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One Important Thing. In 2022, Iranian women protested for their freedom. Now, girls are being poisoned, and the hardliners are engaged in a brutal crackdown to quell dissent. If you posted to social media in support for the protests, please care enough to keep up on the ongoing struggle.
Jezebel is out with an article asking why women aren’t told the “full truth” about pregnancy and childbirth. This is a topic I have thought about a lot since Sloane was born.
Six days after her birth, I was readmitted to the hospital and nearly bled to death in the ER waiting for treatment that no one was in a hurry to give me. It was scary, and terrible, and the cherry on top of a hard pregnancy. Six months later, my body is just barely healed. My mind is not even f**king close.
But strangely enough, I was prepared for it. Not by a doctor, or a friend, but by Hannah Jeter who talked about her own post birth complications in The Captain, a documentary about her husband Derek’s career in baseball. Because of her, I didn’t wait to go to the hospital, I didn’t let them discharge me when they wanted to, and while I was traumatized by the entire experience, I wasn’t surprised by it. I was almost anticipating it. Which made the experience all the more strange.
From my vantage point, there are three reasons women aren’t prepared for this experience: 1) A medical establishment that seems painfully disinterested in the science of women’s bodies, and appears more than happy to maintain maternal mortality rates double most western nations (and even worse for Black women); 2) Not having gone through the experience before, I had no idea what questions to ask my doctor, which made getting advice a challenge; and 3) The experience is so different from woman to woman, sharing stories can be helpful, but often isn’t. For example, I spent months preparing for a c-section that I ultimately didn’t need.
So what do we do for each other? First, I think we need to share our stories, but we also need to listen. Whenever I tried to ask a few of my friends for advice, they would jump in with answers to questions that I hadn’t asked and talk over me. Eventually, I stopped asking most of the women in my life for their thoughts because their experience, not how to offer support to mine was their focus. I don’t blame them for this, since pregnancy and childbirth becomes such a monumental part of your life story, but it made getting help really difficult.
Second, if you’re an OBGYN or a midwife or a hospital admin, could you make the OB appointments longer than 15-minutes? I tried three OB practices, and they all felt like baby factories. There was no nurturing, no time for questions, no support. Just walk in, lay down, hear the heartbeat, tell me how you’re feeling and go home. Compared to my IVF experience where everyone was really kind and patient and supportive, it was a real let down.
Those are my suggestions, I would love to hear others. Because while I agree with much of what is in the article, I don’t think women are failing other women. Instead, we’re all literally just trying to survive an experience that often feels off the rails.
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The points about pregnancy and childbirth have been on my mind too. Now that I’m three months into therapy to process the general trauma around it.
I think one problem is that the universe of complications is so large and varied that in order to get prepared for that universe, you’d have to listen to nonstop horror stories. If I’d had a button I could press to have friends with placenta previa, low birth weight baby, c-section, c-section discovery of endometriosis, and PPA and PPD, tell me their experience, That would’ve been great. But I really didn’t want to hear all the other things that could’ve possibly gone wrong. Even now, hearing about low lying placentas that resolved before birth are triggering. Because mine never resolved.
I think I had good prenatal care, and my OB answered all my questions no matter how hypothetical and fear based they were. But it was all still pretty awful, all things considered.
No solutions, just more problems.
And to be clear, I don’t regret it. And I will in all likelihood have another child if possible. I don’t feel like I was duped into motherhood. I don’t like that suggestion, because despite the fact that I was blindsided about aspects of pregnancy and childbirth, doesn’t mean I was tricked into it. I’m too smart for that, as are all women.
Hi Abra,
I appreciate you being so open with your fertility and pregnancy experience. Oddly enough, I was in a similar situation and was ALSO prepared for it – because it happened less than a month after you wrote about it. I had a miscarriage and started hemorrhaging a week later. It was almost identical to your experience, right down to being ignored by my clinic when I called, not being taken seriously at the hospital, and literally almost dying from blood loss before anyone at the ER paid attention to me. At one point the ER doctor laughed at me for coming in and said it was just a miscarriage. The state of health care in this space is appalling and thank you for telling your story. If you hadn’t, I’m not sure I would have bothered to go to the ER at midnight and fight tooth and nail not to be sent home. My experience was still awful, but I at least was at the hospital where I could get oxygen and an IV when I eventually passed out. It’s tough to view this experience in any sort of positive light but I hope if people keep telling their stories and advocating for themselves we can eventually stop this from being the norm.
From the article: “Sometimes I wonder if all this knowledge is kept from us deliberately because of the belief that if more women knew the truth about giving birth, very few would actually want to do it, and our catastrophically low birth rate would drop even lower.”
