Birth trauma happens for a host of complex reasons.
(1) Barriers to accessing safe and competent care providers,
(2) Unexpected and/or unanticipated pregnancy, labour and birth, and postpartum outcomes,
(3) Practices that serve to prioritize the best interests of a ‘care’ provider and institutional policies over the needs of women and their families,
(4) The disconnect between the social expectations of perfect mothering and the lived reality of the transition(s) to mothering,
(5) How the dynamics of prior experiences of trauma can be re-enacted in the transition of becoming a mother (i.e. people in positions of authority violating fundamental rights to safety, dignity and body integrity), and
(6) Negotiating the transition to mothering in the context of interpersonal/systemic violence.
Birth trauma is misunderstood, minimized, denied and ignored because the needs of women in GENERAL are minimized, denied, and ignored.
This is at least in part why birth is a feminist issue, and why we can not talk about addressing birth related trauma without talking about systemic violence against women more broadly.
I brush only on the very surface of this argument in what follows.
I firmly believe we need to talk about the needs of women prior to becoming pregnant, and consider how the factors that produce birth trauma are intimately and inextricably linked to the politics of women’s oppression and as an extension of violence against women.
Take Back the Night meets Take Back Birth
How can we begin to address what contributes to birth trauma without talking about what it means to be a ‘good’ woman, which often means serving the needs of others, contorting oneself into whatever others’ need in order to feel loved, valued, appreciated and ultimately, safe.
Many of the women we’ve worked with, who seek counseling for birth trauma, describe situations within which they felt they could not have said “no” without risking judgment, harm or shaming by family members and/or their ‘care’ providers.
The desire to avoid these feelings is often misunderstood by women (and society at large) as their own personal failure to prioritize self-preservation over the feelings of others.
“Why didn’t they/I just say “no”?
Well that’s a loaded question, isn’t it?
Rather than blaming the victim or oneself for not speaking out on her/your own behalf, we must question how it has come to be that women find themselves in positions where it feels safer in the moment to ‘consent’ to practices they don’t want rather than risk being constructed as ‘disruptive’, ‘high maintenance’, ‘one of those women’ ‘crazy’ ‘needy’ etc.
I believe that addressing/reducing birth trauma is fundamentally about supporting women’s agency prior to pregnancy, questioning how it is women are groomed to become self-sacrificing, ensuring women are provided with care that maintains their sense of safety and well-being regardless of what (un)expectedly arises, respecting body integrity, and listening and responding appropriately when, regardless of outcome, the birth was not entirely or at all positive.
This, in addition to recognizing that many women will ultimately feel compelled/coerced into making ‘choices’ in the transition to mothering based on how they feel others will feel about them making particular choices or not, at a time when they are intensively vulnerable to and dependent upon, the emotional and physical care of others.