“I caved in”.
This is a sentiment expressed by countless women after undergoing obstetric interventions they planned to avoid in their birth plans. Women blame themselves for the way they respond to the excessive pressure they encounter in maternity care. They never blame the maternity care system or the extreme limitations on their heavily pregnant bodies.
In blaming their own response, women neglect to consider personal self expectations or early socialisation as a part of the problem. The early socialisation we receive becomes a compass for the expectations we have of ourselves, and standardised maternity care exploits that response.
UNICEF states the following in relation to socialisation
“Boys are told not to cry, not to fear, not to be forgiving and instead to be assertive, and strong. Girls on the other hand are asked not to be demanding, to be forgiving and accommodating and “ladylike”. These gender roles and expectations have large scale ramifications. ……. girls face discrimination in the care they receive in terms of their access to nutritious foods and health care, leading them to believe that they deserve to be treated differently than boys.”
Hospitals are like well oiled machines. They’ll get the baby out in a timely and convenient fashion, one way or another. Women these days are informing themselves about natural birth. They’re making birth plans to guide how they’d like to be supported by medical teams. Unfortunately they aren’t considering their inability to navigate the unbending rules of hospital policy. They don’t factor in their urge to avoid conflict, or appear selfless. The desire to be polite at all costs never features during the creation of birth plans. It’s so inbuilt by the time we reach our childbearing years that it might as well be invisible.
Attitudes to Birth Plans
Meanwhile, countless medical professionals are caught out for dismissive, often outrightly nasty attitudes to birth plans. One obstetrician recently posted on social media about how the length of birth plans can be directly linked to the length of the caesarean scar.
“Isn’t there a joke? The length of the caesarean scar correlates directly w the length of the birth plan?”
Someone else responded that they’d be using that in future. Still someone else stated that if a birth plan is laminated it’s to protect it from the obstetric haemorrhage it precipitates. (Click here to see for yourself)
Why!? Writing a birth plan isn’t associated with any known medical conditions that endanger babies is it? The only possible conclusion is that hospital staff have a bad attitude when it comes to women that take the time to inform themselves and to create birth pans.
So women set about making their personalised birth plans based on their wishes, of course, taking into account that health has an impact on the necessity for intervention. What they don’t think about is the difficulty they may have in asserting their plans and responding to heightened pressure when hospital protocols are at odds with their plan.
One problem in this scenario is that women may not expect conflict from their care providers. Another, conversely, is that they don’t understand their own capacity to manage it, or their potential response.
Impact of Socialisation on Conflict
The stress response, in conjunction with the physical and emotional toll of labouring is intense.
According to an article by Lizzie Marvelly titled “How the fight or flight response discredits sexual assault survivors”:
“For women [ . ] The main problem with the fight or flight theory? It was developed with men in mind. Combine that with the fact that the bulk of psychological research has been carried out on college-aged white male Americans, and a different picture begins to emerge. As researchers such as Shelley Taylor and her colleagues have pointed out, however, in an evolutionary sense, fighting or fleeing would likely have endangered a female organism’s offspring, and so a parallel female stress response was more likely: tend and befriend. While the physiological responses in men and women (racing heart beat, dilated pupils etc.) may be the same, it is absolutely possible that men and women will respond differently to a threat.”
Can you think of any situation that is more relevant to a “female organism’s offspring” than childbirth? In childbirth fight or flight is not possible, but tend and befriend is.
Most women expect to be fully supported and encouraged to follow their bodily urges during labour and birth. A small number are aware that they may encounter difficulties. However even those who know about the potential for conflict often miss the crucial part of the puzzle. They expect that they will be able to assertively negotiate for their best interests. After all, we are told that we are liberated now. Girls can do anything ….. But can women?
Owing to early socialisation, even after a birth experience where the woman has undergone multiple interventions she clearly had no medical requirement for, when she articulated her intent to refuse, she often often applies the reasoning “I caved in”. She thinks it’s her fault!
In an article recently written by Lili Loofbourow, titled “The Price of Male Pleasure” the author states quite succinctly:
“Women are enculturated to be uncomfortable most of the time. And to ignore their discomfort.”
She is absolutely spot on. Although she is discussing sexual relationships not birth, the bottom line is that sexual relationships culminate in childbirth. The two are inextricably linked, despite everyone’s best prudish efforts to pretend differently.
Early Socialisation’s part in Self-blame
When a woman brings this lifelong habit of excessive accommodation into her birthspace, her socialisation and personal expectations condemn her to assume the responsibility and guilt.
“I caved in and had the stretch and sweep”
“I caved in and had the epidural”
“I caved in and had the repeat caesarean”
Ironically she sees that she was pressured, but it was easier to submit to a medical procedure she didn’t want than to have her needs met. She doesn’t see the pressure as the problem. She sees her own response, as a heavily pregnant, vulnerable woman, who possibly hadn’t slept for days, or is even under the influence of mind altering pain relief, as being the root of the problem.
We have been very effectively divided and conquered somewhere between our socialisation and our maternity systems. There is a false promise in the sales pitch of modern maternity care: That women are all individuals. Really, we are all lined up and pressured through the exact same routine pregnancy care, and because we’re apparently liberated, the perception that forms is ”I caved in”. Well maybe women do succumb to the pressure, but it’s not because they are inadequate, it’s because of female self suppression and external oppression.
In response to the concept of birth plans people often say “it’s not about preference” but YES IT IS! The fact they would say otherwise confirms the whole premise of this article. Obstetric culture and the expectations of female submission from our early socialisation are a disaster for the emotional wellbeing, and self esteem of pregnant women and new mothers.
Women are expected to be quiet, compliant, convenient, and we’re expected to present with a demure smile throughout it all, lest we make someone uncomfortable. That’s expected of us in all aspects of our lives. In early childhood and schooling, to relationships, sexual encounters and finally during birth. Women expect this of themselves. They also expect to have their needs met by the people who attend them in labour. These two are mutually exclusive within the medicalised model of maternity care, yet the system tells women that they are all individuals? It treats women all identically, and leaves women blaming themselves for flailing in the face of intense pressure to conform.
For Further Reading