The Most Underrated Birth Prep
This weekend, I sat across from two brand-new mothers.
Both had given birth to their first babies within days of each other.
One had experienced a birth that, on paper, sounded incredibly difficult. Labor was long. She was exhausted. Pushing lasted for hours.
And yet, as she told me about it, she glowed. She felt strong and supported. She remembered the people around her encouraging her, explaining what was happening, and helping her keep going. It had been extraordinarily hard…and she was extraordinarily proud of herself.
The other mother had experienced what, from the outside, many people would call an "easy" birth. Things progressed smoothly. There were no major complications. Her birth preferences were largely honored.
But when we talked about her birth, she cried.
She felt hurt by some of the interactions she'd had during labor. There were moments when she hadn't wanted what was happening but couldn't bring herself to say so. She had fallen into an old, familiar pattern: It's fine. Don't make trouble. Just go along with it.
Now she was replaying those moments over and over.
And as I drove home, I couldn't stop thinking about the contrast.
A Hard Birth Isn't Necessarily a Traumatic Birth
We often talk about birth trauma as though we can identify it by looking at someone's medical chart.
Emergency cesarean?
Traumatic.
Long labor?
Traumatic.
Five hours of pushing?
Definitely traumatic.
Short vaginal birth without major complications?
Successful.
But human beings don't experience birth as a list of medical events.
We experience it from inside our hearts and minds.
And research on birth trauma reflects this:
What physically happens during birth does matter. Emergencies, interventions, severe pain, and complications can increase the risk of a traumatic experience…but they aren't the whole story.
Again and again, women describing traumatic births talk about something else:
I didn't know what was happening.
No one listened to me.
I didn't feel like I had a choice.
Things were being done to me instead of with me.
I felt completely out of control.
I was scared.
I felt alone.
Conversely, an objectively difficult birth can still be experienced positively when someone feels safe, supported, informed, respected, and involved in what is happening.
The difficulty of your birth and the way you experience your birth are not necessarily the same thing.
And I think that should fundamentally change the way we prepare for childbirth.
We Spend So Much Time Preparing for the "What"
Most birth preparation focuses on what you're going to do.
Practice your breathing.
Learn labor positions.
Buy the birth ball.
Make the playlist.
Write the birth plan.
Learn counterpressure.
Pack the hospital bag.
All of those things can be useful, of course, but I think there's another kind of preparation that deserves at least as much attention:
What happens inside you when you are overwhelmed?
Do you get quiet?
Do you become irritable?
Do you cry?
Do you freeze?
Do you immediately defer to authority?
Do you start trying to make everyone else comfortable?
Do you say "that's fine" when something very much does not feel fine?
Labor isn't likely to be the moment when those patterns magically disappear. If anything, exhaustion, pain, uncertainty, vulnerability, and stress can make our oldest coping strategies come roaring back.
That's why birth preparation isn't only about learning what your pelvis is doing or memorizing comfort measures. Some of the most important preparation happens much deeper.
Before Birth, Learn How to Find Your Voice
If you're pregnant (especially if you're anxious about birth), I want you to spend some time thinking about this NOW.
Ask yourself:
What do I do when I feel overwhelmed?
Think about situations completely unrelated to birth.
When you're uncomfortable with something a doctor says, what happens?
When someone with more authority than you recommends something you don't really want, do you ask questions, or automatically agree?
When you're scared, can you communicate that?
When you're unsure, are you comfortable saying:
"I need a minute."
"Can you explain why you're recommending this?"
"What happens if we wait?"
"I'd like to talk about this privately before deciding."
Or even simply:
"No. I'm not comfortable with that."
Those are birth skills, and in my experience they're every bit as important as knowing how to breathe through a contraction.
Your Support People Need to Know This About You, Too
Then have this conversation with whoever will be in the room with you.
Not just:
"Here's my birth plan."
Tell them:
"When I'm overwhelmed, I tend to shut down."
"When I start saying 'whatever you think,' that's usually a sign that I'm scared."
"I tend to people-please when I'm uncomfortable."
"If I get really quiet, please check in with me."
"If things change quickly, I need someone to slow down and explain what's happening."
That information may be far more useful to your partner or doula than knowing which position you planned to push in.
Because plans, almost inevitably, change. Knowing you doesn't.
