So You Think You Can Birth?
How you could be unknowingly influencing her birth experience…
I have been working with pregnant women for fifteen years. In my role as a Childbirth Educator, teaching a beautiful program called Calmbirth, I have listened to thousands of women tell me the difficulties they experienced when other people made thoughtless comments. Call it my own peri-menopausal hormones, or my innate maternal nature, but eventually it had to happen – I snapped! I felt the overwhelming need to get vocal and go public with a request to the wider community: please bite your tongues around pregnant women unless you can be enthusiastic and supportive. Here’s how and why what you say could have a lasting impact on the birthing woman, and her birth.
The stage is set and her swollen belly is up in lights. She is about to perform her greatest act ever – giving birth. The crowd gathers, murmuring and muttering advice, declarations and even commandments about what she should and shouldn’t be doing. The frowning judges are itching to criticise, their score cards at the ready, even though some of them have never performed in this arena.
Even comments made with great intentions can play on a woman’s mind, causing her to worry, doubt and become afraid and tense. What you say could remain in her mind indefinitely, going on to influence her physiology and the way her body responds to labour. Yes, the way her body responds to labour.
There’s an emerging awareness, and a mountain of evidence, about the mind/body connection. Put simply, how we think influences our body. Have you ever wondered why birth seems to be getting more and more complicated, when we’ve been doing it for eons? Our ancient sisters had no fear. Fear changes the response to labour, and women are now faced with an ever-growing list of fears. Many of these fears are thoughtlessly instilled by others, and most of them are completely unfounded.
I surveyed more than 200 women for this article. Here are some of the most common fears that are created or fuelled by comments a pregnant woman hears, and how she might respond to them.
Fear #1 – The pain will be too much
You cannot assume that the pain you experienced in labour will be the same as what she experiences.
Pain is a subjective experience. It can be influenced by a woman’s history of painful experiences, along with stress, fatigue, hydration, the position of the baby, the stage of labour, and most importantly, her state of mind in that moment.
My mother said, “Don’t be a martyr.” – Stephanie, retail assistant
When you tell a woman how bad the pain will be, you potentially make her labour feel more painful. Don’t do it! The pain you experienced is not relevant to her. Focus on the beauty of welcoming a baby into the world.
I was told, “Have the epidural, don’t put yourself through it.” – Shannon, accountant
Every woman is different, and every labour is different. Anyone who has had more than one baby can attest to the intensity being different throughout each birth. Women can experience feelings of intense pain, mild and manageable pain, and/or other feelings unlike pain, such as pressure, discomfort, and even ecstasy, bliss and orgasm. The more relaxed a woman is during labour, the more she can experience the benefits of the feel-good hormones endorphins, oxytocin and prolactin. If she is scared, the body will release adrenaline and other stress hormones, which will minimise the release of the feel-good ones. So please don’t talk about how painful you think it will be for her.
Instead, offer positive suggestions and tell her how you were able to manage it. If your only tools were drugs, then don’t say anything. While drugs can be enormously useful in certain circumstances, they come at a cost to both mother and baby, and are not always appropriate – in fact, they can make birth more complicated.
My workmate continually said to me, “All I can say is, drugs, drugs, drugs.” – Wei, teacher
We need to highlight the beauty and wonder of childbirth. It is the welcoming of a baby and the creation or expansion of a family, and yet too often we lose that focus. So reinforce the positives. Childbirth was designed to be a joyful event that women want to experience again and again – to enable the survival of the species. Allow her to feel confident and enjoy the process of giving birth. It is possible. Absorb some birth wisdom from women who have already discovered how.
If you set her up to think that drugs are her only option, you could be doing her a great disservice if she turns up to the hospital only to be told she is too far along in her labour for the drugs she is asking for. Or she might have the drugs and get incredibly sick.
After a female family member asked how I was feeling about my impending labour, I replied, “Actually I’m feeling quite calm and positive, and I’m really looking forward to it.” She replied, “Well, that will change once you start to feel those contractions!” I felt incredibly deflated and frustrated that society focuses on the pain and puts such a negative spin on the birth process. – Katherine, teacher
She needs room in her mind for other strategies to manage labour. There are many options that can be as or more effective than drugs, with fewer side effects. When we push the idea of drugs, what we are really saying is, “You won’t be able to do it!”
My stepsister talked to me about visualisation and other techniques she’d used birthing her daughter and said, “You’re going to be great.” I felt so in control and empowered. – Leanne, public servant
Fear #2 – What if birth gets complicated?
