Some Common Fears for First-Time Pregnancies: How I Can Help

A quick introduction to doulas for pregnant women and their partners

I am afraid of the pain of childbirth? What if I can’t cope with it?

• While not all labours are painful and every woman copes with pain differently, studies show that birth satisfaction is not necessarily correlated with how much pain a woman feels during labour. The number one factor that determines birth satisfaction is a sense of control or coping.¹ A doula will help to prepare you for labour pain in advance by teaching you relaxation and breathing techniques (and will coach you to use them when needed) and can also suggest different positions or perform massage and acupressure in response to your feedback during labour. If your plan is to have a labour without pain medications, your best bet is to hire a doula, as she can help you to stay focused on your goals, remind your health care practitioners of your wishes and guide you through each contraction, so that you feel confident and ‘on top of’ the pain. Women who have labour doulas tend to have shorter labours and are significantly less likely to request pain medication during labour. Studies show that women who have doulas report greater satisfaction with their birth experience.²

My partner is pregnant and I want to be there for her during labour, but I am anxious about seeing her in pain and feel as though I might worry about her health and the baby’s. How can I make sure that my stress doesn’t negatively affect her during labour?

• Partners of women who have labour doulas overwhelmingly report that their doula helped them to feel less anxious and more involved during labour and birth. As a client of mine said to me after the birth of his daughter, “There were so many moments when I know I would have felt anxious or worried, but seeing how confident and relaxed you were helped me to understand that everything was normal and that there was nothing to worry about. I was able to just follow your lead and focus on helping (wife’s name) through each contraction.” Partners are as emotionally invested in their baby’s birth as birthing women are; having an experienced support person present helps both parents feel at ease and can make labour much smoother. Research has demonstrated that women with doulas report improved relationships with their partners after the birth.³

What if my OB isn’t on-call when I go into labour? I’m worried that another doctor might not know my wishes and might push me into interventions that I would rather not have.

• Having a doula present for your birth can help you to self-advocate; she will make sure that you thoroughly understand your options in advance (by providing you with resources and recommending that you check with your doctor and the hospital about their specific policies and preferences) and will remind you to ask for alternatives if an intervention that you object to is proposed while you are in labour. I also carry a copy of my clients’ birth plans with me to the hospital; that way I can ensure that any and all health care professionals who encounter my clients are aware of their wishes. Doulas can also remind doctors, nurses and midwives of particular client requests in a timely fashion during labour, so that things aren’t forgotten or overlooked.

I have heard that some women tear very badly during childbirth. I’m scared of tearing and worried about healing properly if I do tear.

• There are many ways to prepare for childbirth that can minimize or prevent tears. A doula can provide you with information on how to encourage your tissues during the prenatal period to stretch rather than tear and can inform you of options for minimizing or preventing tearing during the birth itself. This may require some coordination with your health care team – a doula will remind you to talk to your health care practitioner about what they are willing to do for you during labour to reduce the likelihood that you will tear. She can also remind your health care team during the birth of any pre-planned tear-prevention strategies so that they aren’t forgotten or overlooked. Finally, in the event that there is some tearing, a doula can provide you with information on how to speed healing and prevent infection that may go above and beyond the basic care information that your health care provider will give you.

What if we have to abandon our birth plan during labour?

• Childbirth is a very unpredictable experience, and sometimes things don’t go as planned. A doula will help you to make informed choices based on available evidence before your birth, so that you are in a stronger position to self-advocate and make sure that your choices are respected during labour. In the event that an unplanned intervention becomes medically necessary, a doula will have helped you to see your birth plan as a ‘wish-list’ rather than a rigid set of expectations, which will help you to be more flexible if changes come up. Also, a doula can help inform you of the options that you may be presented with in advance, so that if changes to your plan do become necessary, you can make informed choices ‘in the moment’. Finally, doulas are trained to help birthing women and their partners cope with loss. Loss can refer to many things; the loss of a hoped-for birth experience is one thing that may need to be grieved for. Having a trained support person at your side can help you to manage that grief and move forward after the birth.

I really want to breastfeed my baby, but I’m worried that it will hurt or that it might be difficult for me.

• Virtually all women are able to breastfeed their babies. Nipple pain or cracking are signs of an improper latch, they are not normal breastfeeding experiences. A doula can help to show you how to get your baby to latch properly after birth and how to make breastfeeding as comfortable as possible for you and your baby, so that you can successfully breastfeed for as long as you’d like. If you are having difficulties with, for example, over- or under- supply, doulas can make suggestions for how to deal with those kinds of issues. If you have problems that persist or are more complex, your doula can recommend a lactation consultant who will come to your home and be available via telephone 24-hours a day to help you through.