relaxation in labor

How to cope with FEAR during birth

In being human, experiencing fear is normal and even beneficial to our survival. We have hormones, like the famous adrenaline, that trigger fear in us when there is a perception of danger, giving us a chance to respond accordingly and fast (fight or flight).

However, if we overreact to fear or are not able to manage it in order to navigate the situation at hand effectively, it can become debilitating. There can a reluctance to do what needs to be done or if there are sustained levels of stress hormones in our system, it can hinder other hormones that assist with our coping and wellbeing.

When it comes to birth, some fear is normal. It is normal for a mother to fear for her wellbeing and her baby as a basic survival instinct. In small doses, this is can be a healthy form of fear if it triggers an urge to prepare well for the anticipated process.

 

If a laboring mother experiences fear, adrenaline is released into the blood stream. If adrenaline levels continue to be sustained, then cortisol (the stress hormone) levels rise accordingly.

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If adrenaline and cortisol are released, and the fear not addressed and resolved before the 2nd stage of labor, it hinders the production of oxytocin and endorphins.

 

This can be due to many reasons, for example:

- negative expectations or memories of birth (first time mother/ poor past birthing experience/ high risk)

- a lack of coping mechanisms or preparation

- a stressful environment (noise and distractions, lack of privacy, lack of inclusion in decision making, harsh lighting…)

- Some fear can be triggered as labor intensifies as a natural reaction to pain

 

The body needs to be relaxed, and the mind at peace during birth, for oxytocin production and release. 

1. Oxytocin causes contractions

2. Endorphins act as natures pain relief during labor.

3. The release of adrenaline and cortisol naturally counteracts oxytocin and endorphin release.

 

FEAR can slow down and even stall labor.

FEAR can make the whole experience itself unpleasant and lead to the use of unnecessary interventions.

 

How to work with FEAR:

Oxytocin is the 'FEEL GOOD' hormone.

Do things that make you feel good during labor, yes! Partners can be prepared to help with this.

Does your partner know how to boost your oxytocin? 

Loved ones can be guided to avoid 'stressing out' around you.

Is there someone that wants to be at your birth that is easily stressed out OR something that easily stresses you out? 

The high levels and fluctuating hormones of birth make you very sensitive to the environment and even the attitudes and feelings of those around you. Choose who to invite to the labor and delivery room and who will wait to meet the baby later. 

How will you ensure quiet and privacy and feelings of safety and respect in your birthing room?

 

Read on to learn HOW to plan ahead!

 

minimize stressors > feel safe

 

 1. One of the most important things is to take good Childbirth Education Classes so the birth process is not a complete mystery. No need to stress-out about the 'unknown' when you can educate yourself all about it. 

Knowledge is power, but too much knowledge can be overwhelming and confusing. Google can be a pregnant woman’s convenient friend at times but can also be a source of outdated, inaccurate or fear-based information.

Find a local, trained person, to consult with for evidence-based information.

Then from there, specific fears can turn into questions and questions into answers, suggestions and tips.

 

2. Another great way to ease fear is to be choosy about the books and media about birth that you are looking at.

Choose positive birth stories, read positive affirmations, write a journal of hopes and dreams for the birth.

How do you imagine your birth? Visualize the best-case scenario...

Take the parts in the movie where the woman's water breaks and suddenly she is in active labor and about to push the baby out in the car and everyone is STRESSED OUT and in a hysterical panic... with grain of salt!

Thankfully, that is hardly the way it happens. 

Find movies with a positive depiction of women giving birth WITHOUT FEAR, for example, Organic Birth (DVD) or The Business of Being Born (DVD). There are plenty on Youtube as well but the point again is, be very selective. 

(For ideas on good books to read, take a look at our Lending Library here)

 

3. Writing a Birth Plan <== click here to create one) can help organize a birthing environment you will feel safe in.

A Birth Plan is not just a piece of paper to hand to the Nurse. 

It serves YOU above all.

In a way, it helps you imagine and 'rehearse' for your birthing day.

Sure birth is unpredictable, but having a GOAL and a PLAN to achieve that goal, is over half the preparation for childbirth!

