The Fear, Tension, Pain Cycle:

How to Avoid it in Labor

Nicole Didizian, RN-BSN, CBC, CCE

Conquering our Fear of the Unknown

It’s natural to be anxious ahead of a new experience. In fact, anxiety and fear are two of the biggest challenges women face as they plan and prepare for labor and birth. The Fear, Tension, Pain Cycle is well studied, and it’s an easy trap to fall into. Your “Fight or Flight” response can be activated in the moments surrounding labor, and not always in a good way. Alternatively, it is widely believed that women can control and decrease this response if they take some time to prepare and learn:

A) What to expect: labor is less scary if you understand what is happening to your body and why.

B) How to calm the body’s natural response to both physical and psychological stressors.

No “War-Stories”, Please!

Any anxiety you feel about labor can be intensified by what I refer to as “war stories” – a.k.a. birth stories that didn’t go as planned. Often these are told in great detail by well-meaning (but unthinking) friends or family members. When your psyche is burdened with fear about what may happen, that fear magnifies any actual physical sensation (hellooo contractions!) and your whole body tenses up. That’s when you can get stuck in the Fear, Tension, Pain Cycle. What began as tolerable, mild discomfort suddenly feels much more painful because it is your only focus.

Breaking Away From the Dreaded “Cycle”

So, what’s the secret? How can you avoid magnifying your discomfort and break yourself out of the cycle? First and foremost, awareness is key. Pay attention to your body and notice the location where any tension is building. It’s easier for some people to identify this tension on their own, and harder for others, but that’s where labor partners come in! For example, my husband knows my shoulders tense up when I feel stressed. So, he knew to watch as they creeped up and settled near my ears (yikes!) during early labor. He was able to gently remind me that my body was tense, and later when I was much more uncomfortable and his voice was not a welcome sound (yes, I ended up there…) he reminded me by gently touching my shoulders with light downward pressure – a non-verbal cue to focus my relaxation intention there.

Tools in Your Toolbox: Learning to Relax

The second step to breaking out of the cycle is to implement Learned Relaxation Techniques. When I teach parents-to-be, I refer to these lifelines as “tools you can put in your toolbox”. During different parts of your labor you’ll likely utilize different tools, but they will all come in handy at various points along the way. They’re the key to staying calm as your body and mind progress towards birth.

Which Tools Do I Need?

Demystifying the unknown by learning about the labor and birth process (and your options!) negates a lot of the baseline fear that couples experience ahead of their baby’s due date. Childbirth classes teach couples what to expect, so they’re what I consider to be the most essential tool. You might even think of your childbirth class as the tool box itself! You can then stock it with comfort techniques you learn with your partner there such as: meditation, mindfulness, massage, visualization/use of focal points, positions for labor, and last but not least, breathing techniques.

Practice Makes Perfect

Knowing what to expect – and knowing that there will be forks in the road because there’s no such thing as a “perfect” birth – is important. It’s also essential that you take the time to identify which tools work for you and actually help you to relax. Also note which ones aren’t ideal and share with your partner.

For a relaxation tool to work most effectively in labor, it requires identification, preparation, communication, and practice. Commit to practicing with your partner ahead of time to be able to fully utilize your chosen strategies. Then you’ll be in the best position to remain positive and present as you bring a brand-new life into the world. Congratulations and good luck!

Nicole Didizian is a Registered Nurse, a Certified Childbirth Educator and a Certified Breastfeeding Counselor who is dedicated to empowering and supporting expectant and new parents. She spent over a decade as a labor and delivery, newborn and postpartum nurse, and now teaches full-time. Nicole is the founder of Main Line Family Education, an education studio offering classes and community for pregnancy and early parenthood located in the suburbs of Philadelphia, PA. During the pandemic all classes and meetups are virtual and live, making them accessible from anywhere. To learn more, visit www.mlfed.com.