THIS. This is the answer. Silence on the dangers of pregnancy and childbirth is a larger cultural problem, because the current American economic system needs women to give birth to future exploited workers. Thanks, capitalism!
Strongly agree with this. I think a lot goes back to the centuries-old idea that women are disposable property, and if your wife died in child birth, you get a new one
I have one child and am having a lot of difficulty considering a second – sometimes a war horse is only good for one charge.
Sorry, I submitted an earlier comment with this same sentiment (which ended up below), but didn’t see it so I re-submitted. So, this is a repeat. Whoops!
The Hulu show Fleishman is in Trouble did a really good job, in my opinion, of showing trauma during and after labor. I was fortunate to have a pretty easy pregnancy but the postpartum depression was real and I even tried to talk myself out of my feelings on occasion, thinking it wasn’t as severe as others I’d read about.
I’m so sorry this happened to you. I had my own birth trauma and postpartum mental health challenges, and it is really brutal.
When you are advocating for longer appointment times, please please please direct your voice at insurance companies (they control reimbursements) and your members of Congress. I promise that the physicians and nurses at your OB office would love to have visits longer than 15 minutes. I say that as a physician who left clinical practice because I could no longer provide the kind of care that patients deserve. I’m not sure that most Americans realize the extent to which our healthcare system is undergoing a slow collapse. As a country we committed to a free-market, for-profit solution to healthcare, under the belief that competition produces the best product. For-profit healthcare forces healthcare systems to maximize productivity, which results in things like 15-minute doctor visits and clinics that are run like assembly lines, all in the name of efficiency.
So well said – thank you for calling this out! Physicians are at the mercy of a system that is not set up to allow them to give the best care, and it’s killing people.
I work in health policy. This.
Twenty years ago when I was trying to get pregnant with my first child (who is now 19), I read the book “Misconceptions” by Naomi Wolf. I told anyone that would listen to me that this book should be required reading for young women starting in the path towards motherhood. There are no easy answers, but at least this book exposed truths that need to be shared in the open.
Strongly agree with the this statement. I think a lot of it dates back to women as basically disposable property – for centuries the view was, oh no, your wife died in childbirth? Well, the woman’s primarily value is to make heirs, so no worries, nothing that could have been done, there are more 18yos to marry.
I think if we knew what we were getting into, many would not do it. I have one child and, despite my husband’s preferences, I dont know if I want to go for a second. Sometimes a war horse is only good for one charge.
I struggle with this as well, as I had a complicated delivery. It drives me nuts that people act and make public policy as if pregnancy/childbirth are no big deal (or that an emergency c-section is the only way things can go wrong) – but at the same time, what are women supposed to do, broadcast to people the specific problems they suffered that are, shall we say, not appropriate for polite conversation? No one wants that visual! Similarly, I learned only after I announced my pregnancy that many of my friends suffered various types of pregnancy / childbirth complications that they hadn’t felt comfortable describing except to other women who had gone through it or were about to go through it. But even that keeps all that knowledge internal to women who have had children.
I’m rambling, but I guess I’m saying I’m torn between shame at the idea of disclosing what happened to me versus wanting people to be aware that even in 2023, having a baby can be dangerous and cause long-term health problems, and that it’s not even that unusual.
I completely agree with your suggestions. I ended up on hospital bed rest at 24 weeks due to preterm labor with twins. I learned afterwards that what I thought was baby movement was actually contractions. No idea. I wish someone would have told me all the complications that could happen – carpel tunnel, constipation, morning sickness the whole pregnancy until after delivery, what contractions felt like (they are mild at 23 weeks). And I was at a high risk doctor. I learned during my hospital stay that pregnancy is the most dangerous condition a woman goes through. I was expecting pure bliss and a healthy baby at the end of it. I also agree with your point about feeling like you are part of a factory. Especially after delivery. Once the baby is out your purpose is over and that was clear with the way I was treated post partum. Thanks for sharing.
I read your postpartum story and was pretty angry on your behalf. I understand what you mean by saying that you feel prepared for it, though. I felt like I heard so many women talk about being dismissed or was told that doctors act like you don’t matter after delivery. I’m not sure if it made me feel better to be mentally prepared, or worse, in that I had a birth injury and felt like nobody cared even prior to giving anyone a chance to care.
