Using Sports Psychology for Childbirth

By | January 15, 2019

Any woman who has ever carried and birthed a child, in whatever fashion, deserves her own ESPN highlight reel — blood, sweat, tears and the eventual triumph of holding her newborn baby. To be clear, childbirth isn’t a game. You can’t plead with the referee when you don’t like a call or leave the field when you’re tired.

Still, as a lifelong athlete, I saw childbirth, especially an unmedicated one, as the ultimate challenge of physical endurance, mental stamina and my ability to handle pain.

When I became pregnant in January 2018 and set about preparing for the monumental task of birthing a human, I loaded up on prenatal vitamins, kept a daily routine of birthing stretches and exercises, and endured an eight-week birthing course. An image of the lead female competitors in the New York City Marathon, who bring me to tears when they run past my Brooklyn apartment each year, filled me with confidence for labor. Washboard-like abs. Lean legs showing off every strand of muscle. Calm, focused and confident expressions on their faces.

However, as my due date came near, I clung to a fear of pain and the unknowns out of my control. How long would my labor be? Would my mind fall apart? What if my pelvis wasn’t the optimal shape or I stopped dilating?

I wanted to face childbirth with the same kind of confidence that radiated from the runners I admired. So I turned to sports psychology for advice.

The field typically uses a hodgepodge of methods like cognitive behavioral therapy and attention control training to improve athletic performance and competitor experience. It suits a laboring woman because it can quickly provide practical tools to achieve a specific goal, said Jay-Lee Nair, a Singapore-based sports psychologist who works with athletes, including professional golfers and Olympic sailors, as well as women preparing for labor. A simple strategy could be mimicking an athlete’s pregame routine like reciting affirmations “reminding them about their game plan or the attitude they want to have,” she said.

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To help me labor like an Olympian, Dr. Nair challenged my unhelpful birth beliefs with rational facts. In the sports context, an unhelpful thought could be “believing a win in a tournament was because of luck or lesser skilled competitors,” she said.

I have a fear of operations and for me, undergoing a cesarean would take more guts than an unmedicated labor. Dr. Nair advised me to gather positive cesarean stories for a process called cognitive restructuring, in which fact-based alternative statements dispute the irrational belief. I was under the impression that a mother could not pick up her child for six weeks after a cesarean, but many of my friends assured me that they could within days.

“It is hard just like a natural birth is hard, and you’re still amazing for going through that,” Dr. Nair said.

Joan Steidinger, a sports psychologist based in the Bay Area and a former ultramarathon runner, told me to develop a mindfulness plan by identifying the extremely difficult moments in labor — the 45-minute cab ride to the hospital under the onslaught of contractions topped my list — and to design a predetermined meditation for each. She used this strategy when she prepared runners for the Western States 100-Mile Endurance Run, in which the track goes through canyons with stagnant 110-degree air. “You might visualize a cool waterfall, something to take your mind off the situation,” said Dr. Steidinger.

I still wondered how athletes reframe their minds if something doesn’t go as planned mid-competition. How does a figure skater shift from aiming for gold to finishing her four-minute routine with dignity when she doesn’t land a jump that took months of practice? “What we usually do is create some kind of action they do to refocus because an action connects mind and body,” said Caroline Silby, a former figure skater turned sports psychologist. That could mean pushing down on the ice or drawing a deep breath to move beyond failure, Dr. Silby said.

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The physical cue I developed to help me reframe mid-labor started with clenched fists during an inhale and then opening them during an exhale, with my palms up in a surrender. I would surrender to the difficult moments or to whatever my body needed for a safe birth, whether that was every intervention under the sun or nothing at all.

The idea of pain with a purpose is common in sports and labor. So are breathing techniques and visualizations to cope. Visualizations didn’t do it for me, but breathing did. During my birth class, I figured out what I liked — a long, loud exhale where I focused on the vibrating hum inside my mouth. I practiced this a few times each week while holding a piece of ice (it’s surprisingly painful). Dr. Silby added a tip: Stay present and enjoy the rest between contractions, much as a marathon runner turns a downhill section into active recovery. “If you’re anticipating the next painful push during recovery, that is a waste,” she said.

After an anxious and tearful 13 days beyond my due date, contractions started on a Monday evening. Labor quickly became a familiar rhythm, not unlike my favorite workout of high-intensity interval training where, say, a minute of squats is followed by a 20-second break.

By 3 a.m., my contractions were down to three minutes apart, our cue to head to the hospital. Excitement. Anticipation. And then my labor stalled. I used my physical cue — releasing clenched fists — again and again to move beyond the disappointment.

My mind held it together until around midday. Why did my stupid body slow the contractions? At the same physical and mental crossroads in a soccer match, I would have raised my hand for a substitution so a more energized teammate could finish what I started. But this was labor. I was the only one who could birth this baby.

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After some bleeding at 2 p.m., my obstetrician advised me to come into the hospital. I assumed I had hours left and that beautiful thought “epidural” appeared on the horizon. However, my body had other ideas.

When I got in the cab, my contractions were 10 minutes apart. When I got out, the contractions were coming every two minutes and my water had broken (yes, in the cab). Minutes later I was in a labor room. I pushed, the obstetrician pulled, my doula held my leg back and my mom propped my head up. It was freeing to finally enlist some brute strength.

After almost 24 hours of labor, and half an hour of pushing, just 90 minutes after arriving at the hospital I had my slimy, alert and, at 9 pounds, 8 ounces, very large son.

After almost 24 hours of labor, the author’s son arrived: 9 pounds, 8 ounces.CreditSean Andrew Murray

The strategies borrowed from sports psychology got me somewhat gracefully through labor. But they are not foolproof. Like Serena Williams at this year’s United States Open final, even elite athletes have their trying moments. I did, too, just as I entered the homestretch of my labor.

Less than two weeks after the birth, I stood on the stoop to watch the New York City Marathon, holding my sleepy newborn. The lead women ran by at their cracking pace, elegant and forceful. A tunnel of spectators along the avenue celebrated them. As usual, I had tears in my eyes. But this year, I felt that I was in their elite league.

Serena Solomon is an Australian journalist based in New York.