THE NECESSARY VULNERABILITY OF BIRTH

 

Although pregnancy and birth is a highly vulnerable time, the part that makes it all feel impossible at times is the sense that we are not enough. We question everything when we are pregnant. We question our ability to grow a baby, to birth a baby, and to raise a baby. Most of us walk around with a shield of armor around us, waiting for something bad to happen. This often consumes our thoughts, and we communicate it in our words. We set intentions that we aren’t even aware of.

We experience our pregnancies through a lens of shame. We are hard on ourselves, and on each other. We keep many of our fears hidden or a secret, to avoid feeling shame when others tell us their opinions about such things as where to give birth to our baby. Or we share our fears out loud in an attempt to seek connection from other women who have experienced those same fears. The problem with the latter is that it just breed’s more fear.

There is a reason why women who refuse to talk about their fears in childbirth, or create very complicated, static birth plans often end up in the very situation they spent months trying to avoid. There is an inherent unwillingness to be vulnerable in our birth culture today. This is a very real and concerning concept, because vulnerability is the very thing we need to embrace when we have created life. When we spend countless hours of time and energy focusing on what we don’t want, we are inadvertently bringing us that much closer to that experience.

So what do we do instead?

We attempt to control everything. We buy all of the essential items (and sometimes more) on our baby registry, we buy cribs and bassinets and we buy breast pumps “in case we can’t breastfeed.” We decorate the nursery because we can’t have a baby without that checked off of our “to-do list.”

“We drown ourselves in all of the things that aren’t important to avoid the things that are.”

We need to feel we have so much control over the outcome of our pregnancy that we forget who we are, and we often become someone else. We become obsessed with how to have the perfect pregnancy, with what foods to eat, and knowing everything we could possibly need to know about pregnancy and birth. We spend our whole pregnancy outside of ourselves, peering in on what it might look like on the other side- once we have “perfected” it. We avoid our feelings, or just simply can’t make sense of them.

We avoid being vulnerable in our obstetrical appointments. We often avoid the hard questions out of fear of sounding stupid, or not feeling worthy of a conversation with someone with such little precious time to give. We choose hospital birth over home birth out of fear that we “won’t be able to do it without pain medications,” or because on a deeper (but more pervasive) level, are we sure we can actually even birth our babies? We avoid telling our loved ones that we are planning a home birth, out of fear of being vulnerable, out of fear of feeling like an idiot when we are transferred in for pain relief. We want to avoid the “I told you so”. We avoid telling each other when we have positive stories, because we feel shame for not being able to identify with other women and their painful experiences.

We consent to interventions that we don’t want because we can’t sum up the courage to ask all of the questions, or say “no” when we really don’t feel like it is the best course of action. We let shame creep in and say, “who do you think you are challenging the doctor, or midwife”? “Who do you think you are pretending like you know birth better than everyone else and choosing to birth your baby at home”? “You better get that epidural, you know you can’t birth this baby without it!” Even worse, we do this to each other. My question to women is always the same- have you ever thought about what it might be like if everything just goes really well? Have you ever considered that you are going to jump off a cliff the day your baby is born, and most certainly will land on two feet? Many women look at you blankly, as if the thought of that is completely irrelevant when preparing for the birth of your baby.


So what SHOULD we do?

The answer to this is easy. It’s called empathy. According to Dr. Brene Brown, empathy is the only way we can beat shame and allow for vulnerability. So this means that when women and their partners share information about birth, you might say, “Oh wow, tell me more about what that would look like, having your baby at home”? Or, “wow, I’m so sorry that you received that bad news about your ultrasound. I don’t even know what to say. My heart is breaking for you, how can I help you through this?” This is in direct comparison to sympathy, which would sound something like “oh really? Well, at least you miscarried before you were really attached to the baby.” Or “Well, at least you transferred into the hospital from home before things got really bad.” Those statements are not helpful, and breed shame. They harm everyone.

We need to say out loud for ourselves to hear, “I’m sorry Doctor, but I don’t understand what you are talking about”, or “to be honest with you, I don’t think that what you are recommending is the best choice for us right now.” Or, “I feel very uneasy being here today for my induction, and I really don’t want anyone else in the room other than my partner and nurse. So could you please make sure that there is no one else other than us?” And we as providers need to respect this decision; we need to empathize with her state of mind and physical discomfort. When we empathize, we breed connection, and therefore trust. Judgment breed’s shame, and where there is shame, there is no vulnerability, and herein lies the problem.

“How can we expect women to grow their babies, birth them, and raise them with an empowered sense of self if they cannot be vulnerable?”

It is our responsibility to ourselves and one another to be vulnerable and in turn express empathy, maybe then we will start to see some real much needed change in our birth culture.

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Instead of focusing on why the cesarean section and induction rates are so high, we should be asking ourselves,

“Why are women so afraid of birth”?

My perception in practice is that they are afraid of vulnerability. Many are afraid of failure, and regret, and losing something they love. So they avoid being vulnerable until the end. They avoid actually considering an unmedicated birth in the event that they may want an epidural, and don’t want to be seen as weak. So if women just plan to get it, it was their choice. Or women may say, “Oh I just had to get an epidural, they made me, I had no choice”. Often times we do have the choice, and if we say yes, then don’t be afraid to admit that. Be empowered by your decisions, and own and accept them because only you can decide what is best in that moment in time.

The second part of this answer pertains to the lack of vulnerability on the part of our healthcare systems. As the care provider, we are taught not to be vulnerable, to be 100% aware and correct at all times. The truth is, we often are not. So care providers need to take a step into vulnerability and be willing to say when they don’t know, or they made a mistake, and we need to be able to meet them with empathy. Maybe if we allowed care providers to be more vulnerable, then we might not be so inclined to do so many cesarean sections in the presence of uncertainty. We may be more inclined to leave women to birth in peace, instead of hovering over them every second.

We need to create more empathy in pregnancy, birth and parenting. We need to be kinder to ourselves, be more open about our vulnerabilities so we can understand that birth is vulnerable. There are no guarantees with any of it. You have to be willing to let go of who you want to become, in order to be who you are.

“You have to stop trying to be the perfect mother, or the perfect patient, in order to be the vulnerable, confused, and scared person you are entitled to be.”

Let’s create a birth world where we minimize shame by having a conversation about it and in turn promote vulnerability. I believe this is essential in our growth as a culture, and it is imperative for us to feel connection with our children and with each other. This is easier said than done, but in my opinion, essential if we want to restore positive birth.