Many people believe that medical interventions cause birth trauma. More often than not, that is incorrect. What causes trauma is expectations…expectations about the pain, how a mother is supported, how she responds to the intensity of labor, and about her labor environment.
It’s a seductive thought to think that we can simply release expectations to avoid trauma and approach birth with a “babies are born in whatever way they need to be” attitude. However, expectations about labor pain, the amount of help one should ask for, how a person in pain should be treated, what the appropriate role of medicine is, and many other factors have been built up throughout one’s entire life. As an active participant in their family and culture, people carry expectations that were taught to them by tradition or experience, whether they recognize them or not.
One of the roles I play in the birth world is doing birth story healing work with mothers, partners, and birth workers. In most of the sessions that I lead with mothers their trauma was not caused by the epidural or the cesarean, but by a fracture in a relationship. Perhaps it was the way she was rushed through a procedure when she really thought that someone would gently guide her. Perhaps it was the fact that her partner didn’t respond in the way she expected when she was uncertain if her water broke. Perhaps it was the way a friend, family member, or birth worker told her birth would go a certain way and in the end, it did not.
Mothers, fathers, and partners look up to doctors, midwives, nurses, doulas, and childbirth educators. They rely on us to provide them with wisdom about birth. When they are instead handed a bouquet of cliches and implied promises (ex. If you just relax, labor won’t hurt. ex. If you go to a birth center, you won’t have a cesarean. ex. Birth is natural.) the seeds of trauma are planted. Black and white messages about childbirth set parents up to have absolute expectations about how the process will play out.
Sometimes they luck out and the stars align so that these messages prove true. These families may go on to spread these overly-simplistic messages to others, expanding the reach of the hurt they can cause. When birth doesn’t go according to the implied promises, mothers may believe that their bodies or minds are somehow defective having not lived up to these expectations.
Only preparing families for unmedicated birth hurts parents. Only teaching parents how to avoid medical technology instead of how to cope with it and stay connected to one another, the baby, and the birth process hurts parents. Using non-inclusive language about birth hurts parents. Shutting down birth trauma with “at least you had a healthy baby” hurts parents. Using absolute language to explain the birth process HURTS PARENTS.
It’s time for a revolution, people. Setting the stage for trauma with unrealistic expectations and idealizing one kind of birth over another is potentially just as harmful as pushing a woman into an induction or cesarean. There is a direct correlation between trauma and fractures in relationships. Let’s bring some balance back to birth. The over-medicalization of birth that has come about in modern times will not be fixed by OVER simplifying birth, by OVER emphasizing the value of one kind birth over another, by OVER indulging in magical thinking about a very intense process. Balance is not found in the extremes.
Balance is found in a place where we can discover compassion for all people involved in a birth. Balance is found in recognizing the positive intentions and helpful uses of any kind of birth tool. Balance is found in evaluating expectations and working to expand the possibilities for what is an acceptable way to get through the birth process. Balance is found in preparing for the birth you want and finding ways to cope, find resilience, and stay flexible through any outcome. Balance comes from knowing that birth is a series of events that are influenced by many, many factors, and that a mother’s worth is inherent, and in no way tied to the outcome of that birth.
Nikki Shaheed CCE(BFW) CD(DONA)