We all need help sometimes.
While it is important not to dwell on the negatives with an expectant mother, it is equally important to acknowledge that sometimes nature needs a helping hand. Now – and this is really important – when mothers and babies need help to start, continue or finish birth, it is not a failure!!! No, never is it a failure. It’s just how it panned out. Please, please, please don’t ever give yourself or anyone else a hard time over needing help. We all need help sometimes. By the same token, please don’t assume she’ll need help or incite panic by sharing horror stories as entertainment.
My friends kept telling me, “Wow, you’re so big, you’d better have a C-section.” Two days before I was to be induced, my aunt and (childless female) cousin regaled me with stories about the most horrific births they knew of – still births, fourth degree tears, foetal distress, major postpartum haemorrhages. This was very counterproductive to my calm birth preparation, even if it was meant to be helpful (and I’m not sure it was). – Jennifer, physiotherapist
We are lucky to have a medical system that is usually very effective in protecting mothers and babies. It is a wonderful safety net we have. Problems that would once threaten mothers and babies don’t happen anywhere near as often now, and we have magnificent, clever, caring, hard-working health professionals to thank for that.
But that is not the end of the story. We need to develop confidence to engage with them in open discussion and even negotiation about how to get the best outcomes for our unique circumstances. Any interference in the birth process comes at a cost. Sometimes that cost is worth paying and other times it is not.
Many health professionals have become (or have been educated and trained to be) highly risk-averse and inclined to use interventional management over a ‘wait and see’ approach. This can create a cascade effect of one intervention leading to the next, and the next. The medicalisation of birth can make birth look like a medical emergency, when it is a normal biological, emotional and spiritual process.
Any birthing woman may end up needing help, so spend some time learning how to navigate and manage the medical system that provides us with such wonderful support.
Fear #3 – The size of the baby… will it fit?
You cannot tell the size of a baby by the size of a pregnant woman’s tummy.
It’s not just baby in there! There’s fluid, placenta and extra blood too. Different women carry babies in different ways. The baby will fit, as long as they aren’t stuck in an awkward position. Many big babies slide out, and some small babies get stuck.
I am normally quite small but put on a lot of weight while pregnant and looked really big. I ended up feeling very self-conscious because of all the comments. In the final trimester, I was hearing from colleagues, strangers on the street and shop assistants things like: “It must be triplets”, and even “You look like you’d topple over if you bent over to get something out of the freezer in the supermarket – do you ever worry about that, that you’ll end up trapped in the freezer? Hahahaha!” – Sam, laboratory technician
The mother and baby’s bodies are designed to work together. Remember that the mother’s pelvis is flexible, and its three thick ligaments that are softened during pregnancy by the hormones. Women being upright and active during labour helps the pelvis to open to its maximum capacity. With such a soft skull, the baby’s head moulds to the birth canal, squashing up so that it can fit. The vagina and perineum are made of soft tissue that receives extra blood flow and hormones during pregnancy to allow it to stretch and open.
From about 28 weeks I started getting comments along the lines of “Oh, you must be close”, “Must be any day for you now”, and “You look ready to pop!” When I told people how long I had left, I would get even more comments about my size, so I started lying and saying “Yes, due very soon”, and “Yes, any day now”, even when I was still two months away. – Mel, manager
Comments like these conjure up visions of babies being too big, getting stuck, ripping her to pieces or the biggest one – being in danger. Commenting on her size might sound harmless, but it can cause fearful, panicked thoughts and ideas to stick in her mind, causing resistance to the birth experience.
I received a lot of comments about my body and putting on weight and watching what I ate, which I didn’t welcome. But I loved it when people told me I had a beautiful bump. I actually loved my enormous tummy. – Keiko, administrative assistant
A lot of pregnant women love their size, and are amazed at what their body is doing. Try not to talk about size as a positive or a negative, as something to be compared, or even at all. If you have to say something, just celebrate their gorgeous swollen belly!
Fear #4 – Will I be able to do it?
Women’s bodies work, but the culture of fear gets in the way of childbirth.
The physiological changes that arise from fear can dramatically affect birth outcomes. When a labouring woman is fearful, this is what can happen:
- Critical blood flow to the uterus is diverted to her arms and legs, as a result of the sympathetic response of her nervous system, more commonly known as ‘fight or flight’ response. This lack of blood flow to the uterus can lead to cramping, tension and lack of dilation, and make labour more painful.
- She sweats more and becomes dehydrated, which increases the pain.
- Her adrenaline blocks oxytocin, and this slows and prolongs labour.
- Her mind gets in the way, taking her away from natural, instinctive responses such as using the movements and positions that will best help the baby descend and emerge.
- The baby may feel and share in the mother’s fear and distress, since they share the same physiology and chemistry through the placenta and cord.
We can create real, significant, game-changing physical and emotional fear, just by a few negative comments.
A very close family member told me, “Don’t risk your baby’s life by choosing water birth.” Another friend said, “It looks like you have a small pelvis, so it will be much harder for you to push.” I was shocked to hear these nonsense comments. I replied, “I have been created to give birth.” Still, those comments made me feel scared, insecure and unhappy. In the end, they had the biggest shock when they heard my amazing birth story, regardless of the cultural pressure and expectations on me. – Leva, nurse/midwife
We need to demystify and culturally pull apart the negative mindset that is commonly held around birth. Open your eyes, look at other cultures, or even other generations and ask the big question – what is the real truth about birth? The real truth is this: women have been doing this forever. Our bodies are wired for it.
My yoga teacher told us the birth experience could be a beautiful thing. I remember feeling quite surprised. She was right – I had two truly beautiful birth experiences. In fact, if I ever have a flat moment, I relive them in my head because the experiences were both so empowering.
– Kathleen, architect
Fear #5 – Will I ever be the same again?
It is not okay to discuss someone else’s vagina in social situations – ever!
Please do not, under any circumstances, feel at liberty to comment upon potential changes to a woman’s vagina after childbirth.
I spent an entire double dinner date with friends of my husband making jokes about how my husband would be “watching his favourite pub burn down” as the baby came out, and how I might be left with a “vaganus” after the delivery. I went home and cried. I felt so humiliated that they’d sat there visualising the most private part of my body being desecrated by the upcoming birth. It also exacerbated my own fears about tearing and whether I would ever be the same again after delivery. – Priya, financial planner
So many people seemed so obsessed. One of my best friends frequently said – “I can’t believe you’re growing a human! And that you have to push it out your vagina!” – until I mentioned it upset me. Another not-close friend, a man, said to me (and a table full of our mates), “Well, I guess you’ll be pushing that out of your special place soon. Ouch.” – Heather, artist
Hmm. Need I say any more about that?
A few final words of advice …
Please remember that any comment, positive or negative, can have lasting impacts on the birthing woman. Always be positive and kind.
If you are pregnant and worried about the birth, ask yourself this: What is the fear that has been triggered here? Then explore that fear. Where has it come from? What do you need to understand for it to lose its power over you? How can you look at things differently? Where is the comfort you can find in the discomfort? It can be an opportunity for you to deal with something that may get in the way of you reaching readiness. You know that you are ready to birth when you say to yourself “Bring it on – I’m ready for anything!”
Don’t get in the way of childbirth unless you need to, but also accept that help is sometimes required. It’s not always easy to ascertain the best approach for your circumstances. Pregnant and labouring couples might be suddenly presented with statistics, ‘usual’ management strategies, hospital policies and medical recommendations, and expected to make decisions quickly. Don’t be afraid to ask questions. What are the benefits? What are the risks? Are there any alternatives? Is there something else we could try first?
If you are a man reading this article, and you have experienced childbirth with your beloved, then tell a pregnant woman how amazing your partner was (and nothing else).
If you have had a rough time birthing your babies, get some help to find peace – you deserve it!
Hats off to birthing women … they all do a remarkable job! Women can do it, have always done it and will always do it!
Tracey Anderson Askew is a mother of four sons, and has helped prepare couples for birth for over 15 years. She is passionate about bringing confidence back to women, and helping them to access the amazing physiological and emotional resources they have within themselves. Tracey runs Calmbirth in Canberra and is pretty calm herself most of the time, but has been known to erupt if she hears anyone say anything less than positive to a pregnant woman! For more information about Calmbirth or to contact Tracey about speaking, writing or teaching opportunities, please go to www.calmbirthcanberra.com.au.
The Calmbirth® Childbirth Preparation program was developed by midwife Peter Jackson. As a midwife working in a country hospital for over 20 years, Peter witnessed mothers whose experience of childbirth was one of fear, anxiety and trauma.
Calmbirth® was developed by Peter as a result of his search for a way to help mothers rediscover their birth power and joy.
empowering parents ~ discovering the joy of birth
Calmbirth ® derives its content from a variety of disciplines and the associated research. Below is a list of references that you may find interesting.
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