How do we help women become less fearful of birth?

Birth is one of the most rewarding experiences of a parent’s life. The complex transition of the human body through labor, the physical and emotional sensations of birth, and the sound of that first cry as a baby stakes their claim to independent life are remarkable events by any measure. Birth is beautiful, intense and unique. Why then do so many young women fear childbirth? What are we are doing wrong to turn this occasion of joy into an event some women view with fear and trepidation?

In this edition, we report findings from a large study of students who completed validated tools to assess fear of childbirth [1]. Overall, 26% of women reported clinically significant fear. There were consequences to this fear. Women reported delaying pregnancy planning, anticipated high levels of pain, and reported high levels of trait and physical anxiety.

We need to ask ourselves as a society why this special moment has become an object of fear to so many young women. Is it the media? Is it the internet? Is it our own fault for constantly talking about the dangers, the pain and what can go wrong instead of describing what can go right? Do we forget to mention how special birth can be?

The current article reports that knowledge may be a protective factor as women with health sciences backgrounds reported lower levels of fear compared to those with social science or humanities backgrounds. Knowledge may reduce fear. However, a previous article in this journal reported that current childbirth education classes do little to combat fear of childbirth [2]. They may be a case of delivering too little, too late. We need to deliver this knowledge to younger women. Strategies to consider could involve reviewing high school curriculums to ensure we provide accurate information about the safety of birth. Mainstream media also have a role to play in delivering reassurance to the public that birth is not something to fear. Our artists and motivators could also play a role. Ancient human civilisations regularly created art to celebrate birth. These ancient treasures lie within our museums. Where are the modern celebratory artworks of birth? Why don’t we display such works in our open spaces?

As clinicians, we should remember that the “difficult patient” might just be frightened and need our patient reassurance, and further access to information and support. A significant number of our antenatal patients will be frightened, and we need to acknowledge their feelings and help alleviate their fears.

Another article in this edition also warrants special comment. The paper by Braga et al. [3] explores the impact of religion, spirituality, and faith on fertility patient outcomes. The study involved 877 patients who completed questionnaires on faith, religiosity and spirituality and answers were correlated against fertility treatment outcomes. Patients who included infertility diagnosis and treatment in their prayers showed a higher subsequent pregnancy rate whereas those who reported their faith was affected by their infertility diagnosis were observed to have fewer high-quality embryos. A belief in treatment success positively influenced embryo quality.

This study reinforces the need to consider the social context of our patients. Beliefs and attitudes significantly impact upon therapy outcomes.

Medicine is both an art and a science. The human psyche and a feeling of being cared for and protected by those around us play a key role in outcomes. Placebo medications and therapies improve outcomes in nearly a third of patients [4]. Why is it hard to accept that faith and spirituality might also provide tangible benefits?

We need to take a holistic approach and remember to surround the science of our care pathways with the arts of humanity.

Disclosure statement

No potential conflict of interest was reported by the authors.