evidence based care

Condescension and Dismissal in Pregnancy and Birth

Being a doula and someone who cares about the emotional, informational, and physical support a birthing person receives, so many of the Lexington, KY, moms’ group Facebook posts about pregnancy and birth light me up! Like right now, I’ve got that temples-about-to-burst feeling from reading through a post about how to manage discomfort in labor without an epidural. A couple commenters wrote that their providers reminded them that they wouldn’t receive a medal for unmedicated labor and that they should do what’s “easiest” and not try to be a superhero. The condescension in those remarks is repulsive.

The overused comment about a medal for forgoing pain medication does not even make sense and is demeaning to all birthing people. One choice doesn’t get some sort of reward that the other does not. Both are valid and can be the best option for any individual or situation.

Anyone who dismisses your preferences or belittles you for the decisions you make is not providing respectful care. In labor, as in every other moment of your life, it is your body. When you are pregnant or laboring, you don’t suddenly lose control over making informed decisions about yourself and your baby. 

A respectful provider should listen to and answer your questions. Yes, they know more about pregnancy and birth than you do. They study and train and practice their work for years. They can understand your medical history and determine your and your baby’s health. But what they are not is YOU. You are a unique human being with experience, values, and thoughts that they may not ask about or may not understand (or that you choose, for one reason or another, not to share). Expecting this level of care is not unreasonable and there are midwives, OBs, and family practice doctors in our area who provide it.

If your provider is demeaning or doesn’t take time to answer your questions, that’s likely the type of care you’ll receive during your labor and birth. And if a friend, family member, or stranger is going to make judgments about you based on your choice to receive pain medication, they’re probably not the ones to go to for advice or pregnancy support. I have seen firsthand how much the birth experience affects the emotional well-being of the birthing person and their family immediately postpartum and months/years afterwards. Please take time to create a birth team that will meet your needs and provide respectful, evidence based care. You are absolutely worth it.