When we speak of fear of childbirth, we must recognize that this term conceals several different kinds of fear connected to the event, present to different degrees and with different intensity in pregnant women, depending on their own characteristics and their own history.
A very common fear among pregnant women is that of not being able to recognize the signs of the start of labor, either going to the hospital too soon or leaving it too late.
To keep this kind of fear in check, it is very helpful to have precise knowledge of the time when birth generally occurs (between the 38th and 42nd week of pregnancy) and of the characteristics of the first of the four phases that make it up, called the prodromal phase, because it prepares the way for the following three.
The prodromal phase varies greatly from woman to woman and is characterized by contractions that are very irregular in intensity and duration, but above all in frequency. During this phase, the mucus plug is expelled (something many women do not even notice), which, during pregnancy, sealed the cervix to protect its contents. The plug appears as a small, gelatinous mass, sometimes streaked with blood. Its expulsion usually marks the beginning of changes in the cervix. The cervix, in fact, must "center" itself relative to the vagina, so that gravity can help the fetus progress. It then begins to shorten and subsequently to dilate (the second phase of labor, or dilating phase).
The preparatory contractions can also be felt as painful and, for a certain time, rhythmic. When in doubt about what to do, experienced midwives used to recommend a warm bath, or alternatively, some relaxing activity (music, reading, meditation, etc.) to see whether, within the space of an hour, the uterus's contractile activity settles down or, instead, the intensity, duration, and regularity of the contractions increase. In this latter case it is advisable to go to the place where you plan to give birth.
Another typical fear is that of breaking your water (with the resulting loss of fluid) in a public place. The embarrassment one fears feeling if this should happen is not tied only to the present moment but can bring back to the surface feelings of guilt, of shame, of fear of losing one's mother's affection, tied to experiences from the childhood period of toilet training.
In a certain percentage of women, in fact, labor begins precisely with the premature rupture of the membranes (that is, out of the usual sequence, ahead of time). In this case one notices a loss of fluid, usually clear (which could be mistaken for urine), that gradually soaks a pad used to check it. If the fluid is "tinged" (colored), one should go to the hospital immediately, since this could indicate fetal distress; otherwise one can calmly prepare to be admitted, since it is not certain that labor will begin right away. It is not uncommon for a woman to arrive at the hospital with dilation already under way. Since every birth has its own story, it is good practice to go to the emergency department in the presence of any anomaly: bleeding, reduced fetal movements, the onset of pain earlier than expected.