Fear of childbirth: how to cope

Let's be honest: childbirth is a very exciting event, if not “frightening”. Conflicting stories from girlfriends who gave birth, a lot of information on the Internet, but at the same time the “unpredictability” of the upcoming process creates a very serious fear of childbirth in many pregnant women. At the same time, every sane woman understands with her mind that fear is an additional factor of stress and tension, without which the process of giving birth to a child will certainly be easier and more comfortable. How to get rid of this absolutely unnecessary “fear of childbirth”?

First of all, you need to understand that the fear of childbirth is not something abstract. This fear is formed from smaller fears and anxieties before specific events or sensations, which ultimately form the collective “fear of childbirth.” To deal with it, you need to deal with the “smaller” ones.

Fear of pain.

Even in childhood, many girls learn that childbirth is painful. Accordingly, this fear “lives” with them for quite a long time and takes “roots” deeply and thoroughly. It is important to understand that pain can be managed, there are several ways to do this:

Psychoprophylactic methods, about which you can find a lot of information on the Internet or learn at courses for pregnant women. These methods primarily include special breathing techniques that help to concentrate and reduce pain.
Epidural anesthesia or drug pain relief, which will certainly relieve you of pain. However, this method has opponents, since this method disrupts the natural course of the birth process. In this case, you should study detailed information about this type of anesthesia, consult with your doctor and make an informed decision. Perhaps in your particular case, epidural anesthesia will be less of an “evil” than panic fear of childbirth.

What signs are the warning signs of labor?

There are 7 main signs that indicate the approach of labor.

Sign 1: prolapse of the uterine fundus

About 10-14 days before birth, the head of the unborn baby is pressed against the bottom of the uterus and pulls it down. Thanks to this, the uterus descends and stops putting pressure on the organs of the abdominal and thoracic cavity, including the diaphragm. The woman notices that it becomes easier for her to breathe, but sitting and walking on the contrary becomes more difficult.

Sign 2: descent of the fetal head into the pelvis

The closer the birth is, the more the baby's head begins to descend into the pelvis. If the fetus has a breech or leg presentation, then the buttocks or legs descend into the pelvis. The fundus of the uterus begins to put pressure on the bladder, which can cause increased urination. A woman may also experience a feeling of heaviness, bursting pain in the pubic symphysis and lower back.

How to relieve unpleasant symptoms? Consult with the obstetrician-gynecologist who is caring for your pregnancy. Your doctor may recommend that you wear a bandage that will support your abdomen and thereby reduce the load on the pelvic organs and spine.

Sign 3: Cervical maturity

During pregnancy, the cervix is long, tight and closed. But as labor approaches, the cervix begins to prepare for the birth of the baby: it shortens, thickens, and becomes loose. In this case, obstetricians-gynecologists say that “the cervix is ripe or ripe for childbirth.”

Sufficient maturity of the cervix is a necessary condition for the normal course of labor. If the cervix is immature, then natural onset of labor is unlikely in the near future. However, it happens that with an immature cervix, premature release of water is observed. In this case, labor may become pathological (protracted).

The maturity of the cervix is determined during a vaginal examination . Using palpation, the obstetrician-gynecologist evaluates 5 indicators of the condition of the cervix.

Consistency - elastic-elastic properties.
Length.
The degree of patency of the cervical canal.
Placement of the cervix relative to the pelvic axis.
The height of the fetal head.

Each criterion is scored from 0 to 2 points. The sum of all points reflects the degree of maturity of the cervix:

0-2 - immature;
3-4—not mature enough;
5-8—mature.

Sign 4: mucus plug coming off

The cervical canal during pregnancy is filled with mucus, which protects the fetus from infection. In the first trimester of gestation, the necessary mucus is produced by the cervix under the influence of special hormones. Subsequently, the mucus becomes denser, turning into a reliable protective barrier against infectious agents.

When the neck shortens, thickens and becomes loose, the mucus softens and begins to come out. During hygiene procedures or going to the toilet, you may see a jelly-like clot on your underwear, which is called a “mucus plug”.

Most often, the mucus plug is colorless, but it happens that it turns into other colors:

brown. There are capillaries inside the cervical canal. If damage occurs when the plug comes out, the mucus may turn brown and contain streaks of blood. This is an absolutely normal phenomenon that should not be regarded as bleeding;
white. If a woman has thrush, the mucus plug may be white and have a cheesy coating.

The mucus plug can come out of the body in one go, but sometimes this process takes several days.

