The most common fears about childbirth (and how to conquer them)

Should you hire a doula as Duchess of Sussex, Meghan Markle is reportedly doing, to get you through childbirth? How bad is the pain, really? And what can you do to prepare if this is your second birth after an ordeal the first time round? Hypnobirthing expert and clinical hypnotherapist Rosie Goode  has helped in the delivery of over 2,500 babies over the 14 years that she’s been practising - she’s been there, seen that and wants to dispel some of the misconceptions about giving birth, plus reassure mothers-to-be, whether they’re on their first or their fifth child, that childbirth is far from a horror story, even if it doesn’t go to plan.

From giving Dr Google a wide berth to trying out hypnobirthing breathing techniques (the Queen herself used them when giving birth), here are some nuggets of childbirth wisdom that Rosie’s learned along the way, starting with things not to be frightened of...

The most common fears about childbirth

Sadly there are many, but the ones that women tell me about most frequently include:

• Fear of not being able to cope with pain.
• Being out of control and panicking
• Tearing
• Being told what to do
• Fear of being 'forced' to have an induction
• Not being listened to in general
• Unnecessary interventions
• Having to wait for pain relief

Much of this is avoidable when we know how to equip ourselves with the right tools to overcome these fears, and even if they do happen, your experience needn't be harrowing.

The childbirth myths I'd like to bust

Birth on TV and in the movies has caused a lot of damage by reinforcing negative, old-skool stereotypes, which we know are potentially harmful for mothers and babies. Giving birth lying on your back in a brightly lit medical room with a midwife shouting "puuuush - push harder" for hours (as we may have seen on shows such as One Born Every Minute) can be damaging, contraindicated by NICE  (the guidelines that the NHS follow) and it is not reflective of how many women are birthing now. There's a new paradigm and all over the UK, women are in a dark, calm, quiet birth centre room and at home with (hopefully!) a calm partner and a midwife by her side as a reassuring presence, supporting her to breathe her baby down.

'Who's the expert?' Midwives and obstetricians most often don't know more about a mother and baby than the mother herself. London City University and St Thomas' hospital undertook a major piece of research recently which overwhelmingly proved that 'you are the expert on you', resulting in an animation of the same name. The project proved what I've known for a long time, that you CAN trust what you feel. No one knows more about your body, your baby, your pregnancy and birth than you. Mothers instinctively know (when encouraged to listen to instinct) when all is well, or if baby needs some help. Mothers know when they are fully in labour and about to deliver their baby. Trust what you feel, get support from your partner and act on what your body’s telling you. If necessary, seek extra support from a team leader or consultant midwife.

"Being allowed" and needing to seek consent. No mother needs to do anything that she doesn't feel comfortable with. Everything that is an 'offer' can also be refused. That includes having the power to say no to sweeps, induction of labour and internal exams within reason- even lying on your back in labour if you don’t want to. It is so important for mothers to be given the time to consider options and that they feel comfortable with their decision. Consent is key. But also, guidelines are just that- they are not rules. If a mother wants a birth centre birth or home birth  or elective caesarean and doesn't fulfil the unit's criteria, she can meet with a consultant midwife who will do her best to build a team to support that mother, so, for example, with a normal breech or normal twins birth, a consultant midwife will try and facilitate that if that is what the mother requests. Many trusts are now taking birth rights training to support their practise. Check out  www.birthrights.org.uk  for more information.

Excruciating pain in childbirth. It’s not inevitable. A mother's birthing body is predominantly a wonderful group of muscles, functioning as all muscles do. When we can provide those muscles with everything they need to function well, they will. After all, would you go to the gym and run on the treadmill, or do a spinning or  HIIT class  without warming up those muscles first? Or without breathing fully, and expect it not to hurt? The same is true in childbirth. A warm-up can work wonders.

How to feel better about the birth experience

If you're married, I don't imagine you that arrived at your wedding, expecting it to be a seamlessly wonderful experience without all the preparation needed before hand. All the work it took ensuring the environment was lovely, the flowers, food, your dress, having your favourite people surrounding you, feeling fully supported and great on the day. The same is true of birth- your choice of birth place matters, wherever that might be. Do some research, check out all your options as early as possible and decide as late as possible. You don't have to commit to anything too soon. Have you chosen an environment as comfortable as possible to support a gentle birth? This includes a caesarean too- that can be a gentle, non-alarming experience. Does the area feel calm, relaxing and positive? Are you surrounded by people who understand birth physiology that can help you feel safe and confident, listen to you, respect your plan and support your breathing?

Plan for a positive birth, but know that every birth can be positive when we are supported in our decision making, even if it doesn’t go precisely to plan.

What we hear and see repeatedly in the weeks and months before birth also impacts the birth. Too much anxiety or fear can create enormous amounts of tension in the body, which can worsen pain, interrupt oxytocin (the birth hormone) and can lead to a more difficult birth. Being surrounded by people who support and encourage you (ideally with positive birth stories!) is hugely valuable as our attitude leads us to make more informed decisions. Optimism and confidence enables you to make good decisions for yourself and your baby in birth and beyond.

