by Rachel Warner MAT, ATC, LAT

Every mother experienced it at least once, and I don’t typically make absolute statements. Whether it was said by a health care provider, a friend, coworker, or a family member, every mom has heard it. 

“An insult disguised as a clinically relevant question.”

For me I was sitting in L&D for the 3rd time at 36 weeks pregnant in so much pain I swore I was going into labor this time. Literally fetal position, stabbing pain, couldn’t make it down the stairs, called 911, the whole nine yards. In walks the resident. She briefly glances at the strip, and tells me I’m not in labor followed by that condescending look. That’s when she says it, “this is your first one, isn’t it?” An insult disguised as a clinically relevant question. She could have seen that in my chart, had she bothered to look, at this point I’m convinced she hadn’t. 

“This is just ONE of my stories, and I’d be willing to bet every mother has at least one.”

She was right, it was my first child and first pregnancy. However, that fact did not eliminate my gallstones she had missed because she failed to order diagnostic imaging or the intrahepatic cholestasis of pregnancy (ICP) that nearly cost me my son and resulted in an emergency cesarean birth 2 weeks late. My inexperience did not negate my concerns for mine or my child’s health. This is just ONE of my stories, and I’d be willing to bet every mother has at least one. 

I am talking about those comments made by friends and family, medical providers, acquaintances, or even perfect strangers. The comments that plant that seed of doubt. Whether you are a first time mom or a battle test pro, it happens. It is always accompanied by a smug tone that makes you doubt all your instincts as a woman and mom-to-be. Occasionally there’s an “oh just wait” tacked on the end, or maybe a “when I had my kids”, or my absolute favorite, “oh you’ll change your mind.” 

The comments are typically well intending, but come off like a punch to the gut. Moms from the very beginning are sold some contradicting advice, “trust your gut, oh, but not about this.” But maybe, if we took steps to educate moms instead of embarrassing them, understanding them instead of questioning them and assisting them instead of opposing them, we’d have fewer women walking away with birth related trauma. 

Yes, the hormone fluctuations can send anxiety into overdrive during the antenatal and postnatal periods. Moms can at times be a bit tough to reason with, we go on the defensive. Can you blame us? America is the only developed nation with an increasing maternal mortality rate, it has more than doubled since 1987. Oh, and if you’re an African American woman, your mortality rate is 3.26 times greater than white women, according to the CDC.  

A small study of 40 mothers, by Beck, found that birth trauma is truly in the eye of the beholder. “Mothers perceived that their traumatic births often were viewed as routine by clinicians.” Other studies have gone on to confirm this finding and recommend implementing assessment and counseling strategies to determine a mothers risk of developing PTSD or other trauma related effects.  

See it isn’t just an off handed comment or necessary clinical question. It is a systematic tendency to negate a mother’s needs or concerns. Practitioners all over the world are simply doing their jobs while women are bringing life into the world. What is an emotional, sensitive, and irreplaceable moment in a woman’s life, is just another day in the office for the birth attendant. This disconnect, in my very humble opinion, leads to anxiety and discontent for mothers surrounding their antenatal, delivery, and postnatal periods. 

So what’s the solution? Ideally it would be a system to screen women to determine the most vulnerable and provide them the support they need to cope with trauma and anxiety surrounding fertility, pregnancy, delivery, and motherhood. Not just a quick questionnaire at a newborn appointment, but regular check-ins for mom by mental health professionals. It would be medical professionals that ask questions and actively listen for concerns.

So what do you do while we wait for those things to be put in place, for the broken system to improve? 

  1. Enlist your partner or another safe person to help. If you become overwhelmed by your anxiety, and moved to tears when bringing up your concerns, that’s normal. Consider discussing your concerns with a safe person prior to the appointment. They can be prepared to speak for your, or the rehearsal will make expressing your concerns easier. 
  2. Request a second opinion. This is always your right. If your health care professional is not providing the care you need, seek a second opinion from another qualified health care provider (not just your favorite mom group). 
  3. Write down your questions. If you tend to feel rushed, or suddenly forget all your questions during your appointment, write them down. Keep a running list during the weeks between appointments and bring them up when you are with your healthcare provider. If you feel rush consider sending the questions via the message system or through a nurse in the office. 
  4. Ask your OB-GYN or Midwife about local resources. Most hospitals have community groups and lactation consultants available. WIC can be a fantastic resource for those that qualify. Churches could be another source of community or support. This is a wonderful question to put out to a local online mom group.
  5. Lastly, find a village. Reach out when you are feeling anxious, alone, or just off. We all need a little help sometimes. 

Lastly, just know, whatever you’re feeling is valid. There is help out there, it is just a shame you have to look so hard for it.