(210) 800-2070

Non-Inclusive Birth Preparation Causes Birth Trauma

birth traumaMany 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 birthing parent is supported, how they respond to the intensity of labor, and about their 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. Therefore, expectations cannot simply be avoided or brushed aside, because they become an ingrained part of our belief system.

One of the roles I play in the birth world is doing birth story healing work with parents and birth workers. In most of the sessions that I lead with parents their trauma was not caused by the epidural or the cesarean, but by a fracture in a relationship. Perhaps it was the way they were rushed through a procedure when they really thought that someone would gently guide them. Perhaps it was the fact that their partner didn’t respond in the way they expected when they were uncertain if their water broke. Perhaps it was the way a friend, family member, or birth worker told them birth would go a certain way and in the end, it did not.

Expecting parents 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 beliefs are confirmed by their experience. 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, parents 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 someone 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 one’s worth is inherent, and in no way tied to the outcome of that birth.

Mic drop.

Nikki Shaheed CCE(BFW) CD(DONA)


  1. Barb Buckner Suárez on April 3, 2017 at 1:44 am

    YES!!!! Great post and it encompasses everything I’ve been teaching as a CBE for almost 20 years! Yay, you! ?

  2. Erin on April 3, 2017 at 5:25 am

    Thank you!!! Absolutely 100% agree.

  3. Shannon on April 3, 2017 at 5:36 am

    I love this perspective. Sharing your viewpoint about a woman’s worth not being tied to the outcome will be important in so many ways to people reading this. The importance of discussing ALL the ways to prepare women and men to love themselves regardless of the outcome cannot be said enough times in my world! Some births can have trauma related to other factors, but this article addresses an important issue that is rarely talked about. And thank you for that ?.

  4. […] motivation to write this post stems from this excellent piece that was linked to by one of my fancy OB/GYN friends.  I don’t know the person that posted […]

  5. Jenny on April 4, 2017 at 6:00 am

    While this is an interesting perspective, I respectfully disagree. I feel that birth trauma has its foundations in the way a medicalised system perceives and treats women, not because of a birthing woman’s expectations. If it were the latter, surely there would be as much trauma in systems where woman-centred contuoty of care and a belief in normal birth underpins treatment of women. Yet academic research and anecdotal evidence suggests this isn’t the case. Implying that birth trauma arises from expectationas is borderline victim-blaming.

    • admin on April 8, 2017 at 2:05 am

      Jenny, thank you for your comment! When you look at the trauma that occurs within various birth experiences, what tends to be the problem? The way the birthing person was treated, right? Because they were expecting to be treated in a different way…they expected that people would take their time, speak directly to them, approach them with kindness, or whatever the case may be. In the article I’m stating that we can’t possibly not have expectations…even if you’re not attached to a medical outcome, your life experiences have set you up (not unreasonably!) to be treated a certain way. Sometimes that disappointment is over an event that occurs during the birth, and other times it’s about the way birth was framed for the birthing person during their prenatal preparation. In either case, there is a rift in the relationship. While unkind treatment in labor is an important seed of trauma, so is the issue of birth pros creating unrealistic expectations for pregnant families. Both need to be addressed, but I think realistic, expansive, compassionate prenatal preparation is one that we can more quickly and easily address. What do you think?

  6. Rosie Smith on April 8, 2017 at 12:11 am

    This is so true. I have counselled hundreds of women and most talk about the things that were said or what they read that influenced how they felt their birth experience went.Unpacking it all later gave them some different ways of talking about the experience in a kinder and more helpful way….

  7. […] article Non-inclusive Birth Preparation is Traumatizing Women very much fits with my two main goals for teaching, and I hope that teaching both the skills for […]

  8. Suzanne Turner on August 29, 2017 at 10:12 pm

    Fantastic article! Thank you so much!!

Leave a Comment