 

4. Choose people that will give comfort and support that does not feel 'judgmental' or like 'pressure' to you, even if some fear does arise. People that understand how to meet your fluctuating needs in childbirth, with understanding. Loved one's in the room can help make us feel safe. However, is ok to be selective if you have a feeling a particular person's presence could be a stressor or distraction! 

- Are you and your partner on the same page about Childbirth?

- Are you and your OB or Midwife on the same page about your options, wishes and fears?

- Are the people that will be with you in the room prepared to support you emotionally, hands-on and in good decision making?

- Will there be stressors or distractions? Can you avoid them? How will you cope?

 

These are just a few good questions to help you plan and prepare yourself and those who wish to be there for you.

 

5. During labor, there are techniques that work very well to calm feelings of fear when they naturally arise: 

- proper breathing

- deep relaxation  

- visualization

- aromatherapy

- affirmations

- prayer/ meditation/ ritual

 

Pick, learn and practice the techniques that would work for you ahead of time so that during labor, you will find relief quickly when you need it.

Affirmations, prayers and meditations can be written down and brought to the labor room for you to read.

Comfort items from home are comforting to look at or hold. Consider packing some small sentiments in your birthing bag. 

 

6. A Doula can also be a perfect addition to a woman’s support system when it comes to coping with fear.

The extra prenatal support can help one

- explore fears 

- learn vital coping techniques

- help turn your childbirth wishes into plans you can count on

Most importantly, during LABOR AND BIRTH, a Doulas hands-on attendance and calming influence in the room can guide the birthing experience to the mother's best wishes.

 

 

I wish you a FEARLESS birthing day!

 

 

What has been your experience with Fear, Pain and Birth so far?

Did this article bring up any questions?

Please do share your story with us in comments below!

 

I AM AFRAID THAT________________________________________________?

WHEN I AM AFRAID, I _________________________________________________?

 

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Most common labor mistakes #2

ACTIVE LABOR:

“Do these 3 things and you won’t feel a thing!” “Don’t do this and you’ll be done in exactly X hours!”

Most of us women would be happy to try almost anything that promised to make birth easier or at least shorten the process. But as nature has it, every one of us is as unique as the children we grow in our bodies and bring to earth with our unconditional love and courage.

Is there a right way and wrong way to birth? If only it was that clear…

For this reason, we decided that instead of the word ‘mistakes’, the words ‘misjudgements’ or ‘miscalculations’ are more compassionate. Let’s face it, labor is no joke.

Early labor may be bearable enough for some to continue with light daily activities. We discussed why this is recommended, along with other suggestions in the article on Common Mistakes: Early Labor. But at some point, the intensity of those sensations changes.

You might be in Active labor when... your contractions feel stronger and harder to bear.

So, unlike before, the distractions may not be working as well anymore. You are finding that you have to stop what you’re doing each time. These are major cues that your body and baby are getting really serious about this birth thing.

How exciting!

Now what, dear Doula?

That’s your cue!

Start timing the contractions again. (Wondering about WHEN, WHY and HOW to time contractions?)

What you are looking for is length and duration.
Longer, Closer, Stronger

 

 

Assuming you had told your OB/ Midwife when you went into labor and depending on whether you chose to have your Doula join you in early labor, let your birthing team know about this new development.

The onset of Active labor is when a woman feels the strong need to do something about the contractions. This in a natural urge designed by our bodies to help baby along. 

So let’s talk about some tempting misjudgements that might go against the natural progression of labor.

 

 

 

 

Doing nothing

This is a go-to whenever we are are in pain or discomfort. Sitting still in a way that feels more comfortable or the good old fashioned bed-rest.  Even though this offers a sense of relief, it could contribute to a longer labor and increase back pain due to pressure on the spine.

If for some reason the mother chooses to or has to stay in bed, it is encouraged to change positions or to lay side to side. Even the smallest change for just a few contractions is helpful.

Moving in rhythm with contractions and changing positions also makes it easier for the baby to navigate the pelvis.

Gravity is a laboring woman’s best friend.
(After a Doula, that is.)

If you would rather hang out in your room for privacy or other reasons, a Doula has got a mind full of positions to ease discomfort and aid the progression. We also bring a ‘bag of tricks’ full of labor equipment you can use.

