Pregnant People Pleasers

 

if-you-keep-knocking-corners-off-to-please-others-you-lose-your-edge-1Have you ever found yourself entertaining 20 people for a dinner at your place, and yet you’re not entirely sure how it happened (as you stand madly peeling potatoes and seasoning them with resentment)?

Have you ever been more driven by guilt than desire to have a coffee with an old friend?

Have you ever kept a burning thought or idea to yourself because you were afraid of what someone else’s response might be?

If you’ve said ‘Yes’ to one or more of the above, and you find yourself generally saying ‘Yes’ to lots of things in life, then you, my friend, might well be a people pleaser… Which is fine, unless you’re also pregnant (or planning to be).

The problem with people pleasers

There’s not really anything wrong with people pleasers – those who go about life with ease and grace and generosity of spirit do make the world a better place. However, without firm boundaries, people pleasers do run the risk of being taken advantage of by smooth operators whose agendas are potentially less noble… And, the word ‘No’ is a very efficient way to set boundaries against such manipulation.

It can be an interesting task to ask oneself what drives people pleasing tendencies – i.e. what is one’s ‘reward’ for this behaviour? Is it the approval of others (to offset self-esteem issues)? Is it taking the path of least resistance (to avoid facing fear)? Does a cost:benefit analysis suggest it’s better to just please others than to instead say ‘No’ and please yourself?

Thought: If you keep knocking corners off in order to please everyone, you eventually lose your edge.

My suggestion to reflect upon the underling drivers of people pleasing behaviour is not intended to promote cynicism. It is, however, intended to prompt pregnant people pleasers – in preparation for making sound birth choices – to discern genuine, conscious acts of altruism from agreements offered out of insecurity, vulnerability and/or fear. Hasty ‘Yeses’ undermine even the best-laid birth plans, particularly when a woman’s decision to question standard care makes the word ‘No’ intrinsic to her journey.

Pregnant people pleasers

During the course of nine months, birthing women are faced with a series of decisions to make about models of care, care providers, birth settings, whether to wait for spontaneous labour, what to use for pain relief… And the list goes on.

In exploring these options, a pregnant people pleaser is very quickly surrounded by folks wanting to be pleased. Each one of the above decisions has a series of people attached to it: doctors, midwives and specialists who provide clinical opinions, receptionists who might be looking for easy bookings and enquiries, friends who have recommendations about birth settings, family members who have expectations about your role as a mother, mothers and mothers-in-law who might want you making the same choices they did, and one’s own partner might have their own birth preferences, too… And so this list continues.

Pregnancy and parenting is full of other people who need you to say ‘Yes’ to their opinions and ideas because that helps them to validate their own beliefs and authority. But, be careful – in aiming to please all of these people in pregnancy, your ‘Yeses’ to others might become ‘Nos’ to your own birth plans.

Start practising ‘No’

There are ample opportunities in your pre-pregnant life to start practising the art of saying ‘No’. That dinner party planned on your behalf? Just say, ‘No’. And, if you can’t do it, why not? Is it because you actually would like to see your friends, but you just can’t commit the time required to get your home guest-ready? Could your answer instead be: ‘No, let’s not do it at my place because that doesn’t really work for me – let’s head out for a meal instead’? Sometimes ‘Nos’ are easier to say when you have an alternative solution to offer.

saying-no3How about the person who gets angry when you say, ‘No’? Is their disapproval a reason to just say, ‘Yes’? Or is their response perhaps a fantastic example of their own short-comings? If you think you are about to say ‘No’ to someone who is used to saying, ‘Yes’, plan ahead of time for some additional support so that you are able to stand strong when you need to.

Sometimes ‘Nos’ might actually be more about a ‘Not now’ situation. Buying yourself time by explaining, ‘I can’t say yes to this right now, but would like some time to consider it’ is sometimes better than simply saying ‘Yes’ and realising later that you wish you hadn’t.

Saying ‘No’ to well-meaning family and friends

The dinner party at your place might be your family’s plans to throw you a baby shower. Similarly, the guilt-laced coffee with an old friend might be the sense of obligation you have to entertain long lists of visitors in your hospital room whilst they have cuddles with your newborn baby. Both cases are examples of well-intentioned actions which might make an outright ‘No’ tricky to manage.