Misunderstanding the Role of a Doula
A doula isn't just someone who shows up when you're in labor with a bag of massage tools!
Some of my most important work happens long before contractions begin.
We talk about how you make decisions, what you're afraid of, what matters most to you behind all the nitty gritty details of interventions.
We dive into how you communicate when you're stressed, what informed consent actually looks like, what questions you can ask when the plan changes, how your partner can recognize when you're struggling, and how we can create enough space in a stressful moment for you to remain part of the conversation.
But there is something I need every pregnant person to understand:
A doula cannot guarantee that you won't experience birth trauma.
A doula cannot read your mind.
I can notice.
I can ask.
I can remind you that you have options.
I can help you understand what you're being told.
I can ask whether you'd like a moment to think.
I can help your partner remember the conversations we had prenatally.
But ultimately, I am there to support your voice, not replace it with mine.
And none of this means that if you freeze, comply, or cannot advocate during a frightening situation, whatever happens afterward is somehow your fault. It isn't! Your medical team remains responsible for obtaining informed consent, communicating clearly, and treating you with dignity and respect.
Self-advocacy is not about taking that responsibility away from them. I want to give you as many tools as possible to remain connected to yourself when birth becomes intense.
So If You're Scared of Giving Birth...
By all means, learn the positions, practice the breathing, make the birth plan, take the childbirth class.
But don't stop there.
Learn yourself!
Notice how you respond to stress.
Practice asking questions when the stakes are low.
Practice saying, "I need more information."
Practice tolerating the discomfort of disagreeing with someone.
Talk honestly with your support people about what you need when you're overwhelmed.
Because you cannot control exactly what will happen during your birth, but you can walk into that room knowing yourself better.
Knowing your options and how you want to be communicated with.
Knowing what helps you feel safe.
And surrounding yourself with people who know those things about you, too.
Those are skills you won't leave behind at the hospital…you'll carry them straight into parenthood.
If you're preparing for birth and realizing you want more than a list of positions and a birth-plan template, this is a big part of the work I do with families prenatally. My doula support and private childbirth education include preparing for the human side of birth: decision-making, communication, advocacy, coping with uncertainty, and helping your support team learn how to support you.
If you'd like help doing that work before your baby arrives, I'd be honored to walk through it with you.
Further Reading
For Parents
If this article has you thinking differently about how you want to prepare for birth, these resources offer thoughtful perspectives on informed decision-making, communication, and the emotional experience of childbirth.
Babies Are Not Pizzas: They're Born, Not Delivered by Rebecca Dekker, PhD, RN
Part memoir and part exploration of maternity care, informed consent, and evidence-based decision-making. Dekker, founder of Evidence Based Birth®, explores how the way people are treated during birth can matter just as much as the medical events themselves.
Transformed by Birth by Britta Bushnell, PhD
A different kind of childbirth-preparation book—one focused less on trying to engineer a particular birth outcome and more on preparing psychologically for uncertainty, transformation, and the realities of becoming a parent.
Pregnancy, Childbirth, and the Newborn by Penny Simkin, PT, et al.
A comprehensive, parent-friendly guide to pregnancy and birth that combines practical preparation with evidence-based information about birth options, interventions, decision-making, and support.
Evidence Based Birth®: Advocacy, Informed Consent & Birth Evidence
Evidence Based Birth offers accessible articles, podcasts, and resources that help families understand maternity-care research and participate meaningfully in decisions about their care.
Peer-Reviewed Research
Reed, R., Sharman, R., & Inglis, C. (2017). Women's descriptions of childbirth trauma relating to care provider actions and interactions. BMC Pregnancy and Childbirth, 17, 21.
Watson, K., White, C., Hall, H., & Hewitt, A. (2021). Women's experiences of birth trauma: A scoping review. Women and Birth, 34(5), 417–424.
Ayers, S., Bond, R., Bertullies, S., & Wijma, K. (2016). The aetiology of post-traumatic stress following childbirth: A meta-analysis and theoretical framework. Psychological Medicine, 46(6), 1121–1134.
Hollander, M. H., van Hastenberg, E., van Dillen, J., van Pampus, M. G., de Miranda, E., & Stramrood, C. A. I. (2017). Preventing traumatic childbirth experiences: 2,192 women's perceptions and views. Archives of Women's Mental Health, 20, 515–523.
