The Fears of Childbirth – 2 – (Dilating Phase)

As labor progresses, the woman's fears change compared with those of the prodromal phase.

The second phase of labor is called the dilating phase because the cervix, under the pressure of the contractions and the fetus, relaxes until it reaches full dilation (about 10 cm). The fears of this phase concern letting go and allowing what is happening in one's own body, which creates pain, to unfold. These are the contractions, muscular spasms that occur involuntarily (the uterus is made of smooth muscle) to shorten and dilate the cervix and allow the fetus to descend through the birth canal for delivery. The contractions of the second phase of labor are distinguished from the earlier ones because they become regular, while their frequency and duration increase: they may occur at intervals of as little as a minute and last around 45 seconds. Once dilation of the cervix has passed the first few centimeters, it is possible to relieve the pain through epidural analgesia (or epidural). This is a "regional" anesthesia obtained by instilling anesthetics into the space of a few millimeters that surrounds the dura mater of the spinal cord.

Contractions should be allowed to happen, with a passive attitude that creates no resistance to dilation. Often, though, the woman in labor is frightened by their frequency and intensity. Fearing she is at the mercy of an unknown force she is unable to control and perceives as devastating and deadly, instead of trying to relax the woman tends to tense up as if resisting, with the result of feeling more pain.

A certain amount of apprehension about the pain of childbirth is physiological and affects all women, both first-time mothers who do not know how they will react and those who have already been through it before. Terror of childbirth, however, which often drives those who experience it to demand a cesarean section in order not to have to face it, should be considered a symptom, that is, the expression of a deep-seated conflict of which the woman is not aware, because it comes from a period very far back in her life, relating not only to childhood but also to intrauterine life. It has its roots, that is, in the suffering caused by the difficulties of the symbiosis-separation relationship experienced at that time with her own mother. Suffering that has been forgotten and repressed into a part of her mind, from which it resurfaces when the woman is confronted with accounts of very painful, difficult, risky births.

During labor the perineum, which normally supports the internal organs, must relax and become active to contribute to the birth of the fetus. It is therefore important to prepare it during pregnancy so that it can perform this task as well as possible.