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Fear of Childbirth Prolongs Labor

Published on August 6, 2012

8.3K views

When I was little, I would constantly ask my mom about childbirth: Is it really as painful as they make it seem on TV? My mom confirmed that it was the most painful thing she ever experienced. Of course, she said, I’d do it all over again because my babies are so special. My eyes were wide in disbelief – I don’t think my siblings and I were ever that special.

The idea of giving birth to a child has always been incredibly scary to me, and now, with more knowledge on the subject, the idea is scarier still. Just thinking about contractions, tearing, and a head coming out of my vagina is enough to make me pass out.

Unfortunately for me, researchers recently found that such fears only draw out the labor process.

Fear of Childbirth Only Prolongs Childbirth

Norwegian researchers published a study in BJOG, An International Journal of Obstetrics and Gynaecology, that found women with a fear of childbirth spend an hour and 32 minutes longer in labor than women without fears of childbirth.

Even after researchers adjusted for other factors that could contribute to the duration of labor, such as having given birth before and instrumental vaginal delivery, women who feared childbirth were still in labor 47 minutes longer than those with no fear.

In addition, labor-fearing patients tended to be more likely to deliver by instrumental vaginal delivery or emergency cesarean delivery than women who were more comfortable with labor.

Stress Hormone May Prolong Labor

Researchers from Akershus University Hospital, The Health Services Research Center, and the University of Oslo, Norway are not exactly sure why women who fear childbirth get to experience the joys of labor for a longer period of time, but some point to stress hormones.

Samantha Salvesen Adams, co-author of the research, shared two theories:

“First, stressed women have higher stress hormones during pregnancy, and high stress hormones may weaken the power of the uterus to contract. And second, we think that women who fear childbirth may communicate in different ways with health care professionals during pregnancy,” which could impede proper assistance for a shorter labor.

Oxytocin and Catecholamines

The hormone oxytocin is released in large amounts during labor, causing the uterus to contract regularly, which is why the name was derived from the Greek word for “quick birth.” Oxytocin has also been shown to increase trust and reduce fear, a happy result for fearful mothers-to-be.

The secretion of oxytocin, however, is repressed by catecholamines, or the fight-or-flight hormones, epinephrine and norepinephrine. Catecholamine levels can rise when a woman feels frightened, and labor can be suppressed.

This is fine at the beginning of the delivery – no need to start contractions too early, catecholamines are even important for the fetal-ejection reflex; but these adrenal-gland hormones can make for a long labor if they continue to inhibit oxytocin from kicking in.

How to Handle the Fear of Childbirth

Studies seem to indicate that fear begets fear, so it seems the best way to handle any anxiety is by coming to the delivery room with as little fear as possible, and that takes preparation.

If I was expecting a baby, I would take advantage of the following methods to reduce anxiety, fear, and excessive amounts of catecholamines:

Massage
Finally, an excuse to get a really good massage. Massages can help keep your head clear and your anxieties at bay. Of course, if you didn’t get your fill of massages prior to delivery, the Traditional Chinese Medicine University claims that massage during labor can significantly shorten the labor process.

If all else fails, massaging the nipples can increase oxytocin production and induce labor. You should consult your doctor prior to using these massage techniques.

Prenatal Yoga
Om.ygod. Prenatal yoga helps to reduce the stress and anxiety that can make delivery last longer than necessary. By focusing on breathing techniques, stretching, strengthening, and mental concentration, you are preparing yourself for labor.

Some studies even suggest that prenatal yoga shortens the overall time of labor, particularly the first stage of labor.

Meditation
I’m not thinking about the pain. I’m not thinking about the pain. I’m not thinking about the pain. With enough practice, you’ll learn to control these thoughts. Like prenatal yoga, meditation focuses on breathing and mental exercises, which minimize the adrenaline and cortisol levels that trigger stress.

In fact, one study found that women who practiced meditation during pregnancy reported a decline in stress and anxiety.

Communication
As Samantha Salvesen Adams stated, fear may prolong labor because of poor communication between doctor and patient. In order to mitigate delayed treatment and assistance, start building a relationship with your doctor by communicating any fears or anxieties you have prior to delivery.

Open communication can give your doctor an idea of how you may handle delivery, and the doctor may, in turn, give you advice to prepare for the upcoming delivery. Communicating early on will also allow you to feel more comfortable discussing fears and pain when you’re in the delivery room.

What Worked for You?

I’ve already made it clear that I have not been in labor, but I would be interested to learn what techniques worked to reduce your fear of childbirth.

