Women Who Are Scared of Childbirth Spend More Time in Labor (STUDY)

We tend to expect to be scared about giving birth. Movies and TV shows offer up worst-case scenarios, horror stories about hospital births and home births abound, and we hear plenty about how painful labor can be. But all that focus on fear may be making things worse for moms-to-be: A new study shows that pregnant women who are afraid of childbirth end up spending more time in labor than women who aren't.

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In the study, published on Wednesday in "BJOG: An International Journal of Obstetrics and Gynaecology," researchers analyzed data from more than 2,206 patients at a hospital in Norway who took a survey about fear and childbirth when they were 32 weeks pregnant. Women who indicated a high level of fear spent, on average, one hour and 32 minutes longer in labor than those who weren't as afraid of giving birth -- 8 hours with contractions coming at least every 3 or so minutes, compared with 6 hours and 28 minutes for those who were less afraid. After adjusting for other factors (mostly hospital interventions like epidurals and inductions), the difference dropped to 47 minutes, but if you've ever been in hard labor you know that 47 minutes is still a pretty significant amount of extra time.

"Fear of childbirth seems to be an increasingly important issue in obstetric care," wrote the study's author, Dr. Samantha Salvesen Adams of Akershus University Hospital at the University of Oslo in Norway. "Our finding of longer duration of labor in women who fear childbirth is a new piece in the puzzle within this intersection between psychology and obstetrics."

The average age of the women was 30.9 years old, and half of them were first-time mothers. The study did not correlate level of fear with experience in childbirth.

"There are a number of reasons why women may develop a fear of childbirth," John Thorp, the medical journal's deputy editor in chief, says. "This research shows that women with fear of childbirth are more likely to need obstetric intervention and this needs to be explored further so that obstetricians and midwives can provide the appropriate support and advice."

Feeling afraid triggers the body's natural "fight or flight" response, flooding the bloodstream with adrenaline, raising your heart rate, and making one feel hyper-alert. "It's not the ideal state for giving birth," explains Ina May Gaskin, homebirth advocate and the author of "Birth Matters." "In fact, it's the ideal state for stopping labor once it has started. Since our skeletal muscles are in a state of hardness and rigidity when we are full of adrenaline, it should be obvious that it would be possible for a baby to push its way through such rigidity into the outer world."

The study also found that women who were afraid of giving birth more often required forceps or other instruments in order to deliver vaginally (17 percent versus 10.6 percent) and more likely to end up with an emergency Caesarean section (10.9 percent versus 6.8 percent).

"Generally, longer labor duration increases the risk of instrumental vaginal delivery and emergency caesarean section," Adams wrote. "However, it is important to note that a large proportion of women with a fear of childbirth successfully had a vaginal delivery and therefore elective caesarean delivery should not be routinely recommended."

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