Late in my third pregnancy, a new and unusual symptom developed that I had never experienced before: I was having serious anxiety about giving birth.
Of course, with my other two births I'd felt nervous about labor. I wondered how I would handle the pain, how long my labor would last, and I even worried about the health of my baby. This time, the anxiety was different. I found myself trying to distract my brain as it ran through each potential worst-case scenario.
I would run through the same list of questions on a regular basis: What if my new doctor is pushy and doesn’t respect me? What if my doctor performs a medical procedure without my consent? What if my baby isn’t healthy? What if I am injured during birth?
After two uncomplicated births, I had no real explanation for my newfound anxiety. One day, it just arrived and became part of my everyday life. In some ways, I blame the news. In a single week on my Facebook feed, I had seen a story of a stillbirth, a mom who had become disabled during childbirth, and a family who'd had their baby taken away because of a disagreement over medical care. I quickly learned to not click on these stories. But even when I tried to avoid them, their headlines were enough to get my thoughts racing.
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I expressed some of my anxiety to my prenatal care provider, and she assured me that the chances of a mishap or complication during birth were incredibly low. Still, I found myself frequently worrying, and I decided to seek out the advice of a Dr. Christine Manzella, clinical director of The Seleni Institute, a nonprofit organization that offers reproductive and maternal mental-health services.
According to Dr. Manzella, worry during pregnancy is something most moms experience, but anxiety that causes distress or begins to interfere with daily living is present in approximately 20 percent of pregnancies.
Here's the advice she gave me.
Mothers experiencing anxiety about their labor and delivery should first establish an open line of communication with their health-care provider.
“Her preferences, are the being heard?" Manzella asked. "If not, can the pregnant mom say, ‘Hey! It’s making me anxious here that I don’t feel like my preferences are being listened to.’”
Additionally, she pointed out that birth has been highly medicalized but that expecting mothers should focus on the fact that birth is a normal and natural process, especially if they are feeling concerned about what could go wrong.
Expecting mothers should focus on the fact that birth is a normal and natural process.
“You and I got here by being born,” she reminded me. “Remember each birth, unless there is some high-risk, ongoing problem, is a normal process.”
She also suggested that expecting mothers reach out for added support during labor. For some women, their partner is all the support they need in the delivery room, but many benefit from the help of a trained birth professional such as a doula.
“A doula is someone who is trained to listen,” she explained. “Having a trusted person who knows what to expect and knows you, like a doula, or a husband or a partner, is great. To walk through [birth] with that person will really ensure you feel safe, secure and supported.”
Lastly, she noted that anxiety may reach a point that the mom-to-be should explore additional support in the form of therapy or psychiatry. In most cases, your OB-GYN can offer a referral for mental-health support specialists who work well with expecting mothers.
“If the anxiety becomes all she can think about any time she thinks about the labor, delivery and birth, if thoughts become so distressing that they interfere with life, let’s find some ways to manage that anxiety," she said.
Taking her advice, I spent some time talking through my fears with my doctor, who connected me with an in-house counselor. I also talked to my husband about how he could support me and help me to stay calm if I felt overwhelmed or fearful. And when my son was born, I was able to use the strategies I had learned to manage my anxiety, allowing me to enjoy the process of bringing my son into the world.