Chilbirth Fear is “taught”

childbirthFearLast week we looked at the philosophy that fear of childbirth is normal. Today we have an equally interesting exploration… what does it mean to believe fear in childbirth is “taught.”  What assumptions do we make when we believe this. How does this belief affect the way we react to women?

Making Assumptions

If we believe fear of childbirth is “taught,” we probably make the  assumption that feelings about childbirth are culturally derived, and result from the experiences of other women rather than the experiences of the expectant mother. We can dig a little deeper into this idea.  What other things about childbirth are taught to the woman by her community? It is not only attitudes about the process, but also specific behaviors and her changing role within the community. Just like the fear, these behaviors and roles my be beneficial or harmful.

The reality is that nearly everything a person learns about the world is taught by the community. It is within the environment of the community the individual learns how to successfully interact with the larger world. The community teaches you ethical conduct, health behaviors, and beliefs about the stages of life. The community is going to teach the individuals how to think about childbirth. So the issue is not whether attitudes about birth are “taught,” but rather, what attitudes about birth have the best value to the community.

While the problem with “normal” was the lack of a strong definition, the problem with “taught” is that it only refers to the method of acquiring the fear, not the benefit or risks of the fear.   You might believe teaching women to fear childbirth is helpful because it allows them to be properly prepared and rallies the community to protect the woman as she gives birth.  Or you might believe teaching women to fear childbirth is harmful because it erodes confidence in women’s ability to successfully give birth.

Going against the community flow

At this point you might be thinking the natural birth movement is counter-culture…so how do women unlearn what they are taught by their community.  There are a few ways to think about this, and you can consider the questions based on your personal experience and the experience of the women you work with.

First, think about the difference between the micro-community of the family and the community of the local society.  For example, in my case I was raised in a family with women who held beliefs that the doctors didn’t “know all” when it came to birth and seemed to only share the stories of births that were not text-book.  My only real memories of birth stories are comments like, “why do they try to tell you not to push, you cannot not push!,” or “He didn’t believe me I was in labor, but he had to come back and catch that baby two hours later.” But these birth stories alone are not responsible for my views on birth, most of my cousins heard them as well and chose epidurals.

Secondly, think about outside influences. In my case the first time I really thought about what I might want when I give birth happened in my teens as a response to documentaries about waterbirth on cable television. I wasn’t anywhere close to wanting to have a family, but this introduction to options helped me to form ideas that stayed in the back of my memories until I needed them.

Third, think about resources available. In my case, when I first knew I was pregnant the nurse at my family doctor office scheduled me for my first prenatal appointment with an OB.  I casually asked if midwifery care was available (pulling out the memories from my teens), and that started a search for midwives I could use with my insurance. At this point I didn’t really know anything about giving birth, or about the differences between midwifery care and obstetrical care, and if the nurse had not known about resources in the community I probably would have accepted her “no” without a second thought.

Finally, think about the normal stages of development. There is a conflict in all individuals in the late teens early twenties between being accepted by the group and forming an individual identity. While this is a simplified explanation of the actual process everyone goes through, we basically make choices about who we are going to be and where we are going to push back against the system.  For me, pushing back against the “normal” American birth wasn’t difficult — and I didn’t even see it as counter-culture when I started down the road.

To Think About

So the process of learning (or unlearning) from the community is perhaps more complex (and highly based on chance) than any woman might initially think. But we still haven’t addressed some of the most challenging problems with this philosophy.  Let me know your ideas about these problems.

First, is there any value to recognizing an increased risk for a woman during the time of pregnancy and birth?  I would argue there is, even if it is easy to be blown out of proportion.

Second, if there is a value to having concern for pregnant/laboring women, how do you balance community acceptance of the protection of women during this time with community acceptance that for most women the process will not be problematic?

Finally, if all beliefs are “taught,” what messages about pregnancy and childbirth would be most beneficial to women and society as a whole?