Things You’ll Never Hear Me Say as a Specialist Doula, Pt. 4
We made it to the end of this four-part series on things you’ll never hear me say as a doula who specializes in supporting folks who are pregnant after experiencing infertility, loss, birth trauma, or with medical complexities. I hope by now that those of you who have been reading along from the beginning have really taken to heart that while these are things that I never say in my practice for the reasons that I explain in each post, the doulas and other professionals who do say these things aren’t ‘bad’ or ‘wrong.’ I genuinely believe that almost every professional who works with pregnant people is out here doing their very best and making care decisions from a place of wanting people to be healthy and supported. We all have different ideas about exactly what this looks like, but I generally assume the best of people. And, likewise, each pregnant person needs something a little bit different from the people who support them. For some, my realist, hyper-nuanced perspective on pregnancy and birth makes them feel understood and empowered to face whatever their journey brings head-on – they know that I understand that things can be messy and I’m here with them through the good and the bad; whereas others might find my approach kind of a downer and they’d prefer to work with someone whose baseline is optimism. That’s okay. You get to choose. There are no wrong answers here as long as it feels good for you. This is your time – not mine, not another doula’s, not your doctor or your midwife’s. This is about you and your family. With that in mind, it’s time to talk about the last item on my list of things I don’t say in my practice so that you, someone looking for a birth doula in Calgary, can decide if I’m the right doula for you.
“(condition or complication) is so rare, you shouldn’t need to worry about it.”
Don’t we all wish that we could look into our crystal balls and predict with absolute certainty whether something is going to happen or not? I sure do. It’s completely natural and normal and human to want to be able to forecast if/when something is going to happen. Worrying about what the future holds and trying to predict or control it is our mind’s way of keeping us safe. If we know what’s coming, we can plan accordingly and do something to either prevent or minimize its negative impacts on us. And pregnancy tends to be one of those times in life when we feel that way even more than usual. Pregnancy is a liminal state – you’re no longer the person you were before you conceived and you now carry this precious life inside you that wasn’t there before, but that life isn’t necessarily ready to carry itself or exist on its own terms yet and you’re not yet the person that you will become. It’s a time of big transitions and changes, a lot of which can have you feeling like things are up in the air for months on end, waiting for your baby to be safe in your arms. Of course, not everyone feels that way. But if you do, you’re definitely not alone. And as care providers, we see people’s worries and anxieties and we want to make them better. We want you to feel safe and comfortable as you navigate this incredible change. And with all the research data we now have easier-than-ever access to via the internet, we feel like we have more knowledge to help us make those predictions about what the future might hold so that we can decide whether a certain scenario is deserving of our worries or not.
A hand holds a crystal ball, which shows the image of a tree with pink blossoms.
As you might foresee (ha ha), I tend not to do this kind of forecasting with my birth clients. Here’s why: 1) it doesn’t actually tell us whether you’re going to encounter a particular issue or not; and 2) it often doesn’t actually help us to address our feelings of worry or anxiety in any case. Let’s talk about these two things in more detail.
Looking at statistical probabilities doesn’t tell us whether you’re going to encounter a particular medical condition or pregnancy/birth complication. When we say things like “only 1 in 160 pregnancies end in stillbirth” or “preeclampsia occurs in 5-7% of pregnancies”, this information is based on statistical data that looks at how often something has already happened within a studied population. It tells you about what has happened in the past, which we use to try to make educated guesses about something that is going to happen in the future. Of course, different medical conditions or complications don’t exist in vacuums – they’re influenced by a host of other physical and social factors, any of which could change in the future to make these things more or less common than they were in the past. So, these frequency predictions are always just educated guesses, not guarantees. Additionally, while we can use this data from the past to see if there were any important similarities between people who encountered these issues before (for example, if we notice that people who had high blood pressure before pregnancy more often experienced preeclampsia in their pregnancies) to see if you’re in a ‘higher-risk’ category than someone else, these educated guesses can’t tell you for sure whether something is going to happen or not. Nobody wants to think about it – for very good reason – but someone is going to be that 1 in 160 or 1 in 20. Sometimes, there are things going on in our lives or our health histories that help our doctors to guess that it might be us so that they can monitor us more closely, but often there isn’t anything obvious that tells us whether that one person is going to be us. Now before we get carried away with the anxiety that this conversation might bring up, it is totally fair to also acknowledge that while we may be that 1 in 100, it’s even more likely that we’ll be one of the 99. When people try to offer reassurance about how rare something is, this is what they’re trying to point out to you. It makes sense why they do. But in my area of specialization, where I’m often working with people who have been the one in some aspect of their life or another (hello – I am a 1 in 160 and a 1 in 100 and possibly even a 1 in 100 of that 1 in 100), these numbers start to not mean very much. If you’ve been the 1 in 100 before, the numbers are no longer very reassuring even if, in the end, you don’t have to deal with any of those things you were worried you might have to deal with. This brings me to point #2.
A parent lovingly holds their sleeping child in their arms, a smile of peace and contentment on their face.
Reassurances that something probably won’t happen often don’t do as much to alleviate our fears as we want them to. So even if you have every reason to believe this rare complication or condition won’t happen to you because you have none of the supposed risk factors, that doesn’t necessarily mean that you won’t still feel worried about it if the seed of worry has been planted. When this happens, people telling you “oh, this only happens in x% of pregnancies so it’s really nothing you need to be worrying about” can feel more dismissive than helpful. Instead, we can take a moment to ask where your worry is coming from and hold space for what comes up. Maybe someone in your family has dealt with this issue before and so the possibility feels more real to you. Maybe it triggers fear or anxiety around a particular body part or sensation that you’ve had issues with before. Or, just as likely, maybe it’s the totally natural fear and worry that most parents develop at some point in their lives over how vulnerable their precious baby feels. It’s true for many people that being deeply in love with your baby also brings with it a lot of anxieties. That’s not to say that if you aren’t feeling anxiety that you’re doing it wrong (lucky you!) but most parents get anxious about their kids sometimes because they love them and they never want anything bad to happen to them. Trying to predict if something is going to happen so we can prevent or control it feels like a natural response to worrying that something bad is going to happen to someone we already love so much. In the end, we can’t predict if these things are going to happen or not. But we can acknowledge that feeling this way is a part of our story and explore how we can hold space for these difficult feelings when they show up for us. We can ask ourselves what kinds of supports we need while we’re navigating these in-between times. And we can use this information we get from exploring these issues with compassion and curiosity to develop skills and support systems that will continue to support us throughout our journeys. And if you are someone who feels reassured by those numbers, that’s okay too! If that really is something that helps you feel grounded and safe in the present moment, there’s nothing wrong about that whatsoever. On the flip side, if you’re that person who really feels like they need to talk about what happens if a bad thing happens, we can do that too. If this thing happened, what might your care look like? What kinds of supports might you want or need?
The point of what I’m trying to say can be simplified as this: I do my best not to offer simple reassurances to people, not only because I can’t actually know what is going to happen, but because I believe its important to be curious about why things are coming up for you and what is needed to show deep, genuine support for whatever those things are. I don’t ever want to be shutting down your feelings or creating a space where you don’t feel like you can be honest with me about what’s coming up for you. I can’t and won’t promise to have all the answers. But I can commit to sitting in the muck with you, even when it’s really hard. For me, that’s one of the most beautiful things about being a doula is being a compassionate witness for everything this journey brings into people’s lives. If that sounds like exactly what you want from your birth doula and you live in the Calgary area, you can set up a free virtual consultation here and learn more about my birth packages here.