I'm worried about how painful labour will be

Thanks to Hollywood and hospital dramas, you're probably expecting to scream through the 'agony' of birth. And there's no denying that delivering a baby could push you to the limits of your pain threshold.

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Broadly speaking, early contractions feel like intense period pains and you may also experience pain in your back or legs. The pain intensifies as labour goes on. But the experience does vary from woman to woman, so listening to someone else's story won't help. "If you're told something's going to be painful, you start to believe it," says Lorna Phelan, consultant obstetrician at Saint Mary's Hospital in London. "And a small percentage of women say they don't feel any pain at all."

How to beat your fear of pain

  1. Investigate all the pain relief options available to you in advance so you know what to ask for.
  2. Write down the pain relief you'd prefer in your birth plan.
  3. Brief your birth partner on the options too.

Might I tear during childbirth?

Tears are classed in 'degrees' of seriousness, from first (a small tear or graze on the vaginal wall or labia) to fourth degree (involving tearing of the perineum, anus and the rectum). "Third and fourth degree tears aren't common," says Lorna. "They can be caused by a big baby coming down the pelvis too quickly, or when forceps are used."

How to beat your fear of tearing when you give birth

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  1. Stay focused - the more you panic, the more you might push and tear.
  2. Ask your midwife about positions that put less pressure on your perineum, such as standing up.
  3. If you've had a bad tear before, you'll get specialist care before giving birth again. You're allowed a caesarean if this is the case.

Could my vagina get damaged when I give birth?

Your whole body changes after pregnancy and labour, so you can't expect the major player to come off completely unscathed. "Your vagina will get stretched, but it will go more or less back to normal after a few months, and to the naked eye it won't look any different," says Lorna. "The most important thing is to look after your pelvic floor muscles to sort out inside your vagina. The extra weight of pregnancy puts them under strain."

How to beat your fear of vaginal damage

  1. Make sure you do pelvic floor exercises every day before the birth. These also increase blood supply to the area, which aids healing if you have any tears after the birth (check with your midwife when it's safe for you to start exercising though).
  2. Don't spend too much time checking out your vagina to see if it looks different once you've given birth.
  3. Most women report that sex is still great and they're not getting any complaints from their partner, so clearly it's all still working properly.

Could I poo during labour?

Sorry to disappoint you, but it's highly likely this will happen! But the good news is, you probably won't notice. "At nearly every birth I attend, the mum poos or passes wind, but we don't even bat an eyelid. Your midwife will discreetly wipe it away and it won't be there when you deliver your baby," says Lorna.

How to beat your fear of bowel motions in birth

  1. If you're really concerned, ask about the possibility of having an enema.
  2. When you feel as if you're about to go into labour eat light!

Just how dangerous is giving birth?

You probably feel foolish and alone worrying about this one, but don't. If you can face a fact, for every 100,000 births in the UK, around 10 women die. The main causes are thrombosis, haemorrhaging, pre-eclampsia, infection and complications with general anaesthetic. "For the majority of healthy women, pregnancy and childbirth is safe
and low risk," says Lorna.

How to beat your fear of dying in childbirth

  1. Speak to your midwife or obstetrician - verbalising your fears can help.
  2. Tell your partner or a non-pregnant friend for reassurance.

Tokophobia - do I have it?

Tokophobia is a condition when women suffer a morbid fear of labour. There are two types of tokophobia:

  1. Primary, which stems from social learning, like a bad birth story you’ve heard
  2. Secondary, which can develop after a traumatic delivery

If you’re pregnant and think you’re affected, talk to your GP, or midwife as some hospitals have systems in place to deal with this. Or visit The Birth Trauma Association for advice and support.

"Hypnobirthing calmed my fears"

“I’m terrible with pain so was really scared of giving birth, until I read an article about hypnobirthing and decided to give it a try. It was fantastic because not only did the classes calm me down before the birth (I’d been stressing out about the pain factor before I had them) I was also so much more relaxed during my labour and managed to get the natural birth I’d always wanted, but so dreaded.”

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Carla, 27, mum to Leo, 3 months

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