Passivity and Blame: Understanding Women in Labor and Childbirth

A couple of weeks ago, I was able to connect with a fellow birthworker to process our feelings about birth. We spoke about why we do what we do, voluntarily going on the front lines in the hospitals to both hold space and at times advocate for the women who are at risk of medical abuse. Something came up that encompassed a silent frustration I’ve felt over the last 5 years of my work as a doula and now midwife.

I have been blamed before for an outcome of pregnancy. I’ve had to work out incredible feelings of guilt and shame, doubting myself and my abilities to be an asset to women. I can still remember that day. The anger in her eyes and the questions as to why I didn’t do something differently shook me to the core. I went home that night and felt so angry – both for what happened to her and because I was being blamed for things out of everyone’s control.  I’ve been chastised for not being impeccable and perfect support. I’ve been given the complete silent treatment, leaving me to wonder if I had done something wrong or didn’t do enough. My work has been undervalued and underpaid, questioned for its validity, and seen as minimal. Often, I’ve wondered why even keep trying to make a change with the pushback that birthworkers have gotten not just from the medical establishment but also the very mothers we seek to aid.

Now, in me writing this piece, I am aware of the heighten sense of emotions in pregnancy and childbirth. I do not condemn women who I’ve described above for how they’ve reacted.  They had reactions fostered by their lives and emotions. It is my duty as a birthworker to learn how not to take anything personal, as difficult as that may be. What I am saying is that we live in a culture of blaming and lawsuits. We have been conditioned to simply react and not process our feelings in ways that lead to breakthroughs. Furthermore, doulas and midwives feel a brunt of displaced feelings that come from women who have been programmed to do the following: to hand over their power to the current medical system, to be passive as women in relation to the power over our bodies, and encouraged to blame someone when things out of everyone’s control happen. Our society perpetuates the myth that women are the eternal mother figures. We are expected to give comfort and hold everyone’s emotions at the expense of being hated, unappreciated and dismissed. This problematic view of women is further expounded by race and class. When this view is combined with the belief that medical professionals are supposed to guarantee outcomes that everyone is happy with, it can be a setup for disappointment.

I mention race and class, as it is something very present in my mind these days with the current social unrest. As a Black Latina, I am harmed by the Strong Black/Latina narrative. I am expected to be a strong pillar of strength that must be infallible and perpetually present. This is compounded by my role as a midwife. I have felt sometimes that I am supposed to save women from birth. I feel that my own feelings of rejection and guilt have been tempered by my ability to know her reaction actually has nothing to do with me.  Childbirth is an intense moment. Because it is focused on the genitals, it is important for me to remember that not only am I holding space for trauma that may be triggered by the pain, but also all other preconceptions about her body, motherhood, sexuality, and anything else that comes up.  It is a common reaction to trauma for a person to leave mentally and spiritually, thus seeming passive or absent. Sometimes women regress to being little girls in childbirth, needing their mothers, which is normal when one is experiencing intense pain that we want to on some level be saved from. It is not my wish to control all of these very really reactions in childbirth. In fact, childbirth can be one of the only times a woman can lose complete control, or on the extreme side, where her need to be in control can be exacerbated.

Yet, there is something to be said about women in general and in childbirth going from being a passive passenger to an active participant in their transformation. We as women have been conditioned to feel powerless and weak. The use of epidurals is symbolic of having been slowly brainwashed that we are not strong enough to withstand the pain of childbirth. I believe in the compassionate use of pain relief but not in the way it is overused. Together we, both birthing women and birthworkers, need to speak about empowerment as it relates to birthing and our bodies. Though I understand not wanting to speak on trauma to others, it is a part of doing the work to not simply “get over it” but rather work through it, in an effort to no longer be controlled by our pasts. These sentiments remind me of the quote, “Stand and Deliver”, which implies a much more powerful stance than being forced on our backs to birth our children. It is time for all of us to empower women to re-imagine the messages they have received not only about themselves but also birth. As far as blame, let us be more conscious of who we place the blame on and why. We must begin to take responsibility of our births.

This is easier said than done but necessary, as we cannot expect to be satisfied by something we don’t completely own. Now, this is also not to say that power and responsibility only looks a certain way. I am suggesting that women and all person who give birth give their birthing process much deeper thought. And you know what? Maybe this space to examine the ways we show up in medical settings isn’t as available. I’ve learned over the years that we are all doing the best we can. The knowledge that used to be inherently ours as women and people is now more and more being remembered. As always, a sense of compassion must go along with holding ourselves accountable, not for the outcomes of our birth (which are mostly unpredictable), but for who we are through it all.  I am speaking about taking responsibility for our prenatal nutrition and lifestyle with the understanding that it doesn’t only affect the growing fetus but the woman’s overall health.  Practicing outside of a hospital, I have a much different point of view on the woman I serve.  I am not a savior nor am I delivering anyone or anything from anywhere. I am a witness and medical professional responsible for the woman and fetus’ well-being, but ultimately the woman is responsible for her health. She is my client, not patient. I also speak from the place of a woman who has not given birth and has attended quite a few births, so I cannot say I know exactly how a pregnant woman feels yet I understand the process of rebirth well enough to know the ownership that comes with it. Even furthermore, for us to birth powerfully, we must begin to challenge and ask of our communities and eventually society to create a much more compassionate, fruitful and healthy space for birthing women. As it is, there is no true conversation around mental health as it relates to pregnancy.  There can be guilt in talking about things that keep us quiet and passive, from years of being silenced.

It is my hope that not just in birth but in our lives, women continue to foster their power and become active participants in their lives. Myself included. These are all things we don’t know all about yet. Many of us are waking up to our bodies and what we want for our families as we break cycles of the same thing from the last couple of centuries. We are collectively learning how to navigate our personal power and accountability; more and more we can let go of passivity, reserve blaming and be active participants in our births and lives.

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