It turns out that isn’t an easy question to answer. To prepare for a recent study on the effects of fear on the childbirth experience, the researchers found between 5 and 40 percent of women fear childbirth. The number varies based on many things like the women’s ages, the cultural perspectives, and what list of questions was used to measure childbirth fear (Elvander, 2013).
For example, in a study of college students who had never given birth, fear of childbirth was measured by responses to 6 questions (Stoll, 2014). In a study of women who were recruited during their first pregnancy, fear of childbirth was measured by responses to a different set of 6 questions (Elvander, 2013). Qualitative research does not scale fear, but groups the terms women use to try to gain understanding of levels of fear (Faisal, 2014, Fisher, 2006). Continue reading
- Elvander C1, Cnattingius S, Kjerulff KH. Birth experience in women with low, intermediate or high levels of fear: findings from the first baby study. Birth. 2013 Dec;40(4):289-96. PMID: 24344710.
- Fisher C1, Hauck Y, Fenwick J. How social context impacts on women’s fears of childbirth: a Western Australian example. Soc Sci Med. 2006 Jul;63(1):64-75. PMID: 16476516.
- Stoll K, Hall W. Vicarious birth experiences and childbirth fear: does it matter how young canadian women learn about birth? J Perinat Educ. 2013 Fall;22(4):226-33. PMID: 24868135.
- Stoll K1, Hall W2, Janssen P3, Carty E4. Why are young Canadians afraid of birth? A survey study of childbirth fear and birth preferences among Canadian University students. Midwifery. 2014 Feb;30(2):220-6. PMID: 23968778.
- Faisal I1, Matinnia N2, Hejar AR1, Khodakarami Z3. Why do primigravidae request caesarean section in a normal pregnancy? A qualitative study in Iran. Midwifery. 2014 Feb;30(2):227-33. PMID: 24055288.
- Fenwick J1, Staff L, Gamble J, Creedy DK, Bayes S. Why do women request caesarean section in a normal, healthy first pregnancy? Midwifery. 2010 Aug;26(4):394-400. PMID: 19117644.
- Dahlen H. Undone by fear? Deluded by trust? Midwifery. 2010 Apr;26(2):156-62. PMID: 20096490.
I meet many childbirth professionals who are interested in global health. I often find their understanding of the issues facing women globally is based on old data or common myths.
Here is an opportunity to learn about maternal and newborn health in low and middle income countries. Check it out.
Before I became involved in global health, the idea that fear of childbirth was about anything other than fear of pain was basically an afterthought. Sure women used to die in childbirth, but that was long ago and didn’t really affect women’s views today. Sure some babies die, but not many so that didn’t really affect women’s views today. In my uninformed philosophy, it was easy to discount the objections I read to home birth and and the praises of cesarean because in my world the problems of childbirth were rare and relics of the past. As my knowledge grew, I began to see some basic conditions of that existed that made my philosophy seem true only existed because I lived in a place where women have access to quality health care.
The first problem was that I failed to understand or accept that bad outcomes do happen, and are not as rare as I think. Globally, 1,000 women die daily during pregnancy or childbirth – only 15 years ago this number was 1/3 larger. Continue reading
So far we have explored the idea that fear of childbirth is normal, and that fear of childbirth is taught. Today, we will explore the idea that fear of childbirth is driven by fear of pain. What do we assume if we hold this belief, and what might we be missing?
My original training as a childbirth educator (wow, 15 years ago!) was centered around the teachings of Grantley Dick-Read and the Fear-Tension-Pain cycle. we can talk about this theory later in the series if you like, but I want to focus today on how I mis-interpreted this theory. You read that correctly, I mis-interpreted this theory. Continue reading
Last week we looked at the philosophy that fear of childbirth is normal. Today we have an equally interesting exploration… what does it mean to believe fear in childbirth is “taught.” What assumptions do we make when we believe this. How does this belief affect the way we react to women?
If we believe fear of childbirth is “taught,” we probably make the assumption that feelings about childbirth are culturally derived, and result from the experiences of other women rather than the experiences of the expectant mother. We can dig a little deeper into this idea. What other things about childbirth are taught to the woman by her community? It is not only attitudes about the process, but also specific behaviors and her changing role within the community. Just like the fear, these behaviors and roles my be beneficial or harmful. Continue reading
Today we will explore what it means to believe fear in childbirth is “normal.” What assumptions do we make when we believe this. How does this belief affect the way we react to women?
With all the haunting and spooking of Halloween, October seems like the perfect time to explore the topic of childbirth fear. This month-long exploration will look at some of the more common philosophies about fear of childbirth, as well as the ways women are taught to deal with that fear. We will look at some statistics, some research, and some tools you can use as you work with women. Continue reading
I hope this has been an interesting, and educational, month for you.
We talked about what you need to know to be a midwife, and how your life goals will dictate what type of midwifery education you should pursue.
We explored the role of midwifery regulation in determining the educational options you have.
We shared tricks for getting the most out of a preceptorship.
We discussed the reasons for certification by competency exam, and why this is the minimum standard.
As you move forward, I would love to hear the decisions you make for your midwifery education.
After making all the other considerations and decisions necessary to define your midwifery path, you will probably be faced with a test for midwifery certification. The idea of competency testing has never bothered me personally, quite possibly because I am a good test taker. While I know standardized tests result in skewed passing rates (with minorities faring worse), this isn’t really the complaint I ever hear about midwifery certification tests. Instead, would-be midwives complain the test is meaningless and doesn’t prove you are a good midwife. I hope such concerns won’t keep any potential midwife from seeking certification, so here are a few other ways to think about the process — and a few hints to help you make good certification decisions. Continue reading
I wanted to take a few minutes to talk about credentialing and licensing – the reason for all the letters at the end of a name. It isn’t always easy to understand how the whole process works, especially when you are just looking into midwifery as an option.
So, my full title (right now) is: Jennifer Vanderlaan, MSN MPH RN CNM FNP
What does all that mean? Continue reading