

2. Support is critical. Having a solid labour support team isn’t a perk: you need to have a team that understands you, your wishes, and your fears to keep you out of the fear-tension-pain cycle. It’s their job to be aware of your emotions and to help you stay calm and relaxed. They can also create a calm and quiet environment, which will help your mind stay on the task at hand, and not on scouting for potential threats.

3. Positive vibes only! We are big fans of feeling your feelings- even the negative ones- but when it comes to preparing for labour, positivity is supreme. And yes, it’s important to be prepared for all birth outcomes (including the ones that feel less than positive). However, it’s important not to dwell or focus on the “what ifs”. This is not the time to listen to birthing horror stories from your sister or your bestie (and it’s totally okay to request that they spare you the gory details until after your baby is here). Focus on envisioning an awesome labour that you feel good about. Picture yourself in labour, totally rocking it and making great progress, and notice what that feels like. Who is there? What are they doing? What words or phrases come to mind? Put all of your energy into creating a positive image, and you’ll be much more likely to make your dreams a reality! If you’re really having trouble with your fear or anxiety about birth, we recommend talking to your doctor or midwife, your doula, and anyone else on your care team (including a counselor or therapist that specializes in birth fear).