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Labouring over labour - how fear lengthens childbirth

Date

Daisy Dumas

Fear of childbirth has been found to add more than an hour to labour.

Fear of childbirth has been found to add more than an hour to labour.

No matter how prepared a pregnant woman may be when it comes to childbirth, there is little she can do about the fear factor.

A Norwegian study has found that women who fear childbirth will spend more than an hour longer in labour than those who are not afraid of delivery.

The study, published in BJOG: An International Journal of Obstetrics and Gynaecology, looked at 2206 women with an average age of 30.9 years.

Using the psychometric Wijma Delivery Expectancy Questionnaire, 7.5 per cent of the women were assessed as fearing childbirth, with reasons including being a first-time mother, being a young mother, a lack of family or social support, and past abuse or medical trauma.

Average labour length for those women was eight hours compared to six hours and 28 minutes for women who were unafraid according to the Wijma scale.

The team measured labour duration from the stage at which a woman was 3-4 centimetres dilated and had three uterine contractions every ten minutes, until delivery of the child.

Researchers also found that those who were afraid of birth were more likley to have caesarean sections or instrumental deliveries - though fear had little effect on intended method of childbirth.

Given that between five and 20 per cent of women fear delivery, the results are likely to shine a light on psychological links to intervention-free deliveries.

Samantha Salvesen Adams, Health Services Research Centre, Akershus University Hospital, University of Oslo, Norway and co-author of the research said: "Fear of childbirth seems to be an increasingly important issue in obstetric care. Our finding of longer duration of labour in women who fear childbirth is a new piece in the puzzle within this intersection between psychology and obstetrics.

"We found a link between fear of childbirth and longer duration of labour. Generally, longer labour duration increases the risk of instrumental vaginal delivery and emergency caesarean section. However, it is important to note that a large proportion of women with a fear of childbirth successfully had a vaginal delivery and therefore elective caesarean delivery should not be routinely recommended."

As those who fear childbirth are more likely to need obstetric intervention, it is hoped that the results may help with providing the right support and advice in light of psychological approaches to delivery.

For more on pregnancy and birth, visit essentialbaby.com.au.

27 comments

  • Hooray a sensible study (for a change). Having no kids but many friends/family who do it is always interesting to talk to them of their experiences. A Doula (pregnancy and birth support person) or midwife can help with the worries of arriving babies. Make it a team effort ladies, there are many people out there who are willing to help you along the way - don't be afraid to ask.

    Commenter
    Ultraviolet
    Location
    Brunswick
    Date and time
    July 03, 2012, 1:37PM
    • I believe it. I was never particularly fearful of labour. I knew it was going to be painful and I accepted that I would deal with that pain to have a much-wanted baby. I was probably a bit more fearful before giving birth the second time because after the first I knew exactly what it would feel like. However, the second time I also knew I could do it, which gave me a lot of confidence. I had gas and air with my first and a pethidine shot with my second, but they didn't appear to make any difference to the level of pain. My four labours were between 5 1/2 and 2 1/2 hours long, so luckily all nice and short. I was also lucky to have uncomplicated births. No doubt there's a lot more fear when something is obviously going wrong. I take my hat off to my two sisters: both had first labours of 20 hours without epidurals!

      Commenter
      mum of four
      Date and time
      July 03, 2012, 1:38PM
      • Why is not using pain relief during childbirth something to be celebrated? I've always been puzzled by this. It's the end result that matters.

        Commenter
        Cimbom
        Location
        Real World
        Date and time
        July 03, 2012, 4:47PM
      • @ Cimbom:

        One of my sisters was convinced that having an epidural would harm her baby, even though she said her labour was agonizing. (I don't think epidurals harm babies, or it would have to be extremely rare, though I've heard some mothers have headaches and numb legs for hours after an epidural, and often there is more intervention during the birth if you have one than without one). Anyway, if I had felt in too much pain I would have had one, but I also wanted my births to go without intervention if at all possible. My other sister is very stoic and wanted to "tough it out", though I believe her fear of epidural side-effects and unnecessary interventions was also a large factor. It's interesting how strong beliefs can help people get through even extremely intense, long-lasting pain. (They both had 10lb babies and required episiotomies as well).

        Commenter
        mum of four
        Date and time
        July 03, 2012, 5:11PM
      • @ Cimbom:

        I take my hat off to my sisters because I doubt I would have lasted 20 hours without an epidural. Yes, they are both "tougher" than me! (5 1/2 hours, my longest labour, was quite enough for me without any pain relief).

        Commenter
        mum of four
        Date and time
        July 03, 2012, 5:14PM
      • Yeah, I agree with your thoughts. My first labour was about 10 hours (only the last 3 really hard) and my second was only about 4 hours total. I think deep breathing was super important in making them go at a pretty rapid pace. It would be awful to experience it over 20 hours or more so if you can stay as relaxed as humanly possible in that situation then I do believe it will speed things up. As for not using pain relief in childbirth being celebrated I think its because the pain does put you in touch with what is happening with your body and I think it facilitates a speedier delivery. Masking the pain sends strange signals to the brain that confuse matters and really slow the process. Thats just my take on it. It wasnt for me but not because I am a matyr. It just didnt suit me but if it got really bad I would have used it. It never got to that point. I wasnt afraid but I really respect women who are frightened and still choose to have children. Its very brave.

        Commenter
        Lu
        Location
        Sydney
        Date and time
        July 03, 2012, 5:30PM
      • From the male perspective I've always pondered this "no painkiller" boast thrown about like a war medal. I thought at the time (3 kids in my history) that it put unnecessary pressure on the poor soon-to-be mother. If it was me pushing one out I'd have every pain killer available at my disposal (within reason of course).

        Commenter
        Basil
        Location
        Hobart
        Date and time
        July 04, 2012, 8:56AM
      • I too wanted a drug free birth but at the end of the day after 8hours of not being able to lay down and birthing in the upright position I simply couldnt put up with it any more...result one beautiful baby boy and one happy and pain free mummy. There is nothing wrong with epidurals. I could feel my legs and was walking two hours after the birth. Best thing ever!

        Commenter
        gixxa
        Date and time
        July 04, 2012, 9:07AM
    • I must be the exception to the rule. I did calm-birth classes, went into labour with a positive attitude and the belief that I just had to let it happen. 100% fear free. After an excruciating posterior labour, the baby got stuck during second stage and I was transferred from birth centre to labour ward. Ventouse failed. An episitomy, forceps and a third degree tear later (all sans pain relief, save a local), the labour tallied some 32 hours, including 6 where the baby was crowning yet unable to get out. My problem wasn't fear, but a large baby.

      Commenter
      RF
      Location
      Blue Mountains
      Date and time
      July 03, 2012, 1:56PM
      • This kind of article makes me angry. It's another reason for women who have easy labours to pat themselves on the back and look down on those of us who have complications as though we brought it on ourselves. I wasn't scared of birthing, didn't have an epidural, but due to a large baby I had complications and significant obstetric damage. As a calmbirth devotee who was going through the birth centre and put in 30 hours of labour before intervention was deemed necessary, I felt like I failed at being a woman, and now there will be a new gloat of easy birthing women to rub salt into my very significant wounds. Sometimes fear has nothing to do with it. Sometimes things just don't go according to plan.

        Commenter
        Mother of 2
        Location
        Blue Mountains
        Date and time
        July 03, 2012, 2:05PM

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