Too posh to push or just plain terrified?

What do you know about labour and childbirth? There’s pain involved, it can take a while and all the pushing might cause you to have a bowel movement. Did you also know having an epidural means you might also need a catheter; that the skin of the perineum may tear; you may well give birth on all fours; and you also need to give birth to the placenta?

If you’ve never been pregnant before, it’s likely you won’t know much about pregnancy or labour beyond what you’ve seen on TV—if you have been pregnant, in this age of instant access to information, it’s likely you’ve devoured as much knowledge as you can about every aspect. Search engines are the first port of call, and they’ll quickly lead you to parenting forums like Mumsnet and Netmums. Type anything into the search bar and thousands of mums will have already discussed it; you’ll find the answers to all your questions, stories about every milestone and step of the way, advice for new mums from those with experience. They can be invaluable to any woman feeling a little worried about her new role in life.

But the help and support comes with a side effect that was—for some reason—unexpected. Academics warn that parenting forums are contributing to a rising fear of childbirth. Despite feeling well acquainted with the idea of labour thanks to programmes like One Born Every Minute, the experience is sterilised and portrayed as the miracle of life. Miraculous as it may be, the no-holds-barred approach to storytelling found on internet forums is proving it’s not always plain sailing, with ‘horror stories’ contributing to the rise in tokophobia—phobia of childbirth.

A 2017 study found 14 percent of women suffer from tokophobia and this number has been rising steadily since 2000.

This could well be attributed to the proliferation of the internet and storytelling online. Some experts have described it as a tsunami of negative birthing stories, joined by celebrities telling the truth about their pregnancies to huge audiences: Beyoncé spoke of her issues with preeclampsia, Serena Williams wrote about her near-death experience giving birth, and Caitlin Moran has written about her traumatic birth.

Women need these platforms and the opportunity to hear first-hand experiences of an event they’ll likely share: dismissing their right to this information is problematic to say the least. Forums and the internet provide vital spaces for women to share their experiences, both good and bad, after years of hush-hush surrounding childbirth.

Understandably, a great deal of messaging about labour focuses on the positive, but this lets the women who have traumatic experiences down. Why didn’t anyone tell them how bad it could be? To prevent this fear! But women have a right to this information; you are absolutely entitled to know the truth—to know that it’s probably going to be absolutely fine, but if it isn’t, this is what could happen.

Actress Emma Thompson waded in saying the ‘lies’ women hear about the pain of childbirth are making them ‘terrified of that pain’, leading to a lot of elective C-sections, without the mothersto-be realising the effects that such a procedure can have on the body.

Miraculous as childbirth may be, the no-holds-barred approach to storytelling on internet forums is accused of contributing to the rise in tokophobia in modern women.

‘The pain of giving birth is now “optional” and yet there’s no honesty about what that option can actually do to your body. It’s odd how frightened we’ve been made to feel about the pain of it.’

Does Emma Thompson have the world’s highest pain threshold? Or is she unintentionally making two very important points? First, the concern that women don’t fully understand the impact a caesarean has: inundated as we are by the normality of being ‘too posh to push’, caesareans can seem the easy way out, for mother and baby alike. No one talks about the six week recovery time, the layers of muscle that need to be sliced through to reach the uterus, the staples holding your belly together… Second, the pain of childbirth should be optional. Make no mistake: women everywhere are aware it has to hurt pushing a baby through a very narrow birth canal. Enter the epidural. There are safe, effective painrelieving drugs available—avoiding pain does not mean avoiding labour. Besides, 75 percent of maternity units refuse elective C-sections.

While Thompson meant well, comments like this simply contribute to the feelings of inadequacy a woman may be prone to surrounding natural birth. Already frightened, the last thing she needs is pressure from a far-off celebrity to ‘push through the pain’—or worse, refuse a C-section if needed. There’s little criticism of public figures swaying our opinions of pregnancy and childbirth, but plenty of focus on normal women sharing their experiences—odd that.