Sign 5: weight loss

Throughout pregnancy, a woman's weight increases. This occurs due to the growth of the fetus, enlargement of the uterus, and the accumulation of excess fluid in the body. In addition, some pregnant women gain weight due to overeating.

But before giving birth, on the contrary, your weight may stabilize or decrease by 1-2 kg . This happens for two reasons:

At the end of the 3rd trimester of gestation, excess fluid is removed from the woman’s body. This occurs due to a decrease in progesterone levels, which provokes fluid retention in the body and the formation of edema. Accordingly, when excess fluid leaves, weight decreases.
In the weeks before giving birth, many women experience a decrease in appetite and cravings for heavy foods. This is due to hormonal changes and changes in the autonomic nervous system. The female body begins to need light foods - cereals, fruits, vegetables.

Correction of nutrition is very important before childbirth. Products such as dumplings, sandwiches, and fast food take a long time to digest and overload the gastrointestinal tract. And in the last weeks of pregnancy, the body should spend energy and strength on preparing for childbirth, and not on digesting food.

Sign 6: Irregular contractions

A few weeks before giving birth, pregnant women may experience false contractions - rhythmic contractions of the uterus that appear irregularly and are short-lived. Why are such fights necessary?

The uterus is a muscular organ. And in order for the muscles of the uterus to do their job well during childbirth, they need preliminary training. False contractions are such training.

How can you distinguish false contractions from real ones?

Record the time and determine how often contractions occur. If the intervals between them are not the same, then these are training contractions. Labor pains are regular.
Listen to your feelings. Labor contractions are always accompanied by pain. There is no pain during training contractions.
Take a warm shower, lie down in bed and relax. If you are having training contractions, they will go away after you relax. If these are real fights, then their dynamics will only intensify.

Training contractions can last 10-14 days. As a rule, they occur during the day or evening and disappear during sleep.

Fear of the unknown and “negative” cases.

This is more of a social fear than a biological one: in the information space there are so many “readable” stories of difficult childbirth, severe consequences, complications and dangers that even the most psychologically stable woman begins to “try on” these negative aspects for herself. And even after studying a lot of information about how childbirth takes place, what difficulties may arise during the process, what “signals” of the body you should pay attention to, childbirth is still scary. In this case, you need to constantly remind yourself that medicine also does not stand still, doctors know how to react in certain situations, moreover, in childbirth. Homes have all the necessary equipment for the most complex and emergency cases. For that. To reassure yourself as much as possible in this matter:

Carefully study all the maternity hospitals “available” to you and choose the one that is most suitable for you.
Find a good “doctor” and develop an “action plan” for yourself.
Take your husband or another loved one with you to the maternity hospital, who can help you sort out the documents there, answer all the staff’s questions, protect you and give you confidence.

How to calm down and stop panicking before childbirth?

The birth of a child is one of the most important moments in the life of any woman, therefore prenatal experiences and worries are considered a normal state. It is important to remember that a pregnant woman does not need extra nerves, and is even more harmful for the baby. Therefore, you should take care to be less nervous during pregnancy and not panic before childbirth.

There are several proven methods that will help you maintain your state of mind and calm down, especially if childbirth is very soon.

Take a break, because a hobby is the best cure for various fears and worries. Do something you have always wanted to do, for example, swimming, embroidery, attend a classical music concert, etc. Before the birth of your baby, you should relax as much as possible and gain strength. Moreover, after his birth it will not be possible to rest his soul like this very soon.
If possible, communicate with people who have successful childbirth experience. Especially before giving birth, it is very important to have a positive attitude, and stories like this can cheer you up and lift your spirits.
Courses for pregnant women are becoming increasingly popular in our country. You can gain valuable knowledge from them, especially if you are experiencing pregnancy and childbirth for the first time. After all, the course covers all the issues that interest you. And if not everything, then you can ask it yourself.
Physical exercise. They will not only help to distract you, but also prevent the deposition of fat accumulation, which very often accompanies pregnant women. In addition, physical exercise promotes the production of endorphins - happiness hormones.

Find something fun to do

Massage also allows you to relax and calm down, and also helps reduce pain during labor and childbirth.
Support from loved ones and relatives. If you are very worried about childbirth, then you can enlist the support of a close relative or friend (or maybe your husband) so as not to give birth “alone.”
Turn fear into action. Instead of just sitting and panicking, build a plan of actions and necessary things for the maternity hospital. By the way, it’s better to start shopping in advance. This will allow you to think less about the “bad”, and by the time labor begins, everything you need will be collected. And then you won’t have to run around pharmacies and children’s stores with contractions. This is another little secret to peace of mind, because you will be all ready.
Get rid of the unknown. For example, read literature for pregnant women. After all, the more you learn about the birth process itself, the easier it will be for you to navigate the process.
Change your attitude towards childbirth. Many psychologists claim that positive thoughts about the child and anticipation of meeting him will help overcome the fear of childbirth. You should not associate the birth of a child with pain and suffering.

