A Healthy Fear of Birth is Good: Here’s Why

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There was a time when I thought that the less you feared birth the better.

I’m not so sure anymore.

I used to think that women feared birth just because of the media and ugly stories they heard at baby showers and from their friends about inductions gone wrong and things that could have been prevented with a doula or a chiropractor.

I’m not so sure about that anymore either.

I used to think that an undisturbed birth was the best way to go and that the intrusion of the other or the expert would throw a kink in the works and make the entire experience go awry.

Yup, you guessed it — I’m not too sure about that anymore either.

Now when I think of being afraid of birth, I think women probably ALWAYS had some fear- always have and always will.  In fact, being afraid of birth might be just as natural as leaving your son intact.

Think about it…

I know we want to believe that if you do everything “right” birth will be blissful and fab and simply amazing and has the capacity to be “orgasmic.”

I love birth.  It is one of my favorite things and probably my life’s passion.  But if I am honest, I have to admit that birth … it hurts. In fact, giving birth hurts a LOT.  The pain of birth is virtually universal and timeless.  It has always been there and it will always be there.  In fact, I think even medications don’t really make the pain of birth disappear, they just force it to come a little later.

And while we might enjoy bandying about the catch phrase, “Birth is as safe as life gets,” the truth is that there is an element of danger in regards to birth.  This was true when your grandmother gave birth and it will be true when our daughters give birth. Some women and some babies will not survive the birth process.  I truly believe we can minimize those deaths with knowledge and skill and medicine and even respect, but I doubt very much that we can totally eliminate the innate underlying danger of giving birth.

If you combine the pain and the danger of birth and add in the inevitable unpredictable beauty of this natural process we come away realizing that fear and pain in birth are not new inventions spewed by “A Baby Story” or the underlying ugliness of modern medicine, but rather a constant that has always been and always will be.

We do women a disservice when we act as though creating a few catchphrases about trust and fearlessness and empowerment will make the power of birth something they can control or even comprehend.  We do women whose births DO go awry a disservice too, because we make it sound as though it somehow was their fault if their body didn’t work in a seamless, mother-circle fashion.  In fact, we do those well-prepared and fearless moms a disservice when they actually GO into labor and discover that it hurts like hell.

Shocker.

Women don’t need a bumper sticker phrase to prepare them for birth. They aren’t empowered by lies and half-truths about rainbows and ponies.  We owe women the truth about birth.  Yes, it often hurts.  Yes, there is an element of danger.  No, you can’t control everything about birth.  But let’s not forget too to tell them that despite (and maybe because of all of these things) birth is amazing.  Birth is transcendent.  Birth is beautiful and it is empowering.

It is true that the modern media and the induction and Cesarean epidemic have changed the face of birth in a negative way.  It is true that things are going very wrong in many hospitals.  But it is UNTRUE that birth was ever this perfect, rosy, “let’s stand in a circle and hold hands so the pain goes away” blissful piece of fantasy.  That idea — that birth was ever perfect and was just ruined by the invention of the OB — that is a lie. Women didn’t just embrace hospital and twilight birth because they were tricked by clever marketing — they were afraid.  Afraid of the pain and afraid of the death that they knew was a part of birth.

What we need to do now is not lie to women and pretend that if we just think the right thoughts every birth, everywhere will be OK.  They won’t.

I have seen enough well-prepared (and yes, sometimes fearless) women who end up with very difficult and even surgical births to know that having your head in the right place simply isn’t always enough.

Birth is big and it is wonderful and it will probably bring you to you knees.

Don’t go into with a head full of fairy dust.  Be prepared.  Be real.  Learn everything you can.  Educate yourself about normality and nutrition and hospital protocol.  Carefully choose your care provider.  Prepare your body and your mind for birth.  Accept that some pain and some unpredictability is part of this biological process.

Be afraid enough of birth to prepare well for it.  Respect birth enough to recognize the awe inspiring power that it yields.  Love birth enough to embrace the process while at the same time letting go of some of the power we think we have over this.

There is no shame in a little bit of birth fear.  There is no shame in a birth that hurts.  There is no shame in admitting that giving birth was the hardest thing you ever did and that you wanted to give up.

Embrace birth for all of it’s many facets- the good and the bad, the beautiful and the ugly, the painful and the euphoric.

Birth is a ride you will never forget.   And despite it’s imperfections, birth is a privilege to experience.   There is no shame in being honest about birth.

