Calming Your Labor and Delivery Fears

Experts provide the calming and reassuring advice you need for a successful labor and delivery.

From the WebMD Archives

"What if I don't get to the hospital on time?"

"What if my doctor doesn't make my delivery?"

"What if the labor pain is more than I can handle?"

"And what if I ... poop on the labor table?

As labor and delivery day draws near, it can certainly seem as if the "what ifs" are raging out of control!

Experts say that most first-time moms -- and many experienced moms, too -- can get a major case of the jitters as their due date draws near.

"If your first pregnancy was easy, you worry that your second one will be hard; if your first one was hard, you're terrified that history will repeat itself. And if you've never done this before, well, your imagination can simply go wild as you begin to imagine every worst-case scenario possible," says high-risk obstetrician Laura Riley, MD, author of Pregnancy: You and Your Baby.

Riley says that even the calmest mother-to-be will likely experience some anxiety as labor and delivery turns from a chapter in that pregnancy book to an episode of real life.

"It's part excitement, part anticipation, and part pure fear of the unknown. But it's also a time when some realistic concerns come to the forefront. And it can begin to feel a bit overwhelming, even for the calmest women," says Riley, a professor at Massachusetts General Hospital in Boston.

If you're thinking you'll control those fears with a detailed birthing plan, guess again. Surprisingly, doctors say this isn't the best approach to easing your fears.Â

"The truth is, the only person controlling things on delivery day is your baby, with maybe a little help from Mother Nature," says Riley. So even if your birth plan is as detailed as War and Peace, she says chances are slim that things are going to go the way you planned.

A far more reassuring method is to jot down five or six points of concern about labor and delivery and discuss them with your doctor long before your due date.

"Knowing that you and your doctor share a similar birthing philosophy can go a long way in calming your fears," says obstetrician Isabel Blumberg, MD. "And if you find out you're not in agreement, it's better to find out early so you can both compromise on some issues, or if need be, you can find another doctor who is more in tune with how you want to deliver your baby."

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Facing Your Labor and Delivery Fears: Some Calming News

When it comes to specific labor and delivery fears, every woman has slightly different concerns. But experts tell WebMD that there are also some that are common to almost every woman, affecting both first-time as well as experienced moms.

To help allay those fears, the experts we talked to offer the following calming and reassuring advice.

Labor and Delivery: Fear of Pain

Any woman who's ever heard a "labor pain horror story" -- and who hasn't -- can't help but feel apprehensive about the pain associated with childbirth. But experts say that if you're even a little frightened about how you will react, talk to your doctor about your medication options well in advance of your due date.

"The one thing that's really important is to find out if the hospital where you will deliver has 24-hour anesthesia -- which means you will have an epidural available to you no matter when you deliver -- because not all hospitals offer that," says Robert Atlas, MD, chairman of the department of obstetrics and gynecology at Mercy Hospital in Baltimore.

If you discover your hospital doesn't, Atlas says not to panic. But do talk to your doctor about other types of pain control that will be available to you, including short- and long-acting narcotics.

Many women are concerned about the narcotics' effect on a baby, but doctors say the impact is mild, often just causing the baby to be a bit sleepy. Atlas says your doctor can tailor your drug regimen to your labor stage so that the impact on baby is minimized.

"The point to remember is that no woman has to experience more than discomfort during labor, and there is no need at all to suffer. The pain medicines used today are generally safe for mother and baby," says Atlas.

Riley says patterned breathing can also help control pain, particularly if you arrive at the hospital too far along to have an epidural. But this isn't something you can learn in the back of a taxi on the way to the delivery room; so prepare ahead of time by taking a few childbirth classes that focus on labor breathing.

Experts say don't underestimate the power of a professional labor support team to help control labor pain. In a 2003 analysis of several studies on about 12,000 women, researchers found there was a decrease in the need for pain-relief medicine -- as well as more successful vaginal births -- among women who had continuous labor support. This could be from a doula, midwife, nurse, or relative.

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Labor and Delivery: Fear of an Epidural

While it may be comforting to know an epidural is available, it can also be a source of anxiety for many women. Fear of the procedure, as well side effects including numbness, can cause some women to avoid pain medication completely. But doctors say there is little to fear. According to Blumberg, "the complication rate is exceedingly small, especially long-term complications." Short-term problems -- like a spinal headache -- are more common she says, but "still rare, affecting only about one in 200 patients, plus they can be easily treated," says Blumberg.

