Birth Words: Language For a Better Birth

In this episode, doula Renee Basham shares about the difference validation made in her pregnancy and birth experiences. Renee is the Executive Director of Hope's Embrace, a non-profit organization in Kentucky that provides doula services to those who need them most.

This episode is a rebroadcast of Episode 4, Discourse: Ways of Speaking and Ways of Being in Birth. Sara explains the linguistic concept of discourse (and Discourse) and what that looks like in a birth setting. Listen to this episode to learn more!

REFERENCE: Gee, J. P. (1999). An introduction to discourse analysis: Theory and method. (Fourth Edition, 2014). London: Routledge.

TRANSCRIPT:

We are going to talk today about a man named James Paul Gee. He is a notable linguist--he's still around today, and he did a lot of work in defining a term called "discourse." So, Gee differentiates between Little D "discourse," as in the word "discourse," spelled with a lowercase D, and Big D "Discourse," as in the word "Discourse" spelled with a capital D. So little D discourse is simply language in use, that is, in its context, and I say simply, but it's really not so simple. We can analyze language within a specific context and that is called studying discourse. Then Gee talks also about big D Discourse, which he uses to include not just language in a context but all of the other semiotic systems at work in that context. So you remember, in an earlier episode, we talked about how language is a semiotic system. It's the use of signs, symbols, words are really signs or symbols to communicate meaning. And Gee talks about how the words we use are not the only things that communicate meaning in a given situation, and that come into play when we're communicating. So, for instance, police Discourse--big D Discourse—includes not only the way that police officers tend to talk, officially, what types of words they tend to use, the way they tend to structure sentences and phrases, but also, the police uniform, the police car, values that are typically held by a police officer, and behavior that tends to go along with a police officer. So Gee talks about how when you think about what Big D Discourse means, it's basically what would you need to imitate to pull off impersonating somebody in a different… that isn't who you are. I think he talks about being like, a mobster or something, and how if he said the right phrases that are typically used in that context, but wore the wrong clothes, he wouldn't be taken seriously. Or vice versa, wearing the right clothes, saying the wrong things, not following all of the different sign-giving systems that indicate identity and how you operate within a context. So let's talk about the two big D Discourses as they relate… that come up a lot in birth. So I say to I think that many who work in birth would agree that there are two prominent discourses, but also that they're not wholly separate or different from one another. So one researcher, actually two working together, put it this way: "People who work in labor and delivery are fluent in two dialects, they can converse in either and they can talk reflectively about and across them." So what are these two dialects as McCaffrey and Mannion termed them or Discourses, as Gee would