By The PPH Foundation
As childbirth approaches, many women carry deep and often unspoken fears. These fears are shaped by personal experiences, health system gaps, community stories, and past trauma. While fear is a natural response, its intensity and persistence can influence how labour unfolds. Understanding these concerns is the first step toward ensuring safer births.
Common Fears Women Face Before Labour
Many mothers-to-be fear the physical pain of childbirth, particularly if they feel unprepared or uncertain about pain relief options. This fear is especially common in settings where information and antenatal education are limited. Women may also dread prolonged labour, fearing exhaustion, distress, or the possibility of emergency interventions.
Another deeply rooted fear is the fear of dying during childbirth. In countries where maternal deaths still occur too often, many women internalise the stories of neighbours, relatives, or friends. This fear is compounded by concerns about excessive bleeding, especially among women who are aware of postpartum haemorrhage cases in their communities.
Some women worry about being mistreated, ignored, or disrespected during labour. Negative experiences in health facilities can create lasting anxiety that resurfaces during pregnancy. Others fear separation from their babies, inadequate support, or delays in receiving medical care. For women with previous traumatic births, the anticipation of labour can bring back intense stress and worry.
These fears, though often invisible from the outside, shape the emotional landscape of pregnancy. They influence how women prepare for childbirth, how soon they seek help, and how confident they feel entering the delivery room.
How These Fears Can Lead to Postpartum Haemorrhage
Fear itself does not directly cause postpartum haemorrhage. However, scientific evidence shows that severe fear and anxiety can disrupt the normal progression of labour in ways that increase the risk of complications.
Research published in the International Journal of Clinical and Experimental Medicine shows that intense fear elevates stress hormones, which interfere with effective uterine contractions. Poor or irregular contractions can prolong labour, leading to fatigue and raising the risk of uterine atony. Uterine atony, where the uterus fails to contract after birth, is the leading cause of postpartum haemorrhage according to the Cleveland Clinic.
When a woman enters labour already overwhelmed with fear, her body may respond by slowing the labour process or causing contractions to become less coordinated. This increases the likelihood of medical interventions, difficult labour, or emergency procedures, all of which are associated with higher risk of heavy bleeding.
Fear of pain can cause tension in the body, making contractions less effective and prolonging labour. Fear of death or excessive bleeding may increase stress to a level that affects the natural rhythm of childbirth. Fear of mistreatment may make women delay going to the hospital, reducing the time available for monitoring and timely intervention.
Although fear is an emotional experience, its effects are physical, influencing labour in ways that may lead to postpartum haemorrhage. Addressing these fears through respectful maternity care, open conversations, antenatal counselling, and supportive birth environments can significantly reduce the risks.
Creating safe spaces where women feel informed, respected, and supported may be one of the most powerful steps toward ending postpartum haemorrhage.
Photo by Yan Krukau: https://www.pexels.com/photo/pregnant-woman-doing-excercise-7155538/
Sources
World Health Organization, Prevention and Management of Postpartum Haemorrhage
Ali MH et al., PMC, The Influence of Fear During Pregnancy and Labour
Feng N et al., High-Risk Factors of Postpartum Haemorrhage, International Journal of Clinical and Experimental Medicine
Cleveland Clinic, Postpartum Haemorrhage