"Many women have described their experiences of childbirth as being associated with a spiritual uplifting, the power of which they have never previously been aware...To such a woman childbirth is a monument of joy within her memory. She turns to it in thought to seek again an ecstasy which passed too soon."

Grantly Dick-Read

Saturday, February 20, 2010

the "Fear-Tension-Pain" cycle

"It didn't hurt. It wasn't meant to, was it, doctor?"

these words were spoken by a poor english woman after she gave birth naturally in the early 1900's. Dr. Grantly Dick-Read had come to attend her in birth, expecting to administer the drug chloroform for pain relief, which rendered the birthing woman unconscious. when he asked the woman why she did not want the drugs, that was her response. 

Dr. Grantly Dick-Read was taken by surprise when he witnessed this woman birth her baby without a struggle - and without medication. this experience intrigued him and he continued to learn about natural childbirth. in 1933, he published a landmark book called "Childbirth Without Fear." this book was ridiculed but as time went by, his findings have been supported and researched further.

through various experiences witnessing women birth naturally, Dick-Read theorized that the more a woman feared childbirth, the more she would tense up, thus feeling more pain during labor.

when you have fear, your body produces chemicals that change the way your body works. this is also called the "fight or flight" response. it is extremely important in helping you escape dangerous situations. it works by diverting blood away from internal organs and out to the limbs to give you more strength and speed. this translates into less oxygen flowing to your uterus. the chemicals that are released also work to slow or stop labor.

the uterus is made from two layers of muscles that go in two different directions. one layer runs from the top to the bottom and the other goes around the sides. during labor, the "first" set of muscles contract to push the baby down and pull the cervix back. after your baby is born, the other set of muscles contract to pull the cervix and uterus back into place.

when you have fear during labor, the muscles around the sides of your uterus contract during labor. effectually, this means that your uterus is working against itself - one set of muscles is trying to open the cervix while the other set of muscles is trying to close the cervix. this can make for a very long, painful, and unproductive labor.

the reason Dick-Read's findings have come to be called the "Fear-Tension-Pain" cycle is because it is exactly just that...a cycle.

a woman fears labor, she tenses up...her contractions feel very painful. because her contractions feel painful, she starts to fear even more, which causes her to become much more tense. the increase of tension in her body produces more pain...and the cycle goes on.

in my first labor - i can look back and clearly see the "Fear-Tension-Pain" cycle. as i labored at home, i was pretty relaxed. however, when i hit active labor and my contractions became even more intense, i started to fear. i had been in labor quite awhile already and was having a hard time finding relief during contractions (my baby was posterior, which probably contributed to feeling such pressure even when i wasn't contracting). i wondered how much longer i could do it. i doubted myself and didn't trust in my body's ability. thinking about how long i "might" have to keep doing this scared me. but, i tried to relax and that helped the pain. when i got to the hospital, dilated to 6 cm, i couldn't find any relief. let me tell you - sitting in a hospital bed strapped to monitors is not the way to labor! i began to fear that i couldn't do it and i decided to get an epidural because the pain was very intense.

basically, i allowed my body to become tense because of the fear i felt which made the pain become intolerable...in early active labor.

when i contrast that with my second labor, it is much different. i did not allow myself to feel ANY fear at all during most of my second labor, and what resulted was virtually painless. i did fear at the very end (since my midwive's had not arrived) and that is when my contractions were incredibly strong and very, very painful. when i was having contractions and was completely relaxed, i was able to breathe through them and honestly - they were not painful, just strong. when i tensed up, my contractions were much more intense and painful.

i can clearly see how the "Fear-Tension-Pain" cycle works because i have experienced it. i believe that the more you can do to release any fears you have of labor or childbirth, the better your labor experience will be. not only will you feel relaxed and be able to marvel at what your body is doing, but you will be able to birth comfortably as well. that does not mean you will not feel "strong" or intense surges in your uterus, but i think you will be able to call your childbirth enjoyable and bearable...not horrifically painful.

what experience have you had when it comes to fear in childbirth? did you have fear? what did it do to your body? have you had an intense, but bearable natural birth? how did you achieve that? did you release your fears and relax? i'd love to hear your thoughts!


  1. What did you use to help relax during your second labor? Did you do anything specific to get rid of the fear? I had a traumatic first labor and am worried that the memory will make me anxious next time.

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  2. sarah, i did a number of things but mostly, it was changing positions and breathing that helped me relax during the contractions. it also helped that i was at home and very comfortable in my surroundings. love and support were the biggest factors in my ability to relax.

    i had many fears that i had to overcome before i gave birth the second time around, mostly fears of complications and the "what-ifs" since i was giving birth at home. through educating myself and researching as much as i could about natural childbirth and homebirth, i felt my fears melt away. through the knowledge i gained, i realized that my fears were just that...fears. i used a lot of prayer to help get rid of my fears and as i did that, i felt peace that everything would be okay and go just as they should.

    i'm sorry you had a traumatic experience with oliver's birth. i don't know what exactly you experienced, so i don't know how to help you work through your specific fears. if you'd like to talk more about it, feel free to email me (kamille.larsen at gmail .com - no spaces) or if you feel comfortable, you could post on here so others could learn from it.

    i think you are smart to work through your fears so that you can have a better birth experience the second time around.

  3. I just finished reading about this very topic in the HypnoBirthing book you let me borrow, but I first learned about the fear-tension-pain sequence during neuroscience classes at BYU. It's real! And I definitely believe that part of the pain I experienced with B's birth was due to the fear and tension I gave into once my water was broken and contractions hit me like a ton of bricks. Exactly why I want to prepare so much better this time around!

    I'm glad you said that most of your fears centered around "what ifs" and complications-- that's exactly what all my fears are about (specifically not making it to the hospital!) and it gives me comfort that if you were able to release your "what if" fears, I can too!

    And thanks for reminding me that prayer is a crucial part of all this- I've been trying to work through my fears on my own and I needed that reminder that the Lord needs to be involved too. Keep your posts coming!

  4. It is true that "fear hath torment" as it says in John 4:18. But perfect love casteth out all fear. Love the new blog.

  5. I found the times leading up to the births of my children incredibly crucial!! I had to "protect" myself from all the negative emotions and feelings that so many people have about birth. It seems that if you tell people that you will be birthing your baby naturally that often they tell you "horror" stories. I found that I had to really focus on the way I knew birth could be and the way I knew my body could make it be. I really believe that if we internalize negative attitudes about birth it can impact our own response to labor. Thanks for the post! Such a true concept.

  6. Very informative article which is about the pain in pregnancy and i must bookmark it, keep posting interesting articles.

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