How to feel more confident about childbirth

Women's experiences of pregnancy, labour, and birth vary widely and it is usual to have mixed feelings and emotions. Some women may be excited about meeting their baby, while others may have struggled through pregnancy and want it to be over. Some women may feel optimistic and positive, but others may be consumed with anxiety and fear.

Fear of pain

Natasha Crowe, a psychotherapist and hypnobirthing practitioner, says: "Some women, but not all, have a generalised fear or some mild anxiety around childbirth. Hypnobirthing teaches relaxation techniques such as visualisation, breathing, and mindfulness to improve the experience of labour and birth. It also provides practical information about labour and recovery.

"This is often in line with fearing pain and discomfort, the uncertainty of birth and the outcomes. Pain is something that most people will try to avoid; we see pain and discomfort as not being in our control. After all, we like to be in control."

Sometimes, fears may be linked to the medicalised nature of hospital births. For example, women may feel anxious about procedures such as inductions, types of pain relief, or caesarean sections. "We can often find that people with blood or needle phobias have greater fears too, due to possible procedures while pregnant," says Crowe.

Women may worry about losing control of their bodily functions during labour and birth too. However, it's important to remember that this is nothing to worry about and that doctors, nurses, and midwives have seen it all before. Many women also fear birth injuries such as tears to the perineal area - between the vagina and anus.

Often, fears and anxieties are linked to the fear of the unknown, too. For many women, their only experience of childbirth is on the TV, which often depicts labour and birth as dramatic and dangerous. We also tend to hear negative birth stories more often, as we are more likely to remember and recount traumatic experiences than positive ones.

"The unhelpful language around childbirth in films and books can have an effect on people. It might be a scary story, witnessing a traumatic birth on screen or a distressing conversation that leaves an impression and creates intense fear," says Crowe.

"This can often happen long before someone is even considering pregnancy. The information we process can then be catastrophised and emphasised by our imaginations."

Although we can plan for childbirth to some extent - for example, by creating a birth plan or deciding to give birth in a midwife-led facility - we can't control what will happen. This can also lead to stress and anxiety, as we may have to deviate from our ideal birthing scenario. However, staying informed about all eventualities can help women feel more confident and in control of the situation.

Every pregnant woman will have some degree of concern about what childbirth will feel like, how they will manage, and what might happen. For some, though, the fear can become physically and emotionally disabling and prevent them from having children altogether, even if they want a baby.

"An extreme and severe fear of childbirth may also affect someone's decision on how to give birth to their baby or even avoid conception altogether," says Crowe. "This is called tokophobia - it can happen in any pregnancy and can often develop after a traumatic birth experience."

It is estimated that 14% of women around the world have tokophobia. When this was broken down by severity in a separate study, 75% of women had 'low-to-moderate' fear of childbirth, 25% exhibited high or very high fear and 1.6% were classified as having 'pathological' tokophobia.

A previous traumatic birth, miscarriage, stillbirth, or termination of pregnancy, as well as being a first-time parent, pre-existing psychological problems and lack of social support, can all contribute to the development of tokophobia.

Pregnancy is often portrayed as a time of great joy, but this isn't the experience for all women. It's normal to feel anxious, scared, or worried, but there are ways you can feel better and more confident.