Ahead, we’ll explore some common fears that many pregnant people have about labor and childbirth—and some information about coping that might be helpful to know, if these are your fears, too.
Fear of Pain
Childbirth is painful. There’s just no getting around it. “Really nothing is going to take the pain away except an epidural, and that’s just honesty,” says Dallas Reed, MD, an OB/GYN and chief of genetics at Tufts Medical Center in Boston. She continues, “It [can] be painful, but we can make plans to address that.” The best way to deal with this fear is to determine in advance how you will cope with the pain. Having a plan in place can be beneficial and will help you mentally and emotionally prepare. And while it might be normal to hope that labor somehow magically won’t be painful for you, it’s important to be realistic. Dr. Reed notes that the best mechanism for meeting success is to be armed with as much information and knowledge as possible.
How to Cope With Fear of Pain
Talk to your OB/GYN or healthcare provider about your options for relieving or managing the pain. An epidural is definitely one option—a very popular option, in fact. According to a 2018 survey conducted by the American Society of Anesthesiologists (ASA), an epidural was the first choice for pain relief for 73% of the 912 people polled. But an epidural isn’t for everyone. Some people opt for other types of relief, such as nitrous oxide, which is an inhaled anesthetic gas. The ASA survey found that only 2% of the people surveyed in 2018 opted for nitrous oxide—it tends to be more commonly used in Europe and Australia—but it seems to be growing in popularity in the U.S., too. Depending on where you deliver, ask about non-medication options that may be available to you to help you cope with the pain. That might include using a birthing ball, taking a shower, various massage techniques, or sitting in a tub of water.
Fear of Needing a C-Section
About one in three birthing people deliver their babies by Cesarian section (or C-section) in a typical year. According to the Centers for Disease Control and Prevention (CDC), 31.8% of all births in the United States in 2020 were Cesarean deliveries. But not everyone wants to deliver by C-section—and experts note that in general, vaginal birth is safe for most birthing people and their babies. However, there are times when a C-section really is the safer option, such as when the placenta is covering the cervix, a condition known as placenta previa. And in some cases, a C-section may be needed for babies in the breech position if they can’t be turned. One C-section-related fear that Dr. Reed wants to address: “Some people feel like it means that they failed in some way, which is not true,” she says. Jennie Jarvis Hauschka, MD, an OB/GYN in Charlotte, North Carolina, agrees. “Either [method of birth] has its pluses and minuses,” she says.
How to Cope With Fear of Needing a C-Section
Let your OB/GYN or healthcare provider know that this is a concern for you. Chances are, they’ll have a similar response to Dr. Reed, who points out, “We don’t take the decision about doing a C-section lightly.” Inquire about what circumstances might constitute a need for a C-section and if there’s anything you can do to avoid needing one. Some of the time, this might not be within your control, but having information and knowledge can do wonders in terms of calming nerves.
Fear of Tearing
Some people worry about the tearing that can happen in the perineal area during childbirth. It’s a reasonable fear, too, because tears do happen. “I tell patients that it’s very common,” says Dr. Reed. “Almost everybody has a tear, especially with your first baby.” In fact, according to a review of multiple studies about perineal care, about 85% of people who deliver babies vaginally experience some type of perineal trauma, such as a tear. First and second-degree tears are definitely the most common, according to the American Urogynecologic Society (AUGS). These involve tears to the vaginal skin and the vaginal muscles underneath. They represent more than 90% of all tears that occur during childbirth. Much more severe are third and fourth-degree tears, in which the skin tears all the way through the anal sphincter muscles. (With a fourth-degree tear, the tear extends to the inner lining of the anus, too.) But those kinds of tears are rare, says Dr. Reed. In fact, they account for only 2% of all tears, according to AUGS.
How to Cope With Fear of Tearing
Your healthcare provider can talk to you about whether you’re at increased risk for a more serious tear. According to a large study of perineal tearing that was published in 2021, risk factors include first-time deliveries, induced labor, delivery assisted with forceps or other tools, and an infant birth weight over 3000 g (that’s about 6.6 pounds). “There are things that we can do to help manage that for some people,” says Dr. Reed. “Some of it is just controlled pushing.” It may also help to learn that if you do experience a tear, your doctor will know how to fix it. They’ll give you an anesthetic (if necessary) and stitch up the tear. It will likely take a few weeks to heal, while severe tears may take longer. And if you need some additional care afterward, Dr. Hauschka suggests seeing a physical therapist who specializes in pelvic floor PT. “I think that should be part of the recovery from the delivery,” she says.
Fear of Pooping During Labor
Yes, sometimes poop happens. When you’re actively trying to push that baby out, something else just might come out instead. You’re bearing down, using the same muscles to try to push the baby out as you would to produce a bowel movement. “I tell [patients] that if they do, that’s normal,” says Dr. Hauschka. “That means they’re pushing in the right spot. It’s just part of having a baby."
How to Cope With Fear of Pooping During Labor
If this is a big fear of yours, you could give yourself an enema at home prior to going to the hospital, or you can ask a nurse to help you once you get there. An enema is designed to flush or clear out your bowels; some people also believe that it might help with perineal wound healing afterward, but a review of research suggests that’s not always the case. But there’s no medical reason to rush for an enema, Dr. Hauschka stresses, and it’s a pretty uncomfortable process for something that’s unnecessary. You might just need to remind yourself that, yes, everyone poops, and your doctor won’t even blink an eye if it happens to you.
Fear of Something Happening to Your Baby
Worrying about what could happen to your baby during labor or delivery is a completely legitimate fear. Babies can be injured during birth, usually as the result of a difficult labor or their positioning. Injuries can range from mild to severe. The most common kind of birth injury is a fracture to the baby’s clavicle or collarbone, according to Stanford Medicine. This fracture can occur when the doctor or midwife is having trouble delivering the baby’s shoulder. It can also happen during breech deliveries. Another common type of birth injury occurs when forceps or vacuum extraction are needed to deliver the baby; the baby may wind up with some bruising, cuts, or lacerations, usually on their scalps.
How to Cope With the Fear of Something Happening to Your Baby
If you’re worried about a birth injury, talk about your fears with your OB/GYN or healthcare provider. They can answer questions about most common types of birth injuries, the causes, and how they handle them in the moment. Dr. Hauschka also tells patients that breech deliveries are relatively rare. According to the American College of Obstetricians and Gynecologists (ACOG), breech presentation occurs in about 3-4% of full-term births. But she reassures her patients that she’s prepared to handle a breech delivery, if it does happen. “There’s good likelihood that yours won’t be, but here’s what we’ll do,” she will say to patients.
A Word From Verywell
It’s normal to have fears surrounding childbirth, and you may worry that giving voice to your fears might make them more likely to happen. But there’s no evidence to suggest that’s true. Instead, talking about your fears with your OB/GYN or healthcare provider gives you the chance to articulate what you’re worried about—and then discuss, in advance, how to handle any situation that may arise. Your healthcare provider can give you some guidance on how to prepare, and they can reassure you, which may reduce some of your anxiety and help you cope. When in doubt, just ask. As Dr. Hauschka puts it: “There are no dumb questions."
