If you or a loved one is fearful of birth, know that you are not alone, it’s understandable, and it’s not your fault.
Each prenatal and postnatal yoga class at Unusual Pearl begins with approximately 20 minutes of doula coaching, and community dialogue. It's a treasured time in class, as student’s voice their struggles, and celebrations amongst community support. Folks witness that they’re not alone in their worries, or their emotional ups and downs that accompany them on their reproductive journey. One conversation that comes up often during community dialogue, and coaching time, is the fear of giving birth… an understandable fear for a multitude of reasons:
1. Many people have never seen a live birth, let alone been a part of the birthing process.
Naturally, people are fearful of new or unfamiliar experiences. Researchers Marian MacDorman and Eugene Declercq wrote that, “in 2017, only 1 of every 62 births in the US was an out-of-hospital birth (1.61%)”. Therefore, birth may not only feel invisible because it’s hidden behind hospital walls, but it also has the ability to bring up unsettling feelings as it happens to be behind the same walls that are there to care for us when we’re sick and/or dying. In effect, despite approximately 385,000 babies being born globally each day, birth may seem mysterious, abnormal, and/or dangerous...similar to the way we view illness or accidents, which also happen to be treated inside of hospitals. Remember, only 6 percent to 8 percent of births involve high-risk complications, in turn requiring highly specialized care. Most pregnant people are classified as low-risk, and should be provided the appropriate care based on their classification.
2. Hollywood movies have etched into our minds dramatized versions of birth rithe with hyperbole, and misrepresentations.
The aim of most movies is to keep an audience entertained rather than informed. Movies often portray birth as a fast-paced process with the goal seemingly being to scream as loud as humanly possible, rather than to direct energy low into the pelvis. Doulas and midwives may be absent or portrayed as eccentric, and/or non-serious people. Many aspects of the reproductive journey are omitted or obfusticated, including fertility treatments and timelines, diversity in family units beyond white cisgender heteronormative couples, clothing choices outside of the standard hospital gown, swelling in a birthing person’s extremities and face, dermatological changes like the linea alba, the birth of the placenta, and the trials and tribulations of breast/chestfeeding. The verdict is out on the level of responsibility Hollywood writers, directors, and producers have in portraying birth with accuracy. Regardless, it’s important to note that the images we repeatedly take in can influence our level of fear, as well as how informed and empowered we feel around the birthing process.
3. In the United States, we are experiencing a deadly maternal healthcare crisis.
According to the Center for Disease Control (CDC), “since the Pregnancy Mortality Surveillance System was implemented, the number of reported pregnancy-related deaths in the United States steadily increased from 7.2 deaths per 100,000 live births in 1987 to 17.3 deaths per 100,000 live births in 2017.” Since the year I was born, maternal deaths have more than doubled and the U.S. is the only westernized country that is experiencing this dramatic uptick. YIKES!
What’s causing this crisis? A perfect storm of compounding factors including but not limited to, provider shortages, lack of insurance and/or federal policies around Universal Healthcare, systemic racism, white supremacy, chronic unaddressed patient conditions due to lack of healthcare access, the over medicalization of birth, and the lack of comprehensive coordinated care between providers (OBGYNs, Midwives, Doulas, Therapists, Social Workers, Pediatricians, Lactation Consultants, Nurses, Yoga Teachers, Pelvic Floor Physical and Occupational Therapists).
If you experience marginalization in the U.S., your likelihood of interfacing with these compounding factors dramatically increases. Every Mother Counts reports that, “the differences in maternal outcomes based on race, ethnicity, socioeconomic status, and indigenous status are stark, and happen to be among the most extreme in any area of health in the United States. For the last 60 years, Black women have consistently been 3 to 4 times as likely to die from a complication of pregnancy or childbirth than other women. Maternal mortality rates are two times as high for women living in counties with high poverty rates, compared with women living in counties with low rates of poverty.” Thus, if you are a person of color and/or are currently experiencing poverty, your fear of birth and its potential outcomes is not unwarranted. Yet, we must simultaneously keep in mind that at least half of all maternal deaths could have been prevented. Meaning, that some of the fear of birth may be misplaced. Giving birth is not necessarily the dangerous part, rather it’s the systems surrounding and facilitating birth and the care for our overall health that can be.
Knowing the difference in these fears can be powerful. It can prompt us to carefully vet providers, and healthcare facilities before a birth. It can elicit us to support local, state, and federal policies that positively address the maternal healthcare crisis, and encourage families to come forward to file formal complaints against healthcare providers and/or facilities that have caused harm. Additionally, it can empower patients to be active participants in the birth process, hone self-advocacy skills, and become up-to-date on the policies of the facility providing care. I write this, not to put the onice of poor care on patients, but to help us remember our choices and points of power while organizations, policy makers, and everyday people work to transform a broken system.
If you or a loved one is fearful of birth... know that you are not alone, it’s understandable, and it’s not your fault. There are many factors that can ramp up fear, including factors not listed above like poor past experiences, unresolved trauma, and COVID-19. The factors that ramp up fear aren’t all avoidable, but there are avenues that can lead you to feel more empowered. Stay tuned for the next blog post where I'll discuss how you can mitigate your childbirth fears, and move into your big day feeling confident and secure.
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