Fear Factor: How Anxiety About Birth Makes Labor Longer

A new reason to keep calm and carry on? According to a recent study from Norway, published in the journal BJOG, women who fear birth may end up spending almost an hour longer in labor and delivery than other moms. Here's why fear can be a factor—and what a doula says moms can do to keep anxiety and worry at bay.

To get to the bottom of fear's affect on childbirth, researchers surveyed more than 2,000 moms-to-be at 32 weeks pregnant. Just over 7 percent said they felt very fearful about giving birth; and—surprise, surprise—many of these women were first-time moms. After checking in with this same group after their babies were born, researchers saw a pattern: Compared to women with more relaxed attitudes towards birth, women who feared childbirth had labors that lasted an average of 47 minutes longer. These same women were also more likely to be induced and to undergo emergency C-section.

The connection? Researchers have two theories. "First, stressed women have higher stress hormones during pregnancy, and high stress hormones may weaken the power of the uterus to contract. And second, we think that women who fear childbirth may communicate in different ways with healthcare professionals during pregnancy—perhaps delaying measures that could speed delivery," says lead author, Samantha Salvesen Adams, a researcher at Akershus University Hospital in Lorenskog, Norway.

If all this sounds a bit familiar, it's probably because the message here—that state of mind matters during childbirth—is something that natural birth advocates like Ina May Gaskin have been saying for years. As Lisa Gould Rubin, certified doula and author of The Birth That's Right for You, explains, the natural birth crowd knows all too well that fear and other negative emotions can slow down labor. As a result, says Rubin, midwives and doulas have developed plenty of ways to help moms feel more confident and positive attitude towards birth.

Among Rubin's favorite tips are:

• Know Yourself: "You don't suddenly turn into somebody else when you are in labor. Take a look at who you are and what you already do in your life to cope with fear, anxiety, discomfort, and pain," says Rubin. When you need to relax, do you watch TV, get in the shower or tub, listen to music, or lie on your bed in the fetal position in darkness with no noise? Bring these coping techniques into the delivery room with you, she advises.

• Get Educated: Rather than take a birthing class that only teaches a specific relaxation technique, Rubin recommends moms look for "a customized childbirth preparation class that doesn't plug you in to some methodology that presumes a one-size-fits-all approach." As you check out offerings in your area, "find a teacher who helps you understand the process of birth and helps you apply what you need to feel safe and secure every step of the way."

• Self-Advocate: Researchers say that one of the reasons fear can get in the way during labor is because it prevents women from effectively communicating their needs. To avoid this, Rubin says to start talking about birth early. "Share what you need with your doctor or midwife in the months leading up to your birth. It's the only way to collaborate so that everybody in the room is there to help you accomplish that which you want for yourself."

• Get Support: When it's time to give birth, have people there with you with whom you feel safe, who can help you through the process physically and emotionally, who let you know your options, and who tell you that all is going just as it should, recommends Rubin. As a doula, Rubin often serves in this very capacity. And give your support team a job! "Have your team keep the room a sacred space—print signs to tape to the inside and outside of the door reminding people to speak quietly and close the door gently on their way in and out," says Rubin.

What's your plan to stay calm, cool, and collected in the delivery room? And if you recently gave birth, what worked—and what didn't—for you?