The Psychology of Childbirth2/4/2023 Throughout pregnancy and postpartum women are constantly warned about the physical changes their body will experience. We have talked more and more about PMADs (perinatal mood and anxiety disorders) recently, but what about the psychological changes that occur during childbirth? Some women describe childbirth as a euphoric feeling that leaves them immediately wanting to do it again while others describe the opposite. Psychological research on childbirth is rare, even though research from other scientific fields such as obstetrics or midwifery highlights the importance of psychological factors in childbirth. Limited research we do have is showing that psychological state during childbirth can also impact infant behavior patterns. Throughout Labor...In the day or two before you go into labour, you may notice heightened anxiety, mood swings, weepiness, or a general sense of impatience. This may not be entirely noticeable due to other hormonal fluctuations that are occurring. Labor and birth entail physical and psychological challenges such as coping with pain, loss of control, and possibly medical interventions. Birth affirmations are a powerful way to help anchor yourself in your mind. Keeping a “birth mindset” may be a beneficial way to promote a positive psychological birthing experience. Some affirmations include:
Your Birth TeamThe people you surround yourself with make a difference too. A study found that the people attending the birth greatly impacted the birthing persons psychological state, “Women’s psychological experience of physiological childbirth is strongly influenced by the people present at their birth. Women indicated that close relatives, mostly their partner and mother, as well as care providers were highly relevant for the way women experienced their birthing process. Women described the presence of their partner as the person with whom they most closely shared their experience and relied on for support, confirming that human birth is a social event. This is consistent with other studies that emphasised the decisive contribution partners can make to feelings of trust and the woman’s wish for a physiological birth. Women indicated the midwife’s presence as being critically important. At the beginning of the labour, women tended to want to be alone and at a distance from the midwife, but, as labour intensified, they wanted the midwife to be more visible and present while supporting the woman’s control, or taking control if women wanted to hand it over.” This study indicates that women are more likely to experience a psychologically positive physiological birth when they feel that a supportive and compassionate companion or healthcare provider is by their side, and is very sensitive and attentive to their cues. Hormones play a huge role in the psychology of birth as well.Oxytocin is the one we hear about most often because it is released in the highest doses throughout childbirth and breastfeeding. Oxytocin is responsible for contractions in labor and postpartum. There is an oxytocin release after birth that causes your senses to be intensified. This allows you to connect with the smell and feel of your baby, and them with yours. Oxytocin is responsible for the letdown reflex when nursing. This increased oxytocin flow during nursing allows the uterus to continue contracting and heal postpartum. Oxytocin is responsible for that euphoric feeling many people with a positive birthing experience describe. It is a stress reliever and helps lower blood pressure and cortisol levels in labor. Endorphins are another important hormone throughout labor! For women who don’t use pain medication during labor, the level of endorphins continues to rise steadily and steeply through the birth of the baby. High endorphin levels during labor and birth can produce an altered state of consciousness that can help a woman through labor even if it is a long labor. High endorphin levels can make you feel alert, attentive and even euphoric (theres that word again!). Approaches to ChildbirthDick-Read Method: Grantley Dick-Read was an English obstetrician and pioneer of prepared childbirth in the 1930s. In his book Childbirth Without Fear, he suggests that the fear of childbirth increases tension and make the process of childbearing more painful. He believed that if mothers were educated, the fear and tension would be reduced and the need for medication could frequently be eliminated. The Dick-Read method emphasized the use of relaxation and proper breathing with contractions as well as family support and education. Lamaze Method: The Lamaze method originated in Russia and was brought to the United States in the 1950s by Fernand Lamaze. The emphasis of this method is on teaching the woman to be in control in the process of delivery. It includes learning muscle relaxation, breathing though contractions, having a focal point during contractions and having a support person who goes through the training process with the mother and serves as a coach during delivery. LeBoyer: The Leboyer Method of “Gentle Birthing” involves giving birth in a quiet, dimly lit room and allowing the newborn to lie on the mother’s stomach with the umbilical cord intact for several minutes while being given a warm bath. Beyond BirthA study found that the psychological state of the mother during childbirth helped predict behavioral challenges in infancy. Social support enhanced the mother’s childbirth experience, benefitting her perceptions of her baby’s early temperament. These findings further support current World Health Organization guidelines (2018) on the importance of making childbirth a ‘positive experience’ for women. Certain obstetric interventions, such as assisted birth, have been directly associated with increased levels of neonatal cortisol and crying (Taylor et al., 2000; Gitau et al., 2001). Newborn infants up to 8 weeks are more likely to be unsettled after an assisted birth or emergency C-section (Taylor et al., 2000; Gitau et al., 2001). Some have suggested that birth complications could affect longer term infant temperament due to the subsequent increase in maternal and foetal cortisol levels. Perinatal or postpartum mood and anxiety disorder (PMAD) is the term used to describe distressing feelings that occur during pregnancy (perinatal) and throughout the first year after pregnancy (postpartum). PMADs can develop in the postpartum period from a traumatic birth experience. A negatively perceived birth experience can have a negative impact on the mother–child interaction even months after birth (Durik et al., 2000) and on the occurrence of postpartum depression (Bell & Andersson, 2016). The TakeawayFor the best chance of a positive psychological birth experience a birthing person should do the following:
References:
Olza, I., Leahy-Warren, P., Benyamini, Y., Kazmierczak, M., Karlsdottir, S. I., Spyridou, A., Crespo-Mirasol, E., Takács, L., Hall, P. J., Murphy, M., Jonsdottir, S. S., Downe, S., & Nieuwenhuijze, M. J. (2018, October 1). Women's psychological experiences of physiological childbirth: A meta-synthesis. BMJ Open. Retrieved May 22, 2022, from https://bmjopen.bmj.com/content/8/10/e020347
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The light isn't green forever. AuthorJess Kimball is a Full Spectrum Doula and Certified Lactation Counselor trained in Ayurvedic and Chinese medicine. 
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