Only a positive attitude!

Fear of giving birth to a premature baby.

All you need to know in this case: even if it happens that the baby is born ahead of schedule, modern medicine will help cope with such a situation! A child born at 22 weeks is quite viable, even babies weighing only 500 grams grow up healthy.

Try to think positively and not create additional stress for yourself and your baby, this will only bring anxiety. Get ready for the difficult work that lies ahead of you and your body during the birth process. But this job is quite up to you! Everything will be fine.

What are the precursors of labor and when do they occur?

Precursors of labor are signs that indicate the body is actively preparing for labor. Female sex hormones play a primary role in this process. And if progesterone “rules” in the female body throughout pregnancy, then before childbirth it gives way to estrogens.

The precursors of labor are a training period before delivery. Most often they occur 10-14 days before the baby is born. However, this figure is individual. It happens that precursors appear a week or even a few days/hours before birth.

What should you not do when dealing with panic before childbirth?

In any other life situations, there are many ways to deal with fears. But during pregnancy it is very important not to resort to the use of such methods:

taking antidepressants and sedatives. The use of medications is permitted only as prescribed by a doctor, but taking sedatives on your own is strictly prohibited. Taking such drugs is extremely undesirable for the expectant mother and her baby;
Avoid people who tell you various “horror stories” that happened during the birth of this or that woman. Remember that each person is individual, and all these “horrors” will not happen to you. You should not focus your attention on the negative experiences of your friends. The same applies to stories on the Internet on forums and websites;
Do not delve into the study of complications during labor. Sometimes being too curious can cause anxiety and increase worry. And remember that when studying the symptoms of any disease, they appear even in a healthy body. So much for the great power of self-suggestion! Point it in the right direction.

Arm yourself with the support of loved ones

When is a caesarean section performed?

Statistics from recent decades show that caesarean sections are being performed more and more often all over the world. According to WHO, this operation for medical reasons should be prescribed no more than 15% of cases. But in reality this number is much higher (in a number of European countries - almost half of all births).

A caesarean section is a medical operation in which childbirth occurs surgically through an incision in the uterus. This method has been known since the times of Ancient Rome. But the conditions under which the operation is carried out have, of course, changed markedly since then. Everything goes quite quickly and, as a rule, only takes an hour. It is the latter fact that is often decisive when women opt for a cesarean section “at will”: some are afraid of hours of contractions, others are afraid of ruptures and stretching of the uterus, etc.

However, a caesarean section is not a cosmetic procedure. For medical reasons, it is prescribed only if there is a threat to the life and health of the mother or baby. Compared to natural childbirth, the risks for both the woman and the baby in the case of a cesarean section are many times higher.

When is a caesarean section performed electively, as prescribed by a doctor?

The woman’s pelvis is too narrow and/or the fetus is too large;
Placenta previa (the placenta covers the entrance to the uterus);
Scars on the uterus from previous operations, threat of rupture;
Multiple pregnancy;
A number of diseases not related to pregnancy (cardiovascular diseases, risk of retinal detachment, varicose veins, viral diseases of the urinary tract, etc.).

When is a caesarean section performed urgently after contractions have started?

When labor takes too long or labor activity suddenly stops;
In case of acute oxygen deficiency and problems with the child’s heartbeat;
With premature placental abruption;
If there is a risk of uterine rupture.

What should you know if you are scheduled for a caesarean section?

The doctor monitoring your pregnancy will most likely report the need for surgery during the first examinations. Especially if you already have a history of uterine surgery or have chronic diseases.
The operation itself is most often scheduled for the end of the third trimester of pregnancy—at 38–39 weeks. Most caesarean sections are performed under local anesthesia (epidural or spinal anesthesia). This way, you will most likely have the opportunity to put your baby to your breast immediately after birth.
The work of surgeons is hidden from the woman in labor using a small curtain. And only after the doctor removes the baby through an incision in the uterus (in most cases horizontal), you will be able to see your baby.

What should you consider if you are considering having a caesarean section without a compelling medical reason?

The likelihood of complications developing in both mother and baby is much higher. You will have a longer recovery after childbirth: while the stitch is healing, your mother will need constant help.
There may be difficulties establishing breastfeeding.
Negative effects of anesthesia and antibiotics received during surgery for the baby.
Difficulty regaining fertility: Research shows that a cesarean section may make it more difficult for you to become pregnant again.