I heard all kinds of stories about birth before having kids but nobody ever told me about my injury (pelvic organ prolapse, a total W T F injury to realize you have). I read so many books and in hindsight, none of them even mentioned things like diastasis recti or prolapse. I wonder why not? Pretty much everyone gets a diastasis. Two different specialists told me that mild pelvic organ prolapse is extremely common and many women don’t know (and aren’t told) that they have it. When I was pregnant I learned about some risky things like avoiding abdominal coning online, but why are women learning this stuff via social media instead of through legitimate medical sources or even books? It’s like nobody cares about your quality of life as long as you don’t die. A lot of insurance doesn’t even cover pelvic floor physical therapy.
I understand your point, but I had the opposite experience with the information I received. I feel like I only ever heard the stories where things went (sometimes very) wrong, that I wouldn’t sleep, that breastfeeding would be terrible to impossible, that I wouldn’t love my baby right away, etc. and it sucked so much of the joy out of my first pregnancy for me (even though I’m usually such an optimist). I think there has to be a balance of informing people about the things that can happen while also leaving space for positive stories.
(I will say not everything was smooth sailing, but I had a wonderful OB team, hospital, and pediatrician, which is really lucky and privileged, and I am sure feeling that support made a huge difference in my view when things came up.)
I am fortunate to have two experiences giving birth, and the adjustments I made after I birthed my first kid made all the difference with my second.
I had prenatal depression and birth trauma with my firstborn, who arrived via c-section after a failed induction. When I become pregnant with my second child, I was hell-bent on vaginal birth, switched practices to a midwifery/OB collab practice, and ended up with the VBAC of my dreams. Sometimes I feel guilty how I felt after my daughter, it was my fault I couldn’t “push her out”, and my postpartum phase was colored with grief over my traumatic birthing experience. Remembering how my son joined the world feels me with remembered pain (I didn’t know epidurals could fail..) but also immense pride thinking of how I was on all fours, and pushed his sweet little head out of my body through the ring of fire. I’m not sure what my point is, but I agree all mothers walk this world with seen and unseen scars. It is wild how pregnancy and childbirth are simultaneously the most metal experiences, but also considered normal. Women are warriors as we walk this tightrope of life and death.
I’m so glad you’re talking about this, Abra. And I’m so, so sorry you went through what you did.
I do not have children, but through the luck (or unluck) of the draw, I’ve had family members and close friends experience myriad painful and dangerous pregnancy and childbirth complications, or outright tragedies. An incomplete list of things I have been close to includes hyperemesis gravidarum for all 9 months of pregnancy, late-term miscarriages, full-term stillbirths, vaginal prolapse, 3rd or 4th degree tearing that did not heal and was treated callously by medical professionals and resulted in months-long infection, baby appearing not to have a heartbeat at birth necessitating a NICU stay, hemorrhage … and those are just the things my friends told me. And to your point, no doctors ever brought up any of this to me.
Neither did doctors pay attention to my own gynecological symptoms for decades — it wasn’t until I was worried I might have cancer that tests revealed endometriosis and uterine fibroids, all of which would have been much easier to treat had it been caught 10-20 years earlier.
Not gonna lie, all this does play into my decisions so far about whether to get pregnant. I make those plans assuming it it quite possible for me to be incapacitated throughout pregnancy and for months afterward. I also assume I will have minimal proactive support from the medical profession and will need to raise hell to get the care I need.
Things have got to change.
One thing that I think the article misses is that a lot of the reason we (professional women) have such a steep learning curve on motherhood is because we’ve chosen to spend our time in very child-free spaces. Universities, offices, conference rooms and courts are not the places that you see the physical realities of childbirth and parenting. This life takes us out of a setting where we are close enough to other people with kids often enough that we can get a feel for what it’s like.
Motherhood is also the giant speed bump that forces us to realize that we’re actually NOT on equal footing with the men at home or at work. It’s maddening.
I don’t know how you fix maternal health care without fixing health care in this country. Abra mentions good care for IVF but I bet that’s an exception not the rule bc it’s very expensive and quasi private. Do folks have other great experiences with health care in this county?
I’ve spent quite a bit of my recent time thinking about the Pregnant Workers Fairness Act, which took a decade to pass but passed in December. Prior to its passage, employers literally denied pregnant workers stools to sit on for reasons so inane as, we don’t think customers should be standing while our pregnant worker sits. I say this because I think the lack of understanding and respect for pregnant people, mothers, really women in general, permeates our society in so many ways, and we often learn after the fact that our experiences are not unique in these areas. I’m in the camp of advocating for systemic changes – more funding for research, changes in the way medical professionals are educated (and perhaps held liable), changes in insurance structures. As a new mom, I think more these days about electing people who have gone through the experiences of childbirth and child-rearing and pushing our elected officials to legislate based on our priorities as childbearing people and parents, particularly working parents.
Somewhat related, have you considered a post about your IVF experience, lessons learned, and recommendations/advice?