If you feel up to it, grab your partner or a family member and take a slow walk down the hall. Feel free to pace back and forth in the room. If you are having a home birth, stroll around your house. You are likely to find that you have to stop at each contraction. Having someone by your side is priceless as you can use them for physical support. You are going to appreciate all the encouragement you can get. Enjoy the company of someone willing to walk the walk with you.

 

Doing Everything

Ah, you can’t win can you? Yes you can, I promise!

There is the complete opposite staying in one place: trying every single position and comfort measure you learned because that is what you are ‘supposed to do’.

It’s great to change positions and techniques during labor, but how do you know when to do what?

The amazing thing about our bodies is that, if you are focused enough, you can pick up on the natural cues on what to do.
 

Try positions and techniques in response to cues from your body; not just "try everything." Once you find a good position or technique, continue through several contractions until you feel your body needs a change.

One of the most humbling lessons as a Doula is to learn to ‘lead by following’. This is one way we honor a woman’s innate wisdom. We may make suggestions and help along the way, but above all we trust that women are capable. Forcing changes during labor can be distracting and can pull mental and physical energy away.

*Wait, I thought distractions were good for labor?

Stick around dear mom, there is a time for everything.

 

Distractions

We established that distractions are great in Early labor. Focusing too much on bodily sensations too soon can cause unnecessary stress and get the mother tired way before she needs all her energy. Active labor is a whole different ball game though...

Active labor feels more intense physically and so it takes a lot of mental energy to go through. At this point, too many distractions can cause the mother to lose her focus.

Having someone beside you to talk to during labor can be calming and reassuring. The down side of this is that, the mother might feel obliged to respond and be an active part of conversation in the room.

It is not easy to be there for someone and give them space at the same time.
This is a balancing act that a good Doula practices.

There is a lot of benefit in being mentally present at the labor. It is easy to miss out on your body’s cues or become irritated or anxious based on what is happening in your environment. This can trigger stress hormones, which do not interact well with birth hormones, leading to a stalled or longer labor.

Relaxation at this stage of labor is a priority. Calming or inspiring music is one way to set the mood for the mother.

If the TV is on in the birthing room, let it be by the mother’s choice and that she has the say on what should be on. Preferably, something pleasant that she does not have to pay too much attention to or to follow.

Sometimes visitors or other staff in the room get carried away talking about topics not relevant to the mother. It is ok to give a polite reminder to keep such conversations out of the room.

As Doulas, we respect the 'birthing space' as a mother’s own NEST.
We allow the mother to set the tone and the pace.

 

So, imagine you've made it this far but there is still a way to go... *They say the next stage of labor, Transition, is the hardest and that it is when women are most likely to ask for an epidural. Next time we discuss how true (or false) this is.

 

 

Most common labor mistakes

 

‘Mistakes’ is a strong word when describing a woman’s reaction to the experience of labor. I imagine telling a woman in labor she’s ‘making a mistake’ might lead to even more anxiety about a process that is already naturally stressful! It might make her feel that she is "failing" at being in labor.

One thing we know is that stress hormones get in the way of labor hormones. The way a woman and her partner and labor team handle the entire process can either enhance or hinder the process.

How about we call them ‘miscalculations’ or ‘misjudgements’?

Miscalculations in early Labor:

Timing contractions

Wait, but aren’t you supposed to time contractions? Yes you are. The reason for timing contractions is to determine if you are actually in labor or pre-labor, also called Braxton-Hicks contractions. (Timing contractions also determines what stage of labor you are in.) At some point, first time moms, will ask, “What do contractions feel like?” Ah, the million dollar question. As a Doula, and a 2-time mom myself, I still do not feel confident I can give a one-size-fits-all answer to this. I can only describe my own experience and sometimes I can’t even find the accurate words. We are all as unique in our reaction to our bodies preparing to bring a mini-human into the world as we are in our every day personalities, habits and tastes. “You will KNOW when you are in labor…” is something many women are told. Movies would have us believe that when your water breaks (usually a huge, dramatic gush), then you’re having a baby right now!!!

But what about women whose water never breaks?

So, when exactly is it really Labor?

Here's the 4-1-1:

Contractions 4 minutes apart, 1 minute long each, for 1 hour.
What you are looking for is CONSISTENCY.