If you are having a caesarean section for medical reasons, remember that this is a vital necessity for your baby, and you are doing everything right. If you are choosing surgery out of uncertainty and fear, you may want to reconsider the situation.

Many expectant mothers periodically experience anxiety. Once you cope with it, you will probably believe in the strength of your own body. After all, if natural childbirth is available to you, you should definitely take advantage of this chance.

What to do if contractions have not started?

It also happens that the due date has approached, but contractions have not started. This phenomenon is not necessarily a cause for concern, but requires medical supervision. The causes of decreased labor function may be previous inflammatory diseases, menstrual irregularities or hormonal disorders.

Typically, birth occurs at 37-40 weeks. If this does not happen, but the doctor does not detect pathologies of the placenta, the baby has enough oxygen and nutrients, and the amniotic fluid is clean, then natural induction of labor will do. Women are advised to take easy walks and stay in an upright position. Sex can also have a positive effect on stimulating labor: substances contained in semen have a softening effect on the cervix, and sexual arousal and orgasm are natural muscle stimuli. The main thing is to take precautions.

What you definitely shouldn’t do is dabble in traditional methods of stimulation. Especially when it comes to herbs. They have a strong and not always controllable effect, so it is generally better for pregnant women to protect themselves from using any infusions and decoctions.

If a decision has been made to medically induce labor, one of the following methods is selected:

1. Taking prostaglandins (if the cervix is not ready to dilate).

2. Amniotomy (opening of the amniotic sac) - used to reduce the contractile functions of the uterus.

3. Administration of oxytocin (intravenously or in tablets) - to stimulate the process of contractions4.

Childbirth is an exciting and responsible event. And the best thing an expectant mother can do in this situation is not to be afraid of the accompanying manifestations. You need to try to perceive contractions not as a source of pain, but as a natural process that contributes to the birth of a tiny beloved baby.

Womenfirst

PROBLEMS OF FALSE CONTRACTIONS IN MODERN OBSTETRICS - Buzumova Zh.O., Bazarbaeva Zh.U., Nurmanalieva E.B., Kanigaeva A.M., Seksenova A.B. – 2022 – Bulletin of the Kazakh National Medical University / No. 3 2018
QUICK BIRTH IN MODERN OBSTETRICS - Zhelezova M.E. – 2016 — Practical medicine / '1 (93) 2016
RATIONALE FOR THE APPROPRIATENESS OF PARAVERTEBRAL BLOCK FOR ANALGESIA OF SPONTANEOUS LABOR - Neimark M.I., Ivanova O.S. – 2018 — Bulletin of anesthesiology and resuscitation / Volume 15 / No. 3/2018
Obstetrics: national guide / ed. E. K. Ailamazyan, V. I. Kulakov, V. E. Radzinsky, G. M. Savelyeva. - M.: GEOTAR-Media, 2014. - 1200 p.

RUS2124800-2 from 03/20/2020

How not to panic during childbirth?

When you are ready for the upcoming process, it is much easier to tune in to it. But not always, sometimes previous experience creates even greater fear that it will happen again. Especially if the interval has been short. In general, panic during childbirth, and even during contractions, can occur in any woman.

The support of family is very important. We have already written that you need to take your girlfriend or husband, or maybe your mother, with you. In general, let any person you trust be nearby. If something goes wrong, he can call a doctor or nurse. Such confidence helps to calm down.
Listen to your doctor. You need to perform actions only on his command, do not exhaust your body just like that.
By the way, use the breaks between contractions to rest. Both you and the baby will really need it. Therefore, we conserve our energy reserves.
Breathe through your nose and exhale through your mouth. Such breathing exercises help reduce pain and sober the mind, which drives away panic. But don't do it too quickly, otherwise you'll get dizzy.

Breathe correctly

If it hurts a lot or you just want to, scream ! Don’t restrain yourself, because “letting off steam” will only do you good.
Nobody forbids drinking water. Therefore, stock up on non-carbonated liquid. This will help avoid dehydration, especially if the process is very long. By the way, another advantage is having someone nearby.
Think and wait for the result. Childbirth cannot last forever. Therefore, direct all your efforts to meet your baby as soon as possible.

If your worries have become obsessive, resulting in insomnia, increased blood pressure, or increased nervousness, you should definitely consult a doctor. In this position, it is very important for a woman to remain calm and balanced, so you should listen to your state of health, as well as rest more and tune in to a positive result.