Stress, Learning and Estradiol

by Chandler Marrs, PhD

Published on November 29, 2011

4.3K views

In many ways, we assume males and females are the same, even though we know each sex has distinct and obvious differences in physiology and behavior. In the case of the stress, although the basic physiological response is comparable, the chemical reactions that the stress response elicits in males versus females are quite dissimilar. The divergent reactions are mediated by the varying concentrations of reproductive hormones that each sex is exposed to. Far beyond just controlling sex differentiation and reproduction, sex hormones like progesterone, estradiol and testosterone modulate brain and body chemistry quite significantly. The differences in the circulating concentrations of these hormones may account for the unequal prevalence rates of many diseases such as of depression, auto-immune disease, or migraine. These diseases are far more common in women than men.

Hormones also influence neurochemistry, and therefore, learning. In general, males and females learn quite differently from one another. Males tend to be better at spatial tasks while females tend to perform better at verbal tasks. Research suggests testosterone and estradiol may mediate those performance differences.

Estradiol affects learning under stress. When exposed to stressful conditions, male rodents learn certain classically conditioned tasks more rapidly than female rodents. However, when the female rodents’ ovaries are removed or estradiol is blocked by a drug like Tamoxifen, the difference between the two sexes is removed. That is, the female rodents acquire the conditioning as quickly and as effectively as the male rodents.

Even though, humans are far more complicated than rodents and the controlled stress and the scope of classical conditioning tasks in the lab are limited compared to the stress and learning that takes place in the real world, it is clear that sex matters, and thus by definition, sex hormones matter.

To read more about sex differences in neurochemistry:
The End of Sex as We Know It

The Stress of Modern Living

by Chandler Marrs, PhD

Published on November 29, 2011

5.7K views

I’m stressed, my friends are stressed, and let’s face it, the entire nation is stressed. In modern life, we’re bombarded with the daily list of to dos, the noise of 24 hour news and cable, the incessant activity of the internet and in the current economy, the constant threat of job loss and financial insecurity. True, the stressors we face today compared to those faced by previous generations are not generally life-threatening, but they are deadly, just over a longer period of time.

Chronic stress, the underbelly of modern life (pun intended), is perhaps as much to blame for the increased rates of obesity, cardiovascular disease, and diabetes as are other lifestyle variables such as diet and exercise. Our physiological responses to stressors were meant to be acute, short-term adaptations that allowed us to survive an immediate threat. The chronicity of modern stress has turned a very basic survival mechanism into a death trap and I’m not sure we’ve fully evolved to adapt to this new, never-ending state of stress.

Think about what happens to the body when it is faced with a stressor; it mounts a physiological response against the stressor. It doesn’t necessarily matter what the stressor is, the physiological responses are quite similar. Have you ever noticed that the early stages of illness look a lot alike, GI disturbances, heart rate changes, loss of appetite, sometimes fever, aches and pains- that general feeling that you are coming down with something? This is your body reacting to an internal stressor, an illness.
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Cortisol: The Stress Hormone

by Chandler Marrs, PhD

Published on November 29, 2011

8.4K views

Cortisol is a steroid hormone produced in the cortex of adrenal gland. It belongs to a class of hormones called glucocorticoids and plays an important role in regulating cardiovascular function, blood pressure, glucose metabolism, sugar maintenance, and inflammatory response. Cortisol is best known as the stress hormone. It is released in response to stress, and is part of the fight or flight system.

Under normal conditions the body regulates cortisol levels which are usually high in the morning and low at night. But under stressful conditions more cortisol is secreted. Small increases in cortisol produce positive effects such as increased sustained energy, diminished pain sensitivity or memory enhancement. But a prolonged cortisol increase during chronic stress results in negative side effects: increased blood pressure, sugar imbalance in blood, decreased bone density, cognitive problems, and reduced thyroid function. It also slows down healing processes and suppresses the immune system, perhaps the reason we are more apt to get sick when we are stressed.

Continuously, stress-induced elevated cortisol levels lead to an increase in the level of other hormones (testosterone, estradiol, insulin). High cortisol levels are often linked to insulin resistance (Type 2 Diabetes), weight gain and general inflammatory conditions. High cortisol is toxic to the brain and can cause memory loss and contribute to Alzheimer’s disease or senile dementia. Elevated cortisol levels and lack of diurnal variation have been identified with Cushing’s disease. Low cortisol levels are found in primary adrenal insufficiency (e.g. adrenal hypoplasia, Addison’s disease).

Cortisol and progesterone bind to common receptors in cells. Cortisol blocks progesterone activity, and some suggest, that high levels of cortisol, initiated by chronic stress, dispose one to a condition called estrogen dominance. Estrogen dominance is condition where women cease to ovulate regularly and progesterone concentrations are lower than necessary during the second half of the menstrual cycle. Many suspect estrogen dominance underlies PMS and other cycle related symptoms.

Hormones Matter

Where health, hormones, and a whole bunch of other stuff, make sense.