Why am I so afraid I’ll die during childbirth?

Excerpt from Asking for a Pregnant Friend: 101 Answers to Questions Women Are Too Embarrassed to Ask about Pregnancy, Childbirth, and Motherhood

You probably feel that way because a culture of fear has permeated childbirth. It bloomed when childbirth actually was a dangerous endeavor — when women weren’t able to get quality care if a special circumstance came up, when doctors didn’t know they needed to wash their hands between treating patients. Those women had good reason to fear death. But many of the risks those women faced are gone, and modern medical advances have made childbirth an incredibly safe experience. There is now effective protocol for even the most dangerous circumstances. And the great thing is, most women don’t even need to receive medical care during childbirth, they just need a trained care provider observing them in case intervention is needed.

So now that we’re covered for worst-case scenarios, we can relax into childbirth, right? We can let go of the fear of death. But that’s easier said than done. Our conscious minds can know that death is a highly unlikely outcome of childbirth, but the subconscious mind still holds onto the belief. There are a few reasons for that. Media is one of them. Think about every depiction of childbirth you’ve seen in mainstream media. I can almost guarantee those images consisted of angry women screaming in pain. Each time you saw one of these images, a seed of fear was planted.

And then there are the scary birth stories. Some women wear their traumatic birth story like a badge of honor and love to tell pregnant women, “Childbirth will be the most painful experience you’ll ever go through.” I’ve even heard some say, “It’s so painful you’ll want to die.”

In addition to these inaccurate, harmful messages, a fear of death during childbirth can be triggered by our mind trying to wrap itself around the process of a human coming out of our body. Many women in my classes have reported a fear that their body will “rip open” during childbirth, or that their heart will give out because of the strain. Even though these are not things that will happen, women still believe it on some level, despite all the evidence to the contrary. Much of this fear comes from the unknown. They’ve never had a baby, and the mind takes them to the scariest place it can imagine. Or maybe they’ve had a baby and the birth was traumatic. Even though they survived the experience, a part of them believes the second time around will be even more traumatic.

When this fear is at its most intense, it has a name: tokophobia. According to an article published in Industrial Psychiatry Journal, tokophobia — a morbid, pathological fear of childbirth — can lead to avoidance of birth and sometimes results in a woman requesting a cesarean section. The authors report a number of circumstances that could trigger tokophobia:

Hearing traumatic birth stories: This is a big one. When women we trust go on and on about traumatic birth experiences, we start to think, “If it happened to them, it could happen to me.” And sometimes, we take it to the next level, thinking, “But I probably won’t be as lucky as they were. I’ll probably be the one that dies because of those complications.” But the likelihood of that is really, really rare.

Concerns about the competency of medical professionals: Fear is an understandable byproduct of not trusting that hospital staff or midwives can keep you safe. If you’re convinced you won’t be properly cared for if you require medical intervention, it’s likely that you have experienced some form of negligence regarding medical care, or heard stories of those who have. Whatever the reasons, the “What to do” section will provide ideas for working through this.

Low self-esteem: If we don’t think highly of ourselves, it’s hard to believe our mind and body can withstand the rigors of childbirth. (But it can!) This wavering belief in our ability to birth can water those aforementioned seeds of fear.

The good news is you don’t have to just grin and bear this often-debilitating fear, regardless of where it’s coming from. There are ways to face it, then move past it.

What to do

One of the most crucial steps to overcoming this fear is realizing it’s not a sign of what’s to come. Even if your mind believes on the deepest level that your birth will not have a good outcome, it doesn’t make it so. Keep reminding yourself that the fear is a false construct of your mind, built by outdated information and stories that are part of someone else’s false constructs or need to impress. And above all, know that you can overcome the fear. Know that the fear doesn’t own you. Know that you are stronger than the fear. The following steps will help you believe that:

Find a care provider you feel safe with. Few things are as reassuring as hearing a care provider you trust tell you that they’ll keep you safe during childbirth. They can explain the protocol for all the situations you’re afraid of, and they can share uplifting stories of births they’ve attended.

The key here is that you trust them. If that trust isn’t there, their reassurance won’t mean much. So interview care providers until you find one who makes you feel safe. While it’s common to have to interview a few before finding the right one, you might also discover that you don’t trust any of them, regardless of how many candidates you interview. If this is the case, you might need to work with a mental health specialist to unpack and examine your unique trust issues with medical care providers.

Write about what you’re afraid of. An interesting thing about fear is that when we name it, it loses some of its power. So write down why you think you’ll die during childbirth. Can you pinpoint where that comes from? Are other fears about pregnancy or childbirth fueling your fear of death? Write it all, letting the words flow until you find clarity. Then, make a list of the primary fears and discuss them with your care provider and/or a mental health specialist.

Carefully select the prenatal testing you’ll undergo. The testing that can be utilized during pregnancy is a double-edged sword. On one side, the testing can offer reassurance if it confirms everything is fine. On the other side is anxiety that can be triggered while waiting for test results, in addition to the fears that arise if results are abnormal. Because of this, it’s crucial to be selective about the testing you agree to. Speak with your care provider about what is available, and what they recommend, then carefully determine what tests are ideal for your unique situation and comfort level.

Avoid scary birth stories. If someone tries to tell you their birth story, stop them and say, “I would love to hear your story if it’s not traumatic and won’t scare me. If you think it will, I would like you to wait to share until after I have my baby.” In addition, if you come across an article, television show, or other media source that portrays birth in a scary light, skip it. You don’t need to be an expert on worst care scenarios; that’s why you have a doctor or midwife.

Reach out to loved ones. The aforementioned study published in Industrial Psychiatry Journal found that there was a 50 percent reduction in elective C-sections when women experiencing severe fear of labor and delivery told trusted friends and family members how they were feeling and asked for support.

Hire a doula. Because feeling heard and supported is such a big part of unraveling your fear of death during childbirth, seeking the support of a doula can offer significant relief. To make sure you find the right person, ask friends for referrals, and keep interviewing candidates until you find the one who is a giant yes for you. You can also get a feel for how they’ll support you through your fear by bringing it up during your initial meeting. How they respond will be indicative of how they’ll support you through it during birth.

Count to ninety when you feel the fear. Any emotion takes ninety seconds to pass through you if you don’t stop it. So when you feel that fear of death gurgle up, think, “Oh, look at that. There’s that fear. I’m not going to ignore it. I’m going to sit with it.” Then set a timer for ninety seconds, and feel the fear until the timer beeps. Anytime you feel the emotions attached to the fear come back, repeat this exercise.

Create an arsenal of relaxation techniques. In addition to the ninety-second fear release, collect practices that soothe you. For example, you could take deep breaths, envisioning calm, trust, and comfort flowing in as you inhale, and fear, tension, and dread flowing out as you exhale. You could also repeat a mantra, such as, “I’m releasing this fear because it doesn’t own me. It is not real. I choose love and trust instead.” Or you can simply repeat, “I am safe.” As an added resource, download this guided meditation that was specifically crafted for releasing the fear of death during childbirth: yourserenelife.wordpress .com/fear-of-dying/.

Birth in the location that makes you feel safest. If the idea of birthing in a hospital freaks you out, consider birthing at home or in a birth center. But if you can’t imagine feeling safe anywhere but a hospital, go to the hospital. And it doesn’t matter what your partner, mom, friend, childbirth educator, or whoever thinks you should do. Do what makes you feel most secure.

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