 Ok, so you’ve timed them for an hour, now what? This is where the ‘misjudgments’ are likely to come in. Do you dash to the hospital? Do you start the comfort measures you’ve learned? Call everybody with the news? Keep timing? There’s excitement and there’s apprehension of everything laying ahead for mom and baby!

Most likely you'll tell your partner first that you are actually in labor. You should let your OB or Midwife know you are definitely having consistent contractions. If you have a Doula, this is the perfect time to call her for support. As your Doula, I would say "great!" How are you handling the exciting news and the contractions? If nothing seems alarming, let’s STOP TIMING.

Here’s why:

For one, timing the contractions and counting the hours will not make the process any faster. If anything, it can add unnecessary stress. Stress leads our bodies to produce catecholamines (stress hormones) that can actually slow down, and even stall labor. Also, can you imagine how long and boring that could get?

So, dear Doula, what to do, what to do?

Here’s a good rule of thumb:
When in labor, do life.
When labor is all you can do, then do labor!

I cannot stress enough the importance of relaxation and distractions during early labor. Remember, your uterus knows how to contract. Trust your body.

Some ideas of what to do in early labor:

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Sleep:

This is easier said than done, especially for first time moms. There’s excitement, there’s nervousness… and there’s partners as well with their own reactions. However, do give it a fair try. Have some sleepytime tea if that helps. Listen to some relaxing music or watch a mindless show to shut your mind off. Have your partner give a soothing massage. Make love if you feel up to it. Then try and get your zzzs in.

If a laboring woman is tired her body's ability to handle stress and discomfort is compromised. So, if the contractions woke you up in the middle of the night, and are bearable enough, find a way to go back to sleep dear mom. You’ll be glad you got the rest; you’ve got some ‘labor’ cut out for you in the morning.

Eat:

Your hospital may have a policy that restricts eating during labor. This is usually a safety precaution in case the mother needs a cesarean. This rule leads many women to think they should not eat anything at all the minute labor begins!

Labor takes a lot of physical energy. Eating light in early labor is an excellent way to store up on this natural resource and prevent exhaustion when you need all the strength you can get. Pick snacks you crave and enjoy. Make your favorite meal, or have your partner/ family make it with you or for you. Cooking can be a fun and satisfying distraction. Go out to eat! Enjoy the look on people’s faces when they ask you when you are due and you answer, “Right now...”

As labor progresses, your desire to eat naturally goes down. When you feel you have an appetite, that’s because the body needs food to store up for fuel later. Hunger is a sign you are most likely still in early labor. Eat up, dear mom. The baby wants it (wink).

Live:

It is tempting to stop everything and lie down as soon as labor begins, especially if it’s your first labor. There is also the misconception that you have to speed to the hospital/ birthing center as soon as you start labor. This is also likely to happen if you have more people than just the mom paying attention to labor too soon. Family and friends mean well and want to be helpful to you in labor. They care about your safety, they do not want to see you in discomfort and they want to pamper you as well.  These 2 misjudgments could set the mother up for a longer and slower labor. It can actually increase the stressfulness of the event or cause mental and emotional fatigue due to boredom.

So long as physically possible, I would encourage mom to continue normal, light activities during labor. So, go to baby’s room and finish setting up. This is sure to put a smile on your face and take you to a relaxed place in your mind. Make sure everything you need is in your bag. If you have other children, doing an activity with them while talking about the new baby's arrival into the world is such great bonding for the family. Prepare snacks for yourself for later, for example, chop fresh fruit or make sandwiches. Take a walk around the neighborhood or at the beach. Go to a store you like to look around or to the mall to people watch. Go sight seeing at the park with your partner or a friend. Really, it is not unsafe to go about your regular daily routine in early labor as long as you are medically sound.

 

Whatever you do however, it is imperative that you have alerted your medical provider and Doula that you are in labor. It is also very important to have your affairs in order, for example, bag packed and handy, car fueled, childcare arranged. If you are travelling to a hospital or birthing center for the birth, stay within a decent mile radius of the location. Travel closer if you anticipate a lot of traffic.

Most importantly, do enjoy this special day. Happy birthing day!

 

*How, then, do you know when you are no longer in early labor? 

You will notice a change in the intensity of contractions. They start to feel stronger and longer. You might also have to stop an activity to relax through the contractions. Then is when to start counting and timing contractions again.

In our next article, we talk about the most common mistakes in active labor.