The Fear-Tension-Pain Cycle: Fighting Fear in Birth

fear-tension-pain cycle

What is the fear-tension-pain cycle?

The fear-tension-pain cycle is an idea developed by Grantly Dick-Read in the 1920’s. Birthing people have known about the effects of fear in birth since ancient times. In this modern concept, the idea is that fear leads to tension. Tension then leads to pain in birth. Pain leads to more fear of the birth process. 

This happens in many ways in pregnancy and birth. Many times, parents develop fear and anxiety in pregnancy that is unresolved and they will carry that into their birth experience. Fear and anxiety causes your body to go into fight or flight mode. This is a physiological change that increases your adrenaline, alterers your circulation, and essentially puts your body in survival mode. My childbirth education course called the ULTIMATE Holistic Birth Course offers learning modules totally dedicated to helping you beat the fear-tension-pain cycle in birth. 

In the holistic birth model, we know that adrenaline is the antithesis to oxytocin. Oxytocin cannot thrive and build when your adrenaline spikes in pregnancy, labor, and birth. Oxytocin is the driver in the labor process. It allows the body to relax and prepare for birth and causes the uterus to contract so labor can unfold. 

What does the fear-tension-pain cycle look like in labor?

In labor, the fear-tension-pain cycle can play out in many different ways. Firstly, fear and anxiety can cause the body to build up tension in the tissues of the pelvis and uterus. This tension can be very strong. It can cause imbalances in the uterus, ligaments, tendons, fascia, and muscles. 

As a doula, I have seen many clients this year have an interesting new labor pattern. Many first time parents this year have started labor with their water breaking, yet their baby is high up in their pelvis (-3 station every time). We’re living in a time of unprecedented anxiety and trauma in the population, especially birthing people. 

Tension in the soft tissues can make it more difficult for a baby to move into the pelvis and engage before labor starts. Then, it can make it more difficult for the baby to move through the pelvis effectively during labor. Lastly, combine that with ruptured membranes, and it can lead to (in this particular set of experiences this year) a long labor pattern where a baby struggles to get into the pelvis for labor to progress. This can lead to a more painful and exhausting experience for the birthing parent. The cycle continues. 

The Fear-Tension-Pain Cycle and Your Pelvic Floor

Interestingly, many people in our generation are often taught that we need to practice tightening our pelvic floor in pregnancy. Do your kegels, they say. What I see more often is that many birthing people are actually struggling with a very tight pelvic floor. I see this much more frequently than a pelvic floor that is too relaxed. I highly encourage you to visit a pelvic floor therapist to learn how your body is really functioning to guide your preparation for birth and postpartum recovery. 

Fear, anxiety, and worry create a scenario where our sphincters (such as the cervix, yoni, and anus) cannot release and open. This is something that is probably happening throughout pregnancy as well. It’s interesting to note that many people who are athletes or do a lot of hard physical work actually have a very tight pelvic floor. It serves them well, but now we need it to release! 

Also, in our society today, we are living in an unprecedented time. There is so much uncertainty, fear, isolation, anxiety, and disconnection. And yet, we were meant to birth through relaxing, opening, and releasing, in a community of support. Check out my course to learn how to relax and find community for a confident and peaceful birth experience!

How to Break Through the Fear-Tension Pain Cycle

Firstly, we need to look at what the alternative cycle might be in order to break the negative cycle. If you can relax in pregnancy, labor, and birth, then you will be more prepared to accept whatever sensations and feelings come your way in the experience. This minimizes the resistance in your body in the physical zone of labor. Then, this leads to a more enjoyable birth experience and leads to more relaxation and confidence. 

So, honestly, I’m a realist. I do believe that “pain-free birth” is possible. But I’ve also had 4 babies of my own and I cannot say that it was a pain-free or totally comfortable experience. It was intense, challenging, powerful, and yet blissful and ecstatic at the same time. I’m pretty real about this. Birth was the most intense sensation, at times very painful, that I have ever experienced in my life. And I would still say that I had great birth experiences

What To Do

Breaking through your fear and tension in pregnancy is key to supporting your body in labor. You need to identify your fears and find a way to process those in a safe space. This could be through a friend, partner, family member, therapist, doula, or honestly just a conversation with yourself. Journaling can be a really great strategy to process your fears during pregnancy so that you can release that tension for birth. 

Breathing patterns make a huge difference in your physiology. In my Blissful Birth Mini-Course, I teach you everything you need to know for relaxation in labor. Take a moment each day to notice your breath. Is it shallow and in your chest? Slow it down and notice where you’re holding tension in your body. You don’t need a long meditation to breathe mindfully. Try to take time each day, throughout the day, to practice relaxation breathing. Practice it in pregnancy so you are able to access this during labor.

Also, another strategy to beat the fear-tension-pain cycle is to boost your oxytocin. Creating a supportive environment with a provider that you 100% trust with your care is key to boosting oxytocin for a more comfortable birth. Strategies to boost oxytocin include minimizing disruptions in labor, comforting touch, receiving love and nurturing care, a dim secluded environment, stimulating the senses, and creating a safe space for labor to unfold. 

Also, consider seeking out bodywork through chiropractic care, massage, craniosacral therapy, acupuncture, or whatever else calls you. These modalities are incredibly supportive to ensure that your energy pathways, hormone balance, and physical tissues are aligned in the path of least resistance for birth. 

Alternative Ideas to Consider

Lately, I’ve been noticing an interesting pattern. I mentioned earlier in this post about a particular labor pattern I have seen a lot recently. When a baby is really stuck high in the pelvis and we have tried every possible strategy to help the baby move into the pelvis, it can be a really challenging decision-making moment for parents. We often advocate for the tincture of time. At this moment, the birthing person is incredibly exhausted and in need of rest and release to continue forward.

For many of these parents, choosing an epidural at this stage has been incredibly helpful for labor progress. For whatever reason, within a few hours of receiving an epidural, whatever restrictions that exist within the pelvis release and the baby engages and labor progresses well from this point.

So, we often see an epidural as a strategy for pain relief, which is very true. However, this is also a great strategy for rest and release if it feels right to the birthing person. 


Looking to give birth with peaceful strength and calm confidence…

Check out my self-paced online childbirth course called the ULTIMATE Holistic Birth Course. In this course, you’ll learn all about how to beat the fear-tension-pain cycle so you can birth with confidence, peace, and power. Enroll TODAY and own this course instantly and forever. You can even use it as a reference in labor for ideas! Use code FOLLOWYOUROWNCOMPASS for 50% off the course in the month of June.

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