A recent survey by Channel Mum found 92 percent of mums actively seek out birth stories when they are pregnant, and 69 percent find it helpful and empowering. Just 29 percent said it made them more fearful. If so many women want honest and frank accounts, why has so much been shrouded in secrecy all this time? In societies around the world and in our history, birth has been a communal experience: women would gather to help and support the mother through pregnancy and labour; would be sharing tips for conception, avoiding morning sickness, and inducing labour; would share the journey. Just as it takes a village to raise a child, it takes a community to make one too. These days, pregnancy and birth can seem a sole endeavour with media depictions of birth making it a clinical event—your water breaks, you rush to hospital, you scream and push twice and voila: baby. Parenting forums have stepped into the gap, providing that community of advice and stories, where women can freely discuss their experiences, thoughts and feelings in a safe place. Reassurance, guidance, expert advice, and support combine to reproduce the birthing community of old.

One thing no one seems to be asking: why do so many women have ‘horror stories’?

Does the horror stem from unexpected complications that no-one warned them about, when it’s our duty to impart medical information about everything that could happen during birth? If shielding women from the truth that complications can happen is meant to help them feel more reassured and relaxed about their pregnancy, we’re doing them a great disservice and putting them at risk in the delivery room. It’s more frightening to consider how much we haven’t been told about something so intrinsic to motherhood—and for some, womanhood.

As for increasing tokophobia rates: remember the stories we like to share are inevitably the unusual stories—emergency operations, blood and pain shared in hushed, conspiratorial tones make for tales of horror. Everyday, normal, boring births don’t merit talking about in comparison to these gory events and they don’t stand out in a forum of experience stories. Some women can speak of the life-changingly beautiful and intensely primal moment they met their baby. You’re likely looking forward to seeing your baby for the first time, the little bundle of joy you’ve spent all these months growing—you expect that moment to be profound and emotional. When this completely normal expectation is realised, your story can seem insignificant and inappropriate next to someone else’s traumatic or heart-breaking experience.

The word 'gossip' originated with people attending childbirths. Friends of women in labour were called gossips, or 'God's sibs (siblings)'. As the first to know how the birth went, the child's gender and all other facets of the experience, the meaning of the word evolved from 'close to God' to 'rumour or report of an intimate nature'.

Discussing a normal childbirth beyond the ordinary doesn’t excite audiences or encourage debate the way a more harrowing story can.

Not to mention, tokophobia is the pathological fear of pregnancy so severe it can impact a woman’s decision to have children: if you’re reading these stories, you’re likely already pregnant. There’s more to tokophobia than the simple fear of childbirth anyway: more intense in women who haven’t had children, it’s fear of the unknown; this fear of pain may be a way of expressing something more complex. Some studies show women fearful of childbirth lack faith in their obstetric team, worry about their own incompetence, and are scared of dying.

Women who have suffered abuse or rape fear the experience of childbirth will cause them to revisit the distress and helplessness they have already experienced; women who have already suffered during childbirth fear re-traumatisation. This is far more complicated than a fear of pain causing a rise in elective C-sections. Reducing the sharing of experiences to ‘oversharing’ minimises the reasons behind a pathological fear experienced by 6 percent of pregnant women and blaming ‘gossiping women’ for scaring new mothers is both inaccurate and plain wrong.

Oversharing on social media may have been instrumental in the rise in fear of childbirth but closing down discussions on supportive female networks isn’t the answer. Knowledge is power when it comes to anything—including giving birth.

Once you understand what’s happening to your body and why, you can cope better. More education on the potential complications is needed; frank and honest discussion of experiences; unfiltered advice on what to expect when you’re expecting. If a woman wants to research real-life experience, she has the right to do so—if the only place to find raw truth is a parenting forum, then we’re failing to adequately prepare women for pregnancy and childbirth. ■