A topic that frequently arises in birth classes is about the fear of “losing control” in labor. Losing control, “losing it,” or “freaking out” are concerns expressed by women preparing to give birth. It is important to acknowledge that this is a common fear. I also like to ask parents to think about what “freaking out” or “losing it” would mean to them? I ask them to consider what benefits there may be to losing control. I also say, “What if you do freak out? Maybe, so what?! Maybe it is okay. Maybe it is good. Maybe it is helpful.” (This doesn’t come across in print quite the way it does in real life!) Surrendering to the flow and power of birthing can be of tremendous benefit. Losing it can mean letting go and letting the power BE. Letting the energy be. Letting birth carry you with it, instead of wrestling for control of it. (When discussing this topic, it is important to remain mindful that for mothers-to-be who are survivors of abuse, language about “surrender” and “letting go” can be very threatening and unhelpful.)
Thinking about “losing control” makes me think about the things that you can have over control of when it comes to your birth experience (I’ve also been reading The Big Book of Birth and it addresses this):
1. You can control who who choose as your doctor or midwife (and can choose to switch at any point in pregnancy if the match is not a good one).
2. You can control where you give birth.
3. You can control who you ask to attend your birth as support–your partner, your best friend, your mother, your sister, a doula. (Anyone who attends should be there for YOU, not because they want to “see a birth” or because you feel obligated to have them.)
4. You can control how you prepare yourself for birth and the education you seek to help you explore your options.
5. You can control the type of books you read and the information you seek about birth.
6. You can control how you care for yourself during pregnancy.
7. If you are having your baby in the hospital, you can control when you go to the hospital.
Hypnobabies rephrases the usual concept of “transition” in labor as “transformation.” This is the time in labor in which many women fear “losing control.” Women may also pass through another transformation point as they move from early labor into active labor–this is sort of a “moment of reckoning” in which it becomes clear that it is really time to DO this! Erica Lyon, who wrote The Big Book of Birth referenced above, addressed this subject really well:
“…as a mother shifts from early labor to active labor, she begins to have an awareness that the labor is getting bigger, strong, more powerful. This often translates into a feeling or idea that you are going to ‘lose it’ or ‘lose control.’ This is a temporary, transient feeling that tells you labor is progressing. It does not mean you will go running naked and screaming down the hallway of your birth facility. What is really happening is a momentary emotional state that reflects your ‘social self’ beginning to fold inward. Labor is not a rational process, it is a body function that is experienced as a gradually intensifying event. You do not think your way through it. You do it. “
Essentially, this is a point in labor when you stop fighting with the “birth power” and begin to BE it. The process of birthing becomes your entire focus. I remind and encourage people to welcome the increasing intensity of labor–and suggest taking a “make it bigger!” approach to greeting and welcoming contractions, rather than trying to avoid or minimize them.
Pam England from Birthing From Within also has a great article about “Losing It” in labor.
Other posts about fear and birth:
Birth Fear
Fear & Birth
Fathers, Fear, and Birth
Fear-Tension-Pain or Excitement-Power-Progress?
Cesarean Birth in a Culture of Fear Handout
Worry is the Work of Pregnancy
Fear Release for Birth
What If…She’s Stronger than She Knows…
Talk Birth 
This is great, Molly. There are a lot of things that give the illusion of control when to comes to birth. Nothing more– just the illusion.
I basically agree with you, Molly. My first three children were all born at home in births attended by certified professional midwives.
Fast forward several years through some scary personal health problems (autoimmune kidney disease and some related co-conditions: anemia, high blood pressure, a stroke) into a happy-but-scary-surprise pregnancy at age 40. Despite being in remission from my conditions and off meds at conception, despite my three uneventful prior home births, I was unable to find a CPM willing to attend me at a home birth. And I live in area where there are several practicing CPMs/homebirth CNMs. I barely managed to convince a CNM to deliver me at a birth center 45 minutes from my home. My nephrologist was pushing me to use a perinatologist–not even a regular OB–he considered me so high risk.
So my choices were, in actuality, rather limited. I could NOT choose a home birth unless I was prepared to do so without an attendant. I could NOT choose a CPM, since there were none willing to attend me with my health history. I did manage to choose midwifery care and to avoid delivering in a hospital, and I am glad of that much.
I guess my point is that there are people who will tell you “I *had* to do ___ ” when they really did have options they didn’t consider or exercise. And sometimes certain options genuinely are precluded for some reason. As my first midwife told me in 1993 at our initial prenatal visit, “I am not the author of life and death.”
All’s well that ends well. I ended up being where I needed to be (long story), even if I didn’t think that would be the case while I suffered the 45 minute car ride in active labor.
Penny–to be sure, women may experience circumstances like yours where choices become unavailable to them (I’m also thinking of the many communities in which there are no midwives practicing, leaving women with only a “choice” to drive very far away, or to work with the local physicians). My basic point in this post is really about surrender–often that happens during birthing, but it certainly may happen beforehand as well.
Thanks for posting!
Molly 🙂
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I think it’s also important for women to know that NOT every woman DOES go through that “losing it” part of labor. I didn’t with my first, to the point that the CNM and L&D nurse nearly wet THEMSELVES when they checked my dilation & I was 8+cm, still very calm. They didn’t expect me to be more than about 6. My son was born within about an hour after that. I never had that “I can’t do this” feeling, never had any fear – and I was totally unmedicated.
My second (also totally unmedicated) was a homebirth. I had a little bit of the losing it bit, but that was more because my DEM had a sick child of her own at home, I knew she wanted to go be with him but thought my husband would insist on transferring to the hospital if she left (which I didn’t express verbally and was totally a wrong assumption on my part). I think the main reason I went through that (and the worse pain that came with it, as well as a longer pushing phase) was because I had emotionally tensed up out of fear that my midwife was going to leave and I would have to birth in a place that smelled “wrong” (can’t stand the smell of the hospital’s cleaning chemicals!) with a bunch of hospital staff I’d never met surrounding me instead of my friends & family who were present (I had been getting regular prenatal care with my family practice physician who catches babies and she knew I was planning to birth at home but would have attended me in the hospital and I love her dearly but she would have been the only staff person I’d ever met and that was a BIG negative with my first birth at a hospital-run birth center – having 8-10 strangers coming in and out of the room while I was pushing was a REAL concentration breaker
I suspect that a lot of the “losing it” feeling is partially fear, partially unfamiliarity (of the process, of the setting, etc) and actually avoidable/partially a conditioned response. Hard to test tho.
Absolutely, Ahmie. I’ve actually never gone through a “losing it” stage either–however, I DID fear that it would happen and I think a lot of women worry about that (and possibly get an epidural in order to avoid that happening–i.e. “I think I might be getting to a point where I’m going to ‘lose it,’ better go ahead and ask for the epidural now.”) I arrived at the birth center the first time fully dilated, without knowing I was so, and the midwife on duty was completely shocked that I was “complete.”
Thanks a lot for commenting and sharing your experiences!
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