At some point in your pregnancy the reality strikes that this baby will need to come out. For most women, the impending prospect of labor and delivery is both exciting and frightening.
There’s a monster on Sesame Street named Telly Monster who frequently acts out anxiety, and in this case, Telly’s worries about labor might sound like, “oh no, what if my water breaks and my OB practitioner wants to induce me? Oh no, what if I can’t handle the contractions? Oh no! What if I need a cesarean? Oh no! What if there’s a problem with the baby?” Sound familiar?
Unfortunately, this worrisome cycle only creates more anxiety. We create and magnify worry by thinking that the worst thing possible will happen. In other words, we spend a lot of time worrying about things that are unlikely to occur. Yet each of these labor concerns are real, valid, and could happen.
We also increase our anxiety when we minimize our strengths, including our coping skills, access to resources and support systems. This makes us feel vulnerable. Not only do we fear that something bad will happen, but we feel that when it does we won’t be able to cope with or handle it.
Rather than worry, spend your time planning for all the possibilities that might happen as your due date approaches. One of the scary parts of birthing a baby is a sense of loss of control. Things don’t always go as “planned.” Preparation for birth begins with having a trusting relationship with your healthcare provider, your partner, embracing a flexible attitude, and creating a plan for all of the contingencies you fear. This should immediately begin to lower your stress.
Many couples go into labor with a birth plan, and while this plan helps your care providers understand your preferences, it’s important to remember that your baby hasn’t read the plan!
Researcher Dr. Kathleen Mooney at the Center for Cognitive Therapy in Newport Beach created the PR Plan for managing anxiety and it’s a great tool to use in preparing for labor and birth.
The first step in the PR Plan is to PREDICT and PREPARE for the feared events, such as being induced, having a long or difficult labor or needing a cesarean birth. For each prediction, make a list of all the positive things you could do, the things you could say to yourself, and people and resources that will help you in the situation. Then, REHEARSE in your mind each of these situations. See yourself using your plan to cope with and manage each situation.
Rather than getting swept into a tidal wave of fear, this approach helps you evaluate each concern and then create an appropriate action plan. Practice the PR plan as you draw near birth and your fears begin to arise. Move beyond your fears into an attitude of increased confidence and flexibility in giving birth.
Prediction:Labor is more uncomfortable than I imagined, breathing isn’t helping to ease the pain. I can’t take it anymore. I want a drug-free delivery, but I am scared.
Plan:I will talk to my healthcare provider in advance about my options for pain management, including non-medication choices such as hypnosis, the Lamaze or Bradley methods and childbirth preparation courses, and we will also discuss pain medications as a possible option. I will include my partner/support people in this process so they will be able to support me in my choices. After the birth I will feel good about my choices, knowing I made the best decision for me when I needed to do so.
Prediction:What if I need a c-section? I will feel like a failure. I will feel like I missed out on a beautiful natural experience. I will feel cheated.
Plan:I will ask my healthcare provider in advance about the likelihood of my needing a cesarean, particularly about what could arise during labor that might indicate one is necessary. I will discuss how a decision to have a c-section will be made, both on a non-emergency and emergency basis. I will ask about the role of my partner if I need a c-section, and when I will be able to see the baby. I will tell my practitioner my wishes and will remember that my most important goal is to have a healthy baby; the outcome is way more important that the process. I will remind myself that growing a healthy baby, eating right and exercising were in my control and that I did that very well.
Prediction:I am afraid of how I might react if there is a problem with the baby.
Plan:I need to remember that the likelihood of a serious problem is quite small. But if there is a problem, it’s okay to cry. I can ask my pediatrician for the best specialist in the area. I can find a support group to join and talk to other parents who have faced a similar problem. I can learn as much as possible about the problem. I will call on my family and friends for emotional support and help. I will be there for my baby. I will remind myself that I did everything I could to have a healthy pregnancy and baby.