Labor and Delivery: Fear of a C-Section

With all the recent headlines touting mother-elected Cesarean births, you might get the idea that this is the delivery method of choice. But doctors say most women still fear the procedure -- and will do everything they can to avoid it.

"Most women are concerned about the after-pain, about the length of time necessary for recovery, about the dangers of being cut open," says Wendy Wilcox, MD, an obstetrician at Montefiore Medical Center in New York City.

If your doctor does suggest a C-section during labor and delivery, experts say be sure to ask why he or she thinks it's necessary and if there is any way to avoid it. But if there's not, then Riley says this is the time to "go with the flow" and "trust the person on the other end of the table."

"The risk of having a C-section isn't zero, but it is exceedingly low. If it's what your doctor says is necessary for a healthy birth, I wouldn't worry about it. ... You're more likely to have problems if you try to deliver vaginally when circumstances dictate that you should not," says Riley.

Common reasons for an unplanned C-section include a very large baby (in proportion to your size), your baby assumes an abnormal position during labor, or your cervix is not dilating enough.

Labor and Delivery: Fear of Not Getting to the Hospital on Time

We've all heard the stories of a baby arriving in the back seat of a taxi -- or in the produce section of the grocery store. But the reality is that for most women, particularly first-time mothers, labor rarely progresses quickly enough for this to happen.

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"The truth is labor will probably be a lot longer than you anticipate. And the chance that your baby will come before you get to the hospital is highly unlikely, even if you live some distance away," says Wilcox. To add an extra layer of protection, she says, talk to your doctor about the true signs of labor, so you know when it's time to head out the door.

If this is not your first baby, however, then labor may be shorter. But doctors say if you pay attention to your body cues, it should still leave you with plenty of time to get to the hospital.

"Essentially you want to time your labor pains -- and as soon as the contractions become regular, then you know that you are definitely in labor, and should at least phone your doctor if not head for the hospital," says Wilcox.

To further calm those "get me there on time" fears, make sure you pack your labor bag at least two weeks before your due date -- and have a definite plan in mind for how you will get to the hospital during both the day and nighttime hours. If this is your second or third child, experts suggest having someone you can call to care for your other children when you leave for the hospital.

Labor and Delivery: Fear Your Doctor Will Miss Your Delivery

OK, so you've made it to labor and delivery with time to spare. Now, where's your doctor? The fear that he or she won't arrive in time is a major one for many women.

Relax -- you're never on your own. First, experts say that most doctors live closer to the hospital than you do, so getting there is almost never a problem.

Most importantly, Wilcox says even if your obstetrician ends up in a horrific traffic jam, you will be far from alone on any labor and delivery floor.

"Every labor floor is attended by dozens of professionals -- from very experienced labor and delivery nurses, to attending physicians, to other obstetricians. So you are definitely entering an environment where the level of professional help is high. And that means you will never actually be alone in this respect," says Wilcox.

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Labor and Delivery: Fear of Pooping on the Table

It may not be life-threatening, but many women fear they'll die of embarrassment if what they see as the ultimate labor horror story occurs -- they poop on the delivery table.

While we can't promise this won't happen, Blumberg has some very reassuring advice if it does.

Says Blumberg: "Nobody is happier than me when a woman in labor has a bowel movement, because that almost always means the baby is on the way, that a vaginal delivery is progressing normally, and that I don't have to be concerned about a C-section. It's really a sign that everything is A-OK and if you can just look at it that way, you'll forget about the embarrassment and feel as happy as I do that your baby is about to enter the world."

WebMD Feature Reviewed by Louise Chang, MD on February 05, 2009

Sources

SOURCES: Laura Riley, MD, high-risk obstetrician, Boston; author, Pregnancy: You and Your Baby. Isabel Blumberg, MD, clinical instructor of obstetrics and gynecology, Mt. Sinai School of Medicine, New York City. Robert Atlas, MD, chairman, department of obstetrics and gynecology, Mercy Hospital, Baltimore. Wendy Wilcox, MD, obstetrician, Montefiore Medical Center, New York City.

© 2007 WebMD, Inc. All rights reserved.

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