If can’t simply say ‘No’, you will still need a different way to address unwanted offers if they are not part of the birth journey you are planning. The good news here is, however, that there is an element of being able to anticipate this sort of situation, particularly if you’re having your first baby (because your family and friends are probably going to want to be involved!).

So, be proactive and take control early! Get on the front foot and plan a mother blessing, for example, and then give your family members special roles for the afternoon. Alternatively, warn family and friends ahead of time that you are planning to have a private babymoon, and explain this to them, saying that you understand this might seem strange, but you look forward to seeing them on {insert day here} when you’re ready to introduce your new baby to his/her broader family.

Saying ‘No’ to a care provider

Because of the power dynamic, women often avoid upsetting their care providers because they are afraid that this will adversely affect the care they receive during pregnancy, labour and birth. What needs to be considered here, however, is how adversely a stream of ‘Yeses’ also affects one’s care… If care providers are not aware that you have an expectation of active involvement in making decisions about your care, they may assume you are simply happy to ‘go with the flow’ and make decisions on your behalf.

A ‘No’ with a care provider might be:

  • “No, I do not consent to that treatment.”
  • “No, I do not feel comfortable with that because I need more time/more information/another opinion, please, before I make my decision.”
  • “Thank you for your opinion about x, I really appreciate that you took the time to explain it to me. I have considered it and believe that I would like to continue with y instead.”

The AMA’s maternal decision making position statement supports a woman’s right to make informed choices and decline treatment.

And, if you feel you need support to be able to say no to a care provider at any point during pregnancy, labour and/or birth, don’t forget that you can ask your partner, a close friend, a doula or a student midwife to advocate your wishes on your behalf.

When you follow your ‘Nos’…

The beautiful thing about birth is that it doesn’t happen in a bubble – it is the perfect time to explore how one functions in life and to identify opportunities for positive change.

If you are a pregnant people pleaser, there is no harm in starting to practise using your ‘No’ muscle; in fact, with motherhood right around the corner (or an increased brood demanding more and more ‘Yeses’ from Mum), it’s a very valuable life skill indeed.

Planning an Empowered Caesarean Birth

This article was first published as ‘What If I Must Have A Caesarian Birth? Making It As Woman-Centred and Empowering As Possible’ on www.birthgoddess.com.au.

My Experience of Caesarean Birthmodern woman's guide_image

As a first-time mum preparing for a natural birth, I did pre-natal yoga, I memorised birth affirmations, hired a TENS machine and prayed for the best. One thing I did not do, however, is read the ‘Caesarean Section’ of the birth books on my bedside table. When the midwives set up a faux Caesarean birth as an antenatal education activity, I daydreamed about better things – my active labour, my drug-free experience of pain and my baby coming out of my vagina.

It therefore comes as no surprise that, when my normal, low-risk pregnancy ended in an ‘emergency’ Caesarean, I was totally unprepared, shocked and – ultimately – traumatised. While time, hindsight and more robust knowledge has shown me that my surgical birth was at best a statistic and, at worst, a medically unnecessary event [1], our first-born’s arrival Earthside changed the course of my life, and for this I am thankful.

Courtesy of that experience of birth (which was a crash course in being a savvy health services consumer!), I found a new calling connecting with mothers who are planning their ‘next birth after Caesarean’. In the five years since this birth, I have supported many women who have sought to make sense of their Caesarean births and assess the birth options available to them next time. I am always struck by the similarities of our stories: it is the shared nature of our experiences which allows me to share the following ideas for making the birth experience as positive, empowering and woman-centred as possible. Whether you are planning a Caesarean out of necessity or unexpectedly, you’ll see that there are lots of things you can proactively do to ensure the experience is the best possible one for you and your baby.

N.B. Please discuss the following with your partner, birth team and doctor – as always, make sure you seek medical advice from trained professionals and, if in doubt, seek a second or third opinion.

PLANNING FOR A POSITIVE, EMPOWERED CAESAREAN

Make the environment as comfortable as possible

–          Have your partner present. Ask the hospital ahead of time if you can have extra support people (such as doulas) present in theatre.

