One More Thing To Worry About In The Delivery Room: Fear Of Childbirth Linked To PPD

pregIf your due date is fast approaching, then you’re probably far from relaxed. I know I was a nervous wreck, especially in the final four weeks leading up to the big day. Not only do you have to give yourself a crash course on the basics of parenting—diapering, feeding, sleeping, keeping a baby alive—but you also have to prepare for the not-so-small-task of gracefully shooting a baby out of your vag hole.

If this is your first baby, that thought alone may be enough to stop you in your pregnant tracks. I spent a lot, a lot of time thinking about exactly what birth was going to be like since no one can prepare you for it. I also don’t do well with a fear of the unknown and had a very difficult time wrapping my mind around just letting “birth happen” as the Good Lord or Mother Nature intended.

If you’re anything like me, and you have a few butterflies or a majorly aggressive moth rumbling in your stomach at the thought of labor, a recent study may give you one more thing to worry about.

A paper published in the journal BMJ Open confirmed that a fear of childbirth can increase the risk of postpartum depression roughly threefold in women without a history of depression. For women with a history of depression, fear of childbirth increases the risk of PPD fivefold.

These conclusions came from a review of birth and health registers in Finland—511,422 single-child births from 2002 to 2010. Out of these cases, 0.3%, or 1438 births, involved postpartum depression. This percentage was similar to PPD rates recorded in US studies.

“As expected … two-thirds of all cases occurred in women with a history of depressive symptoms before or during pregnancy,” wrote lead study author Sari Raisanen, an epidemiologist and visiting scholar at Emory University in Atlanta, and her colleagues.

In fact, a history of depression was associated with a 140-fold increase in risk for postpartum depression.

A third of the PPD cases occurred in women who were considered low-risk without any prior history of depression. Researchers concluded that the “single greatest predisposing factor,” after a history of depression, was an expectant mother that had a fear of childbirth.

To me, these findings are intriguing. I didn’t have postpartum depression, though I did have the baby blues. I didn’t have a crippling fear of childbirth, though I did have anxiety leading up to it.

In my personal story that has absolutely no impact on this research, I had two natural births, one at a birthing center and one at home. Although I was quite nervous about giving birth, I also took a lot of time to mentally prepare for it by focusing on positive outcomes and feeling empowered about my body.

This may sound hippy-dippy to some, but it does jibe with the advice given by many physicians—if you are afraid of pain during labor, your body will tense up, and you will naturally experience even more pain. It’s a vicious cycle. I don’t have any scientific answers for how to address a fear of childbirth, but the subject is worth talking about more openly, especially related to postpartum depression.

(photo: Getty Images)

You can reach this post's author, Bethany Ramos, on twitter.
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    • Janok Place

      My labor was hugely painful, I did the first 14 hours sans meds. However I can’t say I was afraid of it going in, scarred by it after the fact or am currently fearful of my next round in the delivery room (March). I guess I’ve always just felt it’s inevitable, and raised with hippies I try not to worry about that which I cannot change. My biggest fear is a caesarian (which is why I allowed medical/drug intervention after 14 hours in the first place). I didn’t suffer from PPD round 1, but in the event of a c-section I could see having a difficult time recovering emotionally.

    • http://ultimatemamacat.tumblr.com/ Hana Graham

      This article does not comfort me D:

      • Bethany Ramos

        I hear that :(

    • Kay_Sue

      I’d be interested to see what women fear the most about childbirth. Is it birthing itself? Is it the pain? Is it complications with the child? Is it the pressure to have a “perfect” birthing experience?

      Fear of childbirth could cover a very wide range of factors. It definitely bears consideration and discussion, and hopefully more study to determine what women are most afraid of.

      • Bethany Ramos

        What a great point. I’m sure fear of childbirth can encompass many different things. Like I said, I had more of a fear of the unknown because I had no clue how every single detail was going to go, and I like to know that kind of stuff. But I also felt pretty confident in my body, so that was the good part for me.

      • Kay_Sue

        I was anxious for that reason too with my first. I am a control freak–I’ll own it. I like to know every little detail, every step, every single in and out, and if I don’t, it drives me crazy.

        To me, that also begs the question of how they define fear of childbirth. Most women probably experience anxiety–I mean, a root canal is nothing compared to it, and yet the majority of the population would probably admit to serious anxiety ahead of that procedure. Nobody likes pain. That’s basic evolution. So what constitutes a fear of childbirth significant enough to increase your risk of PPD?

        I really look forward to seeing more information come out about it.

      • Bethany Ramos

        We are kindred control freaks :)

      • EX

        I think I’m actually more anxious about childbirth the second time around (due any day now). The first time the whole thing seemed so abstract and surreal whereas this time I know what I’m getting into. That being said, my first time was actually pretty easy (relatively speaking) so I’m not freaking out or anything. But knowing what the pain is like and knowing it’s coming at you no matter what is kind of… unpleasant.