A healthy dose of birth fear is nothing to be afraid of.


21 thoughts on “A Healthy Fear of Birth is Good: Here’s Why”

  1. Excellent piece. Another worrying trend I noticed from the “too-fearless” end of the spectrum is moms who do nothing to prepare themselves for birth because they trust the process, but go to a hospital. It’s just the perfect recipe for being pushed around by medical staff.

  2. I would be very interested in hearing what midwives have to say about how current home birth clients compare with clients from the past, and how each compares with their Amish clients in their approach birth. What are you seeing?

  3. so first I’m going to use your words but substitute the word “life” for “birth”, ready?…..
    Women don’t need a bumper sticker phrase to prepare them for LIFE. They aren’t empowered by lies and half-truths about rainbows and ponies. We owe women the truth about LIFE. Yes, it often hurts. Yes, there is an element of danger. No, you can’t control everything about LIFE. But let’s not forget too to tell them that despite (and maybe because of all of these things) LIFE is amazing. LIFE is transcendent. LIFE is beautiful and it is empowering.
    The problem is that we have taken BIRTH out of everyday LIFE. And then we polarize about it. I had both my kids at home. I wasn’t overly prepared. I figured my body was going to do what it would do and I didn’t need to know alot intellectually. I do remember feeling a fair amount of heightened anticipation as my due date drew closer. This I took as a ‘mother tiger’ sort of preparedness and a natural part of the process. I also read the birth stories in Spiritual Midwifery with rapt interest. While some may object to Ina May’s use of the word “rushes” instead of contractions, she never left any doubt that labor was hard work.

  4. I never tell anyone that birth does or does not hurt. I can only comment on my own experiences, so that is what I do (when asked.) I definitely encourage women to be prepared emotionally for the birth process and to think about all of the components. If you know you don’t want pain meds, prepare for that, etc. If your provider is just not clicking with you, interview some others. I am happy with my more informed births. I went into my first birth blind and it honestly could have been worse, but I would have felt more in control with more information. That has really shaped my opinion that knowledge is better.

  5. Um, how does “birth is as safe as life gets” NOT fit into the point of this article? This sounds like someone bought into the idea that an extremely rare situation of orgasmic rainbow birth was within her grasp simply b/c she squeezed her eyes shut and clicked her heels together. Of course birth is hard work and usually painful for most women. Why would someone discard basic biology, history, science et al and grasp onto a little bumper sticker or pow wow slogan? C’mon, personal responsibility is tantamount. It’s birth after all.

  6. comment 2 of 2
    And as oxymoronic as it may sound, the pain in a normal birth is part of the beauty. The exhaustion adds to the exhilaration just like a long mountain hike that results in a peak with breathtaking views. You can look at the grueling hike, talk and remember how difficult and traumatic it was on the way- or you remember the awe and inspiration of getting to the top, the people who shared it with you, the clouds that rolled in the distant sky, the soft rain that swept your sweaty face and blessed you with gentle relief. Maybe it doesn’t mean as much if you’ve always had birth or you don’t know the trauma of a poor outcome or perilous journey. Maybe you forget to be thankful for the gifts along the way.

    Then too, there are those experiences that are truly traumatic and well- all of mine have been at the hands of someone else who *was* in control instead of me. Sometimes I know, it’s because I gave that control when I was not educated enough to assume my own rights. There’s a great deal difference between the “trauma” of a painful birth and the trauma of a birth that has been hijacked by a power hungry healthcare provider.

    Birth is sacred. The space around birth is sacred. I believe that it’s meant to be experienced by a woman with select few attendants and sometimes, no attendants…. I can’t speak for the whimsy of the author in her repetitive “I use to think…” statements. Sure I’ve changed my thoughts on birth over the years. But I’ve never once regretted that peaceful, low lit room, the birth pool with my husband nearby, nervous and amazed, the ring of fire and feeling the head crown with life that I could barely believe I worked and surrendered to bring forth- and the two of us unhindered in the privacy of our own home with no one watching or listening or judging. How priceless! How precious! How sweet! How glorious! It was the pain and work and years of waiting and learning and wrenching and yearning that brought me to appreciate the depth of the joy of the hope of the release, of the love, of the thankful, grateful, tear-filled, exhilarated, empowered gift of birth that God in His goodness through no deserving gave me- a life changing, transcendent, beautiful birth.

