When I began working in the birth world I was told women were afraid of childbirth because of the media portrayal of birth. Television, movies, and magazines were teaching women to be afraid by their unrealistic labors and horror stories.
So, is this true? Maybe, but maybe not.
Stoll’s (2014) survey of college students found an association between media as a source of birth information and higher fear scores. But two things stand out to me in this sample of college students. First, the mean fear score between those who got information from media and those who didn’t was less than two points different on a 36 point scale — basically one was just below 18 and the other just above. The difference between those who used only the media and only family was less than three points. Second, less than half the students reported using media as a source of information about childbirth.
Another problem to consider is that this is only an association. We don’t know the order of events and so we cannot say it was the media that caused the fear of birth. What if the media use is in response to the fear of childbirth — young men and women trying to find out if their fears are founded? In this scenario those without a fear might not bother using media because there is no perceived need for information.
I have two other studies to share with you on this topic.
Let us begin with Fenwick, 2010. This was a study of women who requested a cesarean in a normal, healthy, first pregnancy. These women reported concern that vaginal birth would result in physical injury to themselves or their baby. Two things stood out to the researchers as unique for these women. First, they couldn’t conceptualize how a baby could be expelled safely from the body — as if the vaginal canal couldn’t accommodate the baby’s head. Second, the women did not seem to derive any personal meaning from birth, it was just a process to get the baby or a means to an end. The women used language that said they were “getting” a baby not “having” a baby.
A similar study is Faisal, 2014. This was a study of Iranian women who also requested a cesarean surgery for a normal pregnancy. These women also reported fear of vaginal birth being too difficult. It was not only the pain, but concerns about pelvic floor disorders and other physical damage to themselves and the baby. They reported believing a cesarean was safer and less traumatic for the baby.
What was similar between these two studies, besides the fear? It was the influence of family on their decision to request a cesarean. It seems the experiences of close friends and family played a major role for these women in conceptualizing what childbirth would be like. These women reported a bad birth experience for a close friend or loved one which served as their “prototype” birth — what they expect all births to be like.
All this to say I’m not quite sold on the theory that media drives fear of childbirth anymore. What do you think?