Why birth matters

Penny Simkin is a physical therapist, childbirth educator and doula since 1968. She is a renowned speaker and writer on childbirth issues and the author of The Birth Partner: Everything You Need to Know to Help a Woman Through Childbirth (2nd edition, Harvard Common Press, 2001). “Although it all takes place within one day,” she says, “the way a woman gives birth can have a profound effect on her and her family.”

We asked Simkin to explore how and why the act of giving birth affects us.

The hours of contractions represent a crisis of sorts, bringing a woman face to face with the deepest and most intense physical sensations and emotional stressors she is ever likely to experience. And at the end of the day, she has gained permanent responsibility for a tiny, dependent, helpless human being.

In a sense, labour and birth take a woman to her core, to the deepest levels of her inner self — her “bare” self. She releases her outer shell temporarily as she sweats, moans, cries out, grunts and trembles. She is vulnerable as she opens herself to the forces of labour and to the actions and attitudes — positive or negative — of those around her.

As we know, the course of labour is determined to a great extent by physical factors, but psychological factors, such as her previous life experience and the emotional support she receives, are equally powerful. Early in her life she learned what the world is like — safe, stable and trustworthy or unsafe, unstable and untrustworthy. Her self-image was formed as she learned to cope with her world.

Labour and birth represent a stiff challenge to her self-esteem and a test of her survival or coping skills. Her learned ways of coping with pain and stress largely determine how she will respond to her circumstances in labour. Women who feel great satisfaction after birth feel they met the challenge and accomplished something huge; others, who are disappointed, regretful or angry, often feel they were overwhelmed, unsupported and unable to cope.

All women want and need encouragement, reassurance, respect and guidance throughout labour and birth, preferably from every person with whom they have contact during labour. They need to feel safe and protected. In fact, the studies of continuous labour support indicate that when these needs are met, psychological outcomes as well as obstetrical outcomes are improved.

Women carry the memory of their childbirths with them throughout their lives. Their self-esteem, self-confidence, their mothering, even their mental health can be profoundly and permanently affected by how they were treated during childbirth.

Though birth takes place in only a day or less, it carries too much impact to be approached casually. By taking her needs, preferences, and concerns seriously and communicating these to her caregivers, and by choosing loving, experienced, confident people to accompany her, a woman can help make her child's birthday one of the best days in her own life.