–          Take music to listen to as they prep you for surgery.

–          Ask for lights to be dimmed or directed away from your face. Alternatively, consider closing your eyes and visiting your meditation place.

–          Ask for conversation to be kept minimal and quiet or, if preferred, indicate your desire for a light-hearted, jovial atmosphere.

–          Ask your hospital if you can provide the receiving blanket for your baby.

Connect with your body and baby during birth

–          Request that the sheet is lowered so that you can see more of what is happening – this may make you feel more involved and less passive.

–          Ask the surgeon to give you a verbal commentary on what is happening to your body.

–          Ask a theatre nurse to raise your upper half slightly so that you feel more ‘active’.

–          Visualise your whole body during surgery – scan your awareness from your head to your toes and back again, filling every corner of your body with white light. Even though you will not be able to feel your lower half, mentally reminding yourself of your wholeness may help you to overcome any feelings of physical disconnection.

–          Research ‘maternally assisted Caesarean’ – this option may be available with some providers and may appeal to some.

–          Discover the sex of your own baby.

A physically mindful experience

–          If your Caesarean is elective, waiting until spontaneous labour begins before being admitted for the birth is one way to offer your baby some of the benefits of natural labour.

–          Ensure your surgeon performs a ‘lower segment Caesarean section’ (LSCS) – the lower segment is the strongest part of the uterus which means LSCS scars are less likely to rupture in subsequent pregnancies and births. (The upper segment is usually only cut in ‘classical’ Caesareans which are quite rare in Australia.)

–          Some surgeons flip the uterus outside of a woman’s body in order to complete the stitching of the incision – avoiding this method of closure can help minimise the feeling of internal bruising post-Caesarean.

–          Ask for stitches instead of staples, and discuss the advantages of a double layer closure for healing and future VBAC chances.

–          Request a Caesarean lotus birth – this is one way to ensure delayed cord clamping and these are possible.

Bonding with your baby

–          In the absence of foetal distress, many post-birth assessments can be performed on your chest (or later!). Ask those present to assist you to hold your baby so that you can enjoy skin-to-skin contact as soon as possible after birth.

–          Some hospitals routinely separate mother from baby, taking Baby to nursery while Mum is in Recovery. Ask ahead of time whether this is standard procedure at your hospital, and negotiate to have Baby stay with you instead.

–          Begin breastfeeding in Recovery. If this is not possible, arrange to express colostrum and have this fed to your baby.

A gentle babymoon

–          Whilst a Caesarean is a birth, it is also major abdominal surgery. In the excitement of birth, your recent experience of surgery can be quickly forgotten. If you had gone in for uterine surgery under different circumstances, you would take time out from home duties, accept offers of help and give your body time to heal. Caesarean birth is no different!

–          Give people things to do when they come to visit – folded washing, a mopped floor and a meal for the freezer are great ways for people to support your babymoon.

–          Invest in some SRC shorts, TubiGrip or shapewear – these can help to offer abdominal support when your incision site feels vulnerable. The Bengkung method of belly binding may also be beneficial once the initial tenderness of your wound has settled.

–          Rest, rest, rest. Plan to do nothing but breastfeed your baby and rest. (The rest can wait!)

–          Take your placenta home with you so that you can return it to the earth, giving thanks for its role in nourishing your baby.

–          Plan a ‘birth sealing’ ceremony to symbolically close your body after birth – this is a particularly useful exercise if your Caesarean has left you feeling open, vulnerable and/or disconnected physically from your body.

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[1] Whilst my ‘unnecesarean’ birth is a symptom of a system of maternity services which sections approximately one third of Australian women giving birth each year, there will always be a proportion of women and babies for whom a Caesarean delivery is genuinely the safest option – the World Health Organization has historically cited a 15% Caesarean section rate as the upper limit for a system which is providing Caesareans to women and babies who need them*.

*“… when caesarean section rates rise above 15%, risks of adverse health outcomes begin to outweigh the benefits.” –  Einarsdóttir K, Kemp A, Haggar FA, Moorin RE, Gunnell AS, et al. (2012) Increase in Caesarean Deliveries after the Australian Private Health Insurance Incentive Policy Reforms.