Giving birth in a safe place is mandatory for labor to progress normally. Because women are more sensitive to the possibility of threat, danger, or trouble when in labor, feeling safe is just as important as actually being safe.
Hospitals often discount the emotions, mental state, and expressed needs of laboring people, in favor of policies and procedures. These are there, presumably, to keep everyone safe, as long as you do what they say.
Let’s set aside the issue of hospital or doctor-caused complications that occur during labor despite sufficient evidence of iatrogenic (caused by medical examination/treatment) emergencies. Given the sky-high cesarean rate and the gut-wrenching maternal mortality rate it’s time to consider that hospitals are not simply “the safest place to have a baby.”
Let’s pretend for a minute that, in fact, the hospital is set up ideally for labor and birth, that the doctors always make choices in mother-baby’s best interest. The way the hospital protocols often treat laboring families on an emotional and psychological level is not conducive to physiological birth.
It’s imperative that the mother feels and believes she is safe, more than intellectually, but subconsciously as well. Stephen Porges’ Polyvagal Theory indicates that in order to illicit normal physiological birth, the mother must receive continuous subconscious signals of safety from the external environment throughout labor.
This includes how the room feels, looks, and smells, what people say and do, how others move around them, the kinds of facial expressions they use, and their tone of voice. The laboring person’s animal brain, not readily accessible to her consciousness, is paying attention to all these factors and many others. We’re always doing this, but in labor we’re on high alert because this moment really matters, physiologically. “Right now, pay attention,” says our body.
The absence of predators, machine guns, and her ex-husband is necessary, but it’s just the first step. Safety is dependent on feeling safe, not merely the absence of outright threatening encounters.
A big warning sign for you subconscious brain is immobilization. When not allowed or able to move freely, the inner part of your brain becomes worried. Being strapped or restricted in any way to a bed is a danger cue, and hospitals still institute this policy which is mandatory any time the mother is hooked up to an IV.
Your thinking brain is actually pretty easy to convince everything is alright. Just throw a few facts and figures provided by someone in a white lab coat and provide specialized machinery, and disbelief is sufficiently suspended. Your subconscious feeling brain, however, is more suspicious and uncompromising. It has different standards for safe which influence the body in a very real, physiological way.
Without any of the calming subconscious cues of safety that tell your feeling brain to relax and produce good hormones conducive to safe and healthy birth, people will still have their babies, but often under greater conditions of stress. The result is they will be much more likely to have complications such as high levels of pain during labor, and they will more often develop postpartum mood disorders including PTSD.
One in thirteen women are now experiencing PTSD postpartum because their birth was intense, particularly due to the way they felt treated. As Jessica Austin points out in Pathways 60, “having medical procedures done without proper informed consent or the opportunity for refusal is commonly what leads to women’s feelings of ‘helplessness, fear, and horror.'” Even in cases where there was no explicit trauma during delivery, trauma results from being treated like a medical experiment rather than a human being.
When stern authority figures perform medical procedures or make decisions about you without talking to you openly first, your feeling brain interprets it as danger. Anytime someone touches your body without warning, and this applies to sensitive parts of the body during birth, it triggers your nervous system’s sympathetic fight or flight response.
This happens everyday in hospitals due to protocols overstepping informed consent and human dignity. Is it any wonder some birthing women feel traumatized?
Safe, physiologically normal birth happens when the environment is safe and mom feels safe. She needs a way to calm her own mind, and the people who are with her during her birth need to appreciate the gestures, expressions, and overall embodiment that communicates to the deepest part of her: “You’re amazing, we’re here for you, you can do this, everything is alright.”
Only then will her whole body know: It’s safe to open up.
Lauren is a childbirth educator (Birth Boot Camp) and the author of the Breech Baby Handbook. She owns Better Birth Graphics, a shop full of practical, intuitive birth media for professionals. Her work has been published in Mothering, Holistic Parenting Magazine, Birth Issues, True Birth, Mama Birth, and elsewhere. She lives in Maryland with her family of five.