By Ali Weatherford

(Trigger warning: discussion of maternal and infant mortality rates)

Or maybe you’ve heard this one, “Healthy baby, healthy mama. That’s what counts.” Are these platitudes true? I think they are absolutely true. But are they really all that matter?

Do Birth Plans Work?

Many people go into birth with a plan. You might have preferences and intentions that you and your care team work to make happen, but the reality is that in birth there are detours. Birth plans are a great way to get you prepared for labor and birth, and have many benefits, but they can not guarantee perfect outcomes.

Sometimes the detours are simple and easy to work around. Other times, they can be very scary and some people have an experience that feels not only like one that is not what they originally planned for, but one that can feel traumatic. Some people end up feeling like birth became a rip current that pulled them off their feet and underwater only to spit them out 50 yards down the beach. I’ve heard many women describe feeling out of control, confused, sad, overwhelmed, and guilty. They might be wondering, “What if I had done something different…”

Am I Wrong for Feeling Like This?

I want you to know that it is absolutely normal to be feeling and thinking ALL the thoughts and feelings you are having—the guilt and sadness, the confusion and feelings of being totally overwhelmed. It’s all so very normal, and it’s also specific and highly personal. It’s a very big thing that your body and brain and emotions are trying to process.

Even more, you might compare your situation to those of others and try to talk yourself out of some of these emotions by thinking, “Well, at least we are safe and healthy now.” That might be true, but it is also very true that a big thing happened and that your feelings are totally valid.

Those feelings, especially the guilt, do not mean that you deserve blame for anything. You did the best you could in each moment on this journey with the information and support that you had. You are here just because you are here, and NOT because you did anything wrong.

You may never know the reasons for everything, so it’s important to feel those feelings, let them move through and out, and then move forward knowing that difficult things just happen sometimes, and you are going to keep doing the next right thing as you know it. No one can do any better than that.

You might also be made to feel that you are ungrateful if you share that you’re not OK about your birth experience as long as everyone is healthy. You might feel pressured to shut up, shake it off and move on, ”At least I have a healthy baby.” When someone makes you feel bad about the feelings you are having, it’s usually not about you. They have their own issues that are coming up for them. They may have had a traumatic experience that ended badly, or maybe they never did and can’t understand what you might be feeling.

Use it for Good

Hopefully you can find some compassion for those people who aren’t able to sympathize. And hopefully you can find plenty of compassion for yourself. Compassion is a very positive feeling!

And remember that you’ve gone through difficult things before. For me, it helps to remember those times and recognize that I did get to the other side of it. I also like to remind myself that, in many ways, I am now better, stronger, and wiser for having lived it. This is one of those moments. You are already stronger and wiser, and you can get to the other side of this too.

Racial Disparities

The difficult emotions might be felt even more in certain racial communities. There are big disparities in care in the United States. The risks of pregnancy and birth are higher for black, brown, and indigenous people, and especially for black women. This is caused by a combination of factors, with systemic racism and implicit bias being the foundation of it all. This should not be happening. This is preventable.

For many of these families, finding out they are pregnant can bring an even greater range of emotions. They might be very happy to be pregnant and expanding their family. They also might feel afraid for their lives or their baby’s. So many more black families fear death as a result of birth than any other racial group, and with good reason. In this case, when they survive the experience, they might feel especially relieved and grateful. But does this mean that they received excellent care and feel completely positive about their experiences?

What to Do?

I encourage all families, and especially black families, to find a supportive care provider, maintain good prenatal care, hire a doula, take birth classes or educate yourself about labor and birth, and make a birth plan. I want everyone to feel empowered going into their birth. That should help you feel less afraid. It’s important to understand your body and your options, and it’s important to have support and an advocate.

It’s About More Than Just Survival

I also want ALL families to have the expectation that they will more than just survive their birth experience. You can and should expect more. Birth can be a positive experience, even when things don’t go exactly as planned. When it’s not a positive experience, it is your right to question that, remembering that it was not your fault. What went wrong? Were there missing pieces in your care? Were you given true informed consent at every step? Do you feel like you were not just a patient, but a true partner and leader in your health care? It’s important to ask those questions out loud. I recommend talking to your providers, and also using the Irth App to share your experiences, good and bad.

And please try to remember this. While there can be other complications, most everyone does survive pregnancy and birth. It’s true that the United States has some of the highest maternal mortality rates in the world compared to most high resource countries. And mortality rates are more than doubled for black families than for white non-hispanic families, and this is unacceptable.

But for your peace of mind, remember that the absolute risk for mortality is still very small. For black women, the risk of death is .05%. For white women, it’s .019%. So, while there is some risk, and there is increased risk for black women, it does not mean that you are most likely to have a bad outcome. You are most likely to have a good outcome.

It’s important to maintain this perspective, so that you can enter your birth time with more confidence and peace. High levels of stress can contribute to complications, and that is definitely not the goal. Keep this perspective while you educate yourself and build your excellent care team. This kind of preparation will help you navigate your labor and birth with more presence and resilience and will also help lower your risks.

We all want healthy bodies and healthy babies, and we all deserve that and more. You deserve to survive and to feel good about your experience.

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About the Author

Ali Weatherford, ICCE is the manager of Parent Education at Breastfeeding Success and a childbirth educator certified by the ICEA. She has also trained with Birthing From Within™, DONA International, Spinning Babies™, and regularly attends annual conferences and training related to childbirth education, perinatal mental health, and more because she will never be done learning! She has a BA in Psychology with a background in research and writing. When she’s not teaching and learning about birth, she’s probably cooking and hanging out with her two wonderful kids and many pets at home in Austin, TX.