Imagery of pregnancy and motherhood surround us, with expectant mothers holding their bulging bellies and appearing to be filled with love, hope, and anticipation. Other photos of new mothers looking into the face of their child with a certain kind of love and fulfillment associated only with the connection between mother and baby also tell us what we should be expecting in the transition into parenthood. A visibly pregnant woman often becomes the object of projected nostalgia for those whose years with young children have passed. Strangers approach with pressured questioning and statements: “Don’t you love being pregnant? I loved it!” This follows with highly personal, socially loaded questions and unsolicited opinions such as “Are you going to find out the sex of the baby? Are you going to work or stay home? Really you shouldn’t work; a child needs its mother. Are you going to use pain medication? Women should really experience having their baby without drugs. That’s how it used to be.” Following delivery, there are similar statements and questions; something along the lines of “relish every moment” or “isn’t it so fun and amazing?”
Often times, these projections land on the right woman and reflect some or all of her pregnancy, labor and delivery, and mothering experience. The process of pregnancy and delivering a baby happen many times per day all over the world. The connection between mother and child that follows also occurs with regularity and is an accurate reflection of experience. However, the transition into motherhood is the only human event that is simultaneously miraculous and mundane. It may feel safer and simpler to acknowledge the beauty in it and forget the occasional terror and darkness that are also real.
Modern medicine has clearly influenced the both the survival rate of women and newborns as well as mitigated associated challenges. Women have a variety of choices, and having a baby has turned into “an experience” that can be designed by pain management, home deliveries, or scheduled cesarean sections. Each approach seems to make a significant statement about values, identity, and parenting philosophy. It seems plausible that in this process we are attempting to distance ourselves from how animalistic birthing can be by turning it into something luxurious that we have control over. The truth, though, is that ultimately this process is out of our hands and has the capacity to go completely awry. Mothers whose experiences do not fit into the ideal (meaning their pregnancies were not pleasant or were dangerous, their deliveries were frightening or overwhelmingly painful, or something happened to their baby) find themselves in a position commonly associated with being a trauma survivor; they are alone.
The juxtaposition of pressure to have a perfect pregnancy, a perfect (and courageous) delivery, be a perfect mother, and relish every second alongside the prenatal or postpartum trauma is a true collision of opposing experiences. Our bodies were meant to deliver babies, but sometimes they don’t work. Sometimes the body fails us, and in an effort to avoid the possibility that something as commonplace as childbirth could be out of our hands, it becomes simpler to ask the mother what she did wrong, to ignore her pain, or to impose our expectations of how it’s supposed to be.
How does a mother contend with holding a baby for whom she is supposed to feel overwhelming love but for whom she instead feels nothing? What if her only fantasy is of escape versus of building a life with her child? What if she feels rage toward the baby? What if she is consumed by flashbacks and nightmares or replays chunks of pregnancy or delivery repeatedly in her mind? Her task is to absorb the projected experiences of maternal love and somehow integrate this information with how she is feeling in the moment. A possible comparison might be something like having been in a terrifying car accident and having the world tell you to enjoy it, seize the moment, and hold on to every second of it. Should you be incapable of doing so, there must be something wrong with you. You didn’t do it right.
My goal here is to attempt to increase sensitivity to the complexities of birthing and the coinciding responses to it. A woman’s response to the birthing experience is multifaceted, even when there are no complications; with them, it can be devastating. As therapists, treating postpartum depression may require treatment of prenatal or delivery trauma. As members of our society, we need to honor the range of possible experiences while offering nurturance to the mother as well as the child to provide open space for healing, possibility for connection between mother and child, and a smaller gap between expectation and experience.
Related articles:
How Trauma Impacts Your Sense of “Me-ness” – Part I
When the Bough Breaks: Resources for Overcoming Perinatal Loss

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