It’s time to break the vicious Cycle in Birth – reframing how we think about labour, and the fear/tension/pain surrounding it.

When I talk to my doula clients about how they are feeling about their upcoming birth I almost always get the same answer. “I’m scared to death!” Or when asked what emotions they have surrounding that upcoming birth their answer is almost always the same “FEAR”.

My main goal in my prenatal visits for my clients is to dispel the myths surrounding birth, and reprogramming all of the nonsense Hollywood and society has led us to believe about birth so much that we are scared of it! The change the word a mama uses to describe how she’s feeling from FEAR to EXCITEMENT. To help her to lose some of the anxiety, stress, worry and tension surrounding the anticipation of that big day!

Childbirth isn’t scary and shouldn’t be feared. Though labor and birth are processes that can seem scary and uncontrollable, fear about them that is not “managed” can have significant impacts on both body and mind – and ultimately, on the birth experience itself.

WHAT IS THE FEAR-TENSION-PAIN CYCLE?

Ok, so what is the fear-tension-pain cycle? The fear-tension-pain cycle is talking about our nervous systems. When you are scared of something, your body naturally kicks into a “fight or flight” response. (aka stress!) This is a protective mechanism that is actually really good in most circumstances, because it encourages you to remove yourselves from dangerous or unhealthy situations. But remember – birth ISN’T dangerous!

For more information from the experts check out this article here. Pain in Labor: A Conceptual Model for Intervention – JOGN nursing

When your body goes into “fight or flight mode” it may cause this increase of adrenaline, send blood to essential organs, and increase respirations and heart rate. It might also cause increased tension because the body senses a threat. Your body then clenches its job, tightens fists, shoulders, and whole body.

In relation to how this impacts labour, as the contractions get stronger if we are afraid our body then has tension about each one that comes, thus tensing up in the jaw, hips and pelvis. Our breathing can become shallower and more interrupted. Because of all of this tension in our body, each contraction is more painful. Our fears magnify because our fears were confirmed, we felt more pain. And thus, the cycle continues. Hard to break it!

The fear-pain-tension cycle was first discovered when researchers looked at the differences in labour pain and outcomes as they relate to socioeconomic status. The two obstetricians doing this work found that those who were less affluent and less educated actually felt less pain in labor and had better outcomes. Their conclusions were that those who were less educated had less fear around the process – and it led to greater pain control, less complications, and better outcomes.

WHY DOES THE FEAR-PAIN-TENSION CYCLE MATTER?

Ok, great. More fear = more pain. You got it – but what else should you know? The fear-tension-pain cycle can actually do more than cause you more pain. It can also slow down or stall labor as well. Recall how I talked about fight or flight mode. Remember how the body causes the blood to move to “more important” organ systems? Guess what isn’t considered “important” in these moments? The uterus! Some believe that fight or flight mode actually causes less blood flow to the uterus. This can then diminish the contraction strength or frequency.

If a stall happens, it can become another mental block to overcome. It can reinforce this false mindset of “I’m not capable of doing this forever” fear. You get trapped in the cycle.

HOW TO CHANGE THE CYCLE?

Fear is normal. Fear can be healthy. And honestly, I think it makes perfect sense to expect fear to sneak up on you a bit during your labor and birth process. It’s new to first time birthers. It’s also been falsely represented in society and movies that are all around this concept that birth is scary and something to be feared. So, what can you do to make sure when fear shows up, you can push back before getting caught in the fear-tension-pain cycle?

BREAK THE CYCLE with these 3 things:

Education: But this means proper education surrounding what birth is ACTUALLY like. Not what is on the big screen in movies with insane scenes that aren’t true. I spend tons of time with my clients talking about what birth will feel like, look like, and what to truly expect. If you know what’s coming, you can prepare, and for most of us being prepared for what’s to come means when it comes it’s not so foreign or unfamiliar. Naturally we have less fear then.

Environment: Research shows that the birth environment plays a big role in you feeling safe. When you are safe, you are less fearful. Another bonus? Feeling safe leads to more oxytocin (yes, please). Consider who is in your space, and also the atmosphere of that space. Smells, lighting, temperature. Pick your environment wisely for your birth.

Birth support: A good birth support team should know your birth vision and also your fears around birth. They can then support you by reassuring you and helping keep the fear and tension down. When they see you slipping back into the fear/tension/pain cycle and help to ensure you continue to break the vicious cycle.

Actually, 4 things. You can also:

Reframe and create a new cycle: Instead of Fear/Tension/Pain… switch it to:

Knowledge/Understanding

Relaxation/Peace

Comfort/Well-being

Heading into birth full of knowledge and an understanding of the physiological process that lies ahead (education).

Ensuring that we can find more peace in the birth space and more relaxation (as relaxed as one can feel during powerful surges, but relaxing around the confidence we have in oneself and the process), which helps relax the body.

Finding comfort and well-being (yes, there is a certain level of comfort in each surge that comes in birthing, when we realize that with each one, we are closer to meeting our baby). Finding a sense of well-being in those moments. Knowing you know how to do this and are protected by that strength. In having more well-being, we further understand the process, relaxing more into each moment, and finding comfort in our bodies and trust me know what we are doing. 

Need more research and studies around the fear tension pain cycle? Check out this article. Pain in labor: a conceptual model for intervention – PubMed (nih.gov)

TO SUM THINGS UP

If we can head into birth with a new mindset around it, it will be a very different experience. We can lean into the idea that birth is “normal” “birth is safe” “birth doesn’t need to be feared.” I get it! Birth is often a new experience for us. Unchartered territory. It makes sense to be afraid of the unknown. But I urge you to educate yourself, think about the environment in which you are choosing to give birth, and the people you will allow to be with you in that space. Birth is a big event. Ensure those around you are helping to add excitement and confidence surrounding it! Ensure the space you choose doesn’t bring more fear and tension, but instead calms and relaxes you.

And in the end when someone asks you “how are you feeling about your upcoming birth?” Your answer is a confident and loud “EXCITED!”

Happy Birthing!

Lori