      • Bethany Ramos

        Good luck!!!

      • EX

        Thanks!

    • AnotherMel

      I was terrified of child birth. I tried to do everything “right” read the natural child birth books, hired a doula, etc. But I was still terrified – of the unknown and of needing an epidural. I spent over 17 hours in natural labour before I was more scared of hurting myself than I was of the epidural. My son was born after about 27 hours in labour. I was never diagnosed with PPD but I think I probably had a mild case of it looking back (I was a mess for months) so it’s interesting that it might have had something to do with my fear. I’m grateful I got an epidural because it kept both my baby and I safe and because it’s a requirement where I live if you’re delivering twins – which I can expect to do anytime in the next 5 weeks. So this time I don’t have the same fear although I will admit to a little bit of anxiousness because there are still lots of variables and I could end up with a C section. I’m mentally trying to prepare for a C – but this time I’m a lot less scared even of that possibility.

    • Stephanie

      I was young and really stupid when I had my daughter. I just kept thinking “Oh no biggie. I’ll just have an epidural and the pain will stop..la dee dah….hey, is that a cupcake?” Luckily the patron saint of stupid people smiled on me and I was able to get an epidural and it worked like a charm. But when I look back at how blasé I was about the whole thing, I kinda have to shake my head.

    • pineapplegrasss

      My 4th was a c-section. Breech. I was always sooo scared of a C-section. I tried everything to get him to turn, watching tv upside down, putting headphones on the lowest part of my belly, handstands in the pool, etc, Then we had a Version, which is where they try to move him manually from the outside, and he was stuck. The Version hurt worse than any labor or anything I’d ever experienced. I never had any real fear of labor or delivery until my Midwife made me choose whether to have a C-section scheduled or to see if he flipped during labor, which she said was unlikely, since he wouldn’t budge during the Version. I chose to schedule the C-section bc I was so afraid of an emergency during labor. I think I was mostly scared bc I didn’t want my labor/ delivery to be a medical procedure, I just wanted a do what your body does natural childbirth. The kicker is, a year later, my oldest daughter (sounds weird, I know, a grandbaby 1 year younger than my youngest..) had to have an emergency C-section, and I was able to stay calm and keep her calm and trust in our midwife bc I had just experienced it. Strange how the universe works.

      • pineapplegrasss

        And the healing from the Cesarean wasn’t that bad for me bc I’m pretty thin. And my Vag was still perfect afterwards :) Not to be pro C-section.. just saying. Not anything like I thought it would be.

      • Bethany Ramos

        That’s an awesome story though – how it all worked out! I can’t even imagine how painful the Version would be, wow.

    • Anna

      It’s not just hippy-dippy, it’s victim blaming. This is what’s wrong with natural birth fanatics.

      Birth hurts. The mother’s thoughts or feelings are not to blame for that. In every time and culture throughout history giving birth was a byword for pain and suffering. Just check the bible if you don’t believe me. Women were afraid of it. Birth preparations used to involve going to confession and making up your last will and testament. Thanks to modern medicine we’ve mostly lost that fear. Unfortunately some replaced it with a bunch of smug, ignorant tree-huggers who convince women thhat the watermelon going through the keyhole will somehow produce an orgasm instead of just a whole lotta pain.

      • Bethany Ramos

        I am not a natural birth fanatic, and I am definitely not blaming any victims. I also don’t ascribe to the belief that birth has to be a terrible experience. But even if a mother has a truly horrific experience, I wouldn’t blame her for it.

      • AcesPlace

        That’s true. Natural birth fanatics don’t seem to understand how to mind their own business. You can’t tell them to shut up and go away without threatening to beat the daylights out of them. Idiots. Unwelcome, unwanted, unheeded, mocked idiots. Why can’t they figure out that they are irrelevant???

    • SusannahJoy

      The more I read stuff like this, the more grateful I am for the prenatal care I got. At every visit they asked how I was doing, and now just a polite “hi, how are you.” but they actually cared and listened and made sure that not only was I doing well physically, but that I was doing well mentally and emotionally.

    • meteor_echo

      Aaaand this is why, if I ever get pregnant, I’ll Ctrl+X that little sucker asap. I’ll also chew out every single all-knowing ass who has the guts to suggest adoption – because pregnancy and childbirth are Alien-esque, painful and horrifying, and I don’t need my chronic depression to flare up again.

      • AcesPlace

        That’s exactly the way I feel. You get all kinds of smart-assed intruders trying to tell you what to do. Pregnancy is disgusting, it’s self-abusive, mutilating and it reminds me of slaughter. No way. If someone gets smart with you, smack ‘em down. You really can teach people how to behave.