How to relax in the run-up

By relaxing your body and baby frequently in the weeks before birth, practising breathing techniques, releasing anxiety with  calming hypnobirthing tracks , avoiding unhelpful TV and internet searching (!) and finding your own ways of boosting optimism daily, your body and baby will be perfectly ready for birth to flow smoothly, as nature intended.

Having a partner, friend or family member by your side who knows how to reassure you and keep both themselves and you calm (and knows how to be gently assertive if necessary) is also a huge benefit. Many of my hypnobirthing clients over the years have said that birth felt like the most wonderfully bonding experience and that they really felt like a 'team' (although obviously, mothers do the real work!)

For some mothers and couples a birth doula  provides a wonderful support by emotionally and physically protecting a mother in birth. Acupuncture , reflexology, osteopathy  and massage all have an important role to play for many women in supporting their pregnancy, for instance they can be helpful for realigning pelvic girdle and helping babies turn, but always seek a professional medical opinion before you dive in.

In our fast paced, over stimulated world, as a general rule, we need to slow down. When we calm our mind, our body follows, our breathing normalises, we sleep better and for longer, our immune system is supported and everything begins to align. This all leads to a happier pregnancy, a gentler birth, happier babies, easier breastfeeding and happier parenting. It sounds cliché, but it’s true. Never forget to pace yourself.

How your loved ones can help you

What we hear repeatedly in pregnancy affects our behaviour, attitude, expectations of childbirth and ultimately the birth itself. So, if family, friends or colleagues have had a difficult experience, it will be very helpful if they can avoid sharing all of the gory details with the mother-to-be. If family and friends have had a positive experience, then it is incredibly helpful to share and help to create a positive expectation. Ask friends about how they prepared for their experience and model what works. Check out the Positive Birth Movement  and  Tell Me a Good Birth Story , where women and partners are doing just that, sharing what works, even if their births haven’t been “perfect”.

Joining a hypnobirthing class with your partner prior to birth can be calming for both of you- it’s been totally embraced by the NHS and private maternity units over the past ten years, and it can really help you to feel optimistic and prepared. Take a yoga or pilates course with a supportive partner or friend, swim, walk, have fresh air every day and learn and master breathing and relaxation techniques - they’re as important during pregnancy as they are for childbirth. They may even help your partner too...

Feeling supported in your decision making is key too. This is such a pivotal time in a woman's life, and as in life, but especially now, you need to be listened to, respected, encouraged and trusted to make good decisions for yourself and your baby. It’s vital to feel empowered, not undermined.

Finally, encourage partners to be actively involved. Birth flows well when a woman feels safe and protected, and it really is easy to create this environment when your birth partner’s as prepared as you.

How to prepare for a positive birth if you’ve had a negative experience in the past

Firstly, we need to distinguish between a difficult birth and trauma, which very often leads to post-traumatic stress. Our brain takes a while to process the emotion of a difficult experience, so we can think about that experience and not be deeply or viscerally upset by it at the time, but the impact hits later. If after about three months, a mother or father is still suffering from a difficult or traumatic experience, this may indicate post-traumatic stress. Markers include feeling hyper vigilant and experiencing panic attacks , among other symptoms. Effective support for these parents will be somewhat different to the ideas provided above- consult the  NHS guide to PTSD  and consider booking in with your GP if it’s affecting your mental health, daily life and work and preparation for birth.

A mother who has had a difficult birth may well benefit from a 'birth reflections' or debrief appointment with a specialist midwife to talk through the notes of her birth, allowing her to make sense of her experience. A parent who has been traumatised will be likely to be re-traumatised if being encouraged to revisit the experience via typical talking therapies. One of the most effective techniques to quickly and effectively reduce trauma is the 'rewind' or '3 step rewind’ technique. This is a highly effective  NLP/hypnotherapy-based relaxation technique  designed to reduce the emotional and physical response to the memory and is increasingly available as a post-natal therapy in the UK. For more information visit the birth trauma centre website.

Clinical hypnotherapy and hypnobirthing can combine to offer a safe and effective antenatal programme of support for any parent who has had a difficult or traumatic birth. Letting go of the emotion attached to the past, allows us to start to create a new pattern for a future birth.

As a clinical hypnotherapist and hypnobirthing teacher of 14 years, mothers I've taught who have had a previously difficult or traumatic experience have gone on to have a wonderful, healing birth. That is my mission, to spread the word of hypnobirthing so that as many women as possible can benefit from it and have very special birth experiences as a result.

Rosie Goode is one of the UK’s leading hypnotherapists and founder of London’s. Hypnobirthing Works. She works both in the private sector and with the NHS. Rosie and her team of experts deliver a timetable of intimate group and private hypnobirthing courses with bespoke methods tailored to every client’s’ needs. For more information visit  Rosie’s website

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