    One final thought…

    Perfect love casts out fear, because fear has torment…(1 John 4:18) …but *thanks* be to God who *gives* us the victory! (1Corinthians 15:57)

    Blessings,
    Lori

    2004 c-sec
    2006 failed homebirth attempt, repeat c
    2010 UWBA2C

  7. I think I understand this perspective, but it does not reflect my experience. I don’t particularly recall any fear with my first baby. The only real “fear” I had with my second and third labours was that of ending up in a hospital with another c-section (fortunately both were the homebirths I wanted). Despite 1-2 weeks of constant prodromal labour, and 2-3 days of real labour with my second and third babies, I do not remember much pain or hurt. Even with the Pitocin-induced contractions with my first baby, I was never in pain. The only actual moment of pain was that brief instant when the head emerged with my last two children. I agree that we should be honest about birth, but those of us who had mostly non-painful experiences without fear also need to be able to tell our stories honestly as well. Far too many women hear only the negative, scary stories.

  8. I’m glad to hear people saying this. Sometimes the internet becomes a bit of an echo chamber.

    I was pretty fearful with my first birth. It hurt a lot but she came out fine. I had very little to no fear or anxiety around my second birth. After all, I’d done it once before, right? It didn’t hurt much at all, until the end, and then we were unlucky, and later she died because of intrapartum injuries. She died because of how she was born. Life isn’t safe, and neither is birth and there is so much we can’t control. No, I do not “trust birth.” Mother nature is a stone cold B who does not care if your baby lives or dies. A little fear is good, it’s your body’s way of telling you to pay attention. Anxiety is when we think we can control the outcome. We can’t. All we can do is make the best choices we can with the information we have, and then hope for the best.

  9. Upon reading this, I too found myself both bristling and identifying, perhaps more of the former than the latter. Just what is this healthy dose of fear, and why do we need to assume it is about pain? How do we know that our prescription for “the therapeutic dose” is the appropriate dose for THIS or THAT particular women’s needs.

    Is it the healthy dose of birth fear that women need? I think not. I’m unconvinced that this prescription would really be a one size fits all, or a successful model. Women come to birth with their own set of fears, often lying very deep in their minds and hearts. I don’t share the author’s opinion that what women need is a healthy dose of birth fear. I think instead they need a place where they can come and talk about their fears, (all of them). A place where they will not be judged for their own fears and the choices they make based on their risk assessments. Let’s address fears, let’s plan for less than desirable outcomes. What’s the next step if XYZ happens? I think reducing fears, is more desirable than increasing them. I’m not convinced that the suggestion that adding fear to a woman’s preparation for birth is a healthy choice. Fear causes the release of the wrong kinds of hormones in labor. Fear will stop a laboring mammal.

    I

  10. What about the woman whose mother lost a baby to stillbirth, all be it she has 5 live siblings…yet she insisted on scheduling an early induction, because she was afraid of being pregnant on her due date? Her scheduled induction resulted in a complicated all be it “orchestrated ” c/section. What’s her dosage of necessary birth fear? Now she doesn’t know what to do because she doesn’t want another c/section, but she doesn’t want to go to her due date either. What’s her dosage of necessary birth fear?
    What about the woman who is afraid of being “handled and managed by the medical community, believing that it will interfere with her birth”? What’s her dose for birth fear?

    What about my friend who birthed two babies who did not come into the world alive? What’s the prescription for her birth fear?

    My first birth was an out of hospital midwifery planned birth. Initially in my journey, my biggest fears were about birthing in the location with the best NICU, because my fear was about the baby needing a NICU, and I wanted the best NICU. I chose a care provider who practiced with the hospital with the best NICU. How I got from there to the medwifery model is a journey, but it never had anything to do with fear of the pain of labor. Maybe I was naive, but it wasn’t part of my fear set. In retrospect, I wish I had an appropriate dose of birth fear, so that I would have been afraid of midwives who practice like doctors, who do unnecessary interventions. I didn’t get that dose. There was no prescription for red flags.

    I went into my second birth, afraid of vaginal exams, (something I was never afraid of the first time, ( but hey…when an unnecessary vaginal exam results in your membranes breaking, and cascading into an unnecessary abdominal surgery the day your baby comes into the world)…that fear seemed reasonable to me. I was afraid that I wouldn’t find a care provider who would let me be pregnant and labor without a vaginal exam. Wonder what the prescription for the dose of birth fear would have been for me?

    To suggest that we might be failing women because we teach them that the pain may be worth it: that they may feel ecstatic during and after the labor if their hormones are allowed to support the process without interruption, finds me shaking my head in disbelief. I think not. (cont 2)

  11. Do we really need to teach women that birth hurts? It’s 2013, and if we are talking birth in the Western world; I think most women know that birth hurts, and believe that that’s the purpose of the epidural. To manage the pain. To make the pain more bearable.
    To suggest that we might be failing women because we teach them that the pain may be worth it: that they may feel ecstatic during and after the labor if their hormones are allowed to support the process without interruption, seems simplistic. Would we deny telling them about orgasms even though there is a possibility that they may not experience that level of intimacy in their earliest sexual experience? Do you want to know some things you can do to possibly promote those “kumbayah experiences” (read orgasmic) or just say “let’s not talk about it, because it wasn’t my reality”.

    Let’s talk about how it feels to recover from major abdominal surgery with a new baby. Let

  12. We signed the consent form for the complications, but must don’t understand many of them. We as a society don’t value those baby’s first hours ENOUGH, or a successful breastfeeding relationship ENOUGH. We do value a recovering mom and a recovering baby and we don’t care if we orchestrate cesareans, as long as baby and mom are recovering.
    Is it the healthy dose of birth fear that women need? I think not. I’m unconvinced that this prescription would really be a one size fits all, or a successful model. Women come to birth with their own set of fears, often lying very deep in their minds and hearts. I don’t share the author’s opinion that what women need is a healthy dose of birth fear, unless that dose includes how they are likely to be orchestrating their own cesareans while they think they are having a natural birth. I think instead they need a place where they can come and talk about their fears, (all of them). A place where they will not be judged for their own fears and the choices they make based on their risk assessments. Let’s address fears, let’s plan for less than desirable outcomes. What’s the next step if XYZ happens? I think reducing fears, is more desirable than increasing them. I’m not convinced that the suggestion that adding fear to a woman’s preparation for birth is a healthy choice. Fear causes the release of the wrong kinds of hormones in labor. Fear will stop a laboring mammal. We know this.

    Birth is part of a woman’s biology. Just like your first experience with getting your period, or intercourse may not result in your expectations realized, your birth experiences might not either. That’s life. Your subsequent experiences will probably be different. We grow and learn, our bodies change. What dosage of fear do you wish you had for each of those experiences? Would you have benefited from more information, or more fear? More tools or more fear? Honestly, I think the response to that question speaks much more to me, than any suggestion of “HEALTHY dosages of birth fear.” (cont 5)

  13. We can no more predict your experience with intercourse the first time, than we can predict your birth experience. We don’t know whether your will be supported enough for lubrication to allow for painless or pleasurable penetration or whether it won’t. We don’t know if you will experience your menstrual period with debilitating cramps or not.
    I’m not sure what the appropriate dose of fear is for women to have, but I personally, would prefer birthing with trust and love…knowing that there are risks and no guarantees. I want those present at the birth of my children to bring their love, knowing that their love and trust of the process is greater than their fears.

    mom to 3. One c/sec, 2 hbacs. Breastfed three babies for 7 total years.
    (cont 4)

  14. I wish I had read more articles like this and taken their advice and listened less to my Hypnobabies CDs telling me to avoid “negative” consideratins and not use other birth preparation methods.

  15. I had a fear of birth so bad I never wanted to go through with it. I was watching just terrified. I heard everyone’s horror stories and how much it was found to suck. I had ONE person tell e that if I get a an epidural I’d not feel too much and be fine. I had already chosen that route anyways, and I was fine. It was not horrible. It was easy! With my second I decided I was not going to waste any time on what ifs. I knew that what ever was going to happen would happen and there is no way to get out of birth so just go with the flow. I did. Have worries a and fear and pain once labor started but the difference is I let the fear come when I was actually in labor instead of worring a about it for 9 months. And by that time you have to suck it up a and grow some balls to get through it

  16. I was one of those “well-prepared (and yes, sometimes fearless) women who end up with very difficult and even surgical births to know that having your head in the right place simply isn’t always enough.” Despite the c-section and other things I would have preferred not to go through, the miracle of my daughter’s birth was still transformative. Don’t let circumstances which could save your life ruin your birth story.

  17. Dear Sarah Clark, I am a Brazilian doula and would like to ask your permission to publish my husband’s translation of this article in our blog. Thank you very much, beforehand.
    Best regards,
    Alessandra

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