For so long, birth trauma was largely the byproduct of over-medicalization. Thanks to radical social movements that began in the 50s and culminated in the 70s, we started to see a resurgence of "natural" birth practices and values that shook the status quo for modern birth. This movement was in direct response to the level of abuse, obstetrical violence, and trauma that was slowly but steadily being reported by highly concerned nurses who worked in the labor wards. Twilight Sleep, a combination of morphine and scopolamine for putting women in a state of unconsciousness in order to have no recollection of the birth, had become standard practice in America. Though this drug combination had promised "pain free" childbirth, it was more accurately an inability to remember the pain. During labor, women under Twilight Sleep would begin thrashing and flailing wildly to the point of self-harm causing nurses to have to blindfold their clients, tie their limbs to the bed, and place them in straight jackets and padded labor cribs. This truly represents the pinnacle of medicalized birth and the tipping point for social movement.
Here we are many decades later and the natural birth movement has certainly come a long way. We are seeing greater percentages of birthers preferring fewer interventions in the hospital setting and choosing out of hospital birthing locations. As a doula, I feel privileged to be able to support my clients wherever they feel safest and most supported. I celebrate that they have choices, here in the state of Utah, between multiple hospitals, birth centers, and home birth, with ample birth providers to choose from that are highly qualified for each setting. So why, then, was I caught off-guard when I started to see that some of my clients, all of whom had thoughtfully, even passionately, educated themselves and chosen wonderful providers for their births, were still experiencing birth trauma?
The answer to this question can be represented pictorially as a spectrum. On the lefthand side we have what I call the trauma of Over-Medicalization. Then over on the righthand side we find the newly born trauma of Over-Idealization.
In our effort to course correct, our birth culture has veered into the realm of making birth so sacred and so natural that we have come to fully expect it to go smoothly, by candlelight, in the birthing tub, with no medical interventions, every single time. And to need assistance in delivering one's baby is a sign of failure or an admission of weakness. I was witnessing, over and over again, clients that had taken the best natural birth classes, read all the latest books, meditated daily, ate exceptionally well, exercised, and still required medical assistance at varying levels of intervention. This led to profound disappointment, shame, and feelings of "not good enough" from those unmet expectations. These were not instances of over-medicalization, but medicalized in direct response to what was indicated. My clients were being traumatized by neeeding and receiving essential, sometimes life-saving, interventions.
Is there a middle way? How do we help guide the over-correction into a balanced, centered middle ground that still rejects unnecessary or non-indicated intervention but that equally accepts the crucial role it plays when necessary and indicated?
Developing a paradigm of mindfulness has been life-changing, personally and professionally, for fostering that middle way. It enables us to more fully experience birth (and life) without judgement, failed expectations, or suffering. It teaches us to be curious, open-minded, and prepared for the unexpected. It fosters resilience, fortitude, and emotional stamina. It doesn't necessarily make birth easy or guarantee specific birth outcomes but it can shift our interpretations and perceptions, allowing us to cope rather than suffer. It is a learnable way of life that can bring peace and contentment on your birth journey because the only thing you can control is your response to what is. Some of my favorite "mindful mantras" in the birth space have become:
This is happening.
Here we are.
I'm here for this.
I'm having an experience.
This is my baby's story unfolding in real-time.
I'm choosing to be curious and open.
I'm so good at pivoting.
I'm expecting the unexpected.
This is happening for me, not to me.
This is the way.
The only way out is through.
I have also begun to guide my clients away from outcomes-based preparation because it fosters a rigid fixation on the destination that undermines the transformative nature and beauty of the birth journey itself. I strive to help my clients see the entire experience as valuable, not solely the labor or method of delivery. By no means should we cease striving for optimal health, minimal interventions, and physiological birth, but at the same time we can sow seeds of "accepting what is" into the birth preparation soil. Birth is wild, untamed, and unpredictable--three qualities that make it impossible to predict and plan, and also what make it profoundly transformative. We can no sooner control birth than we can the children that emerge from it.
What would you add to the list? As you've navigated birth, personally or professionally, what has helped you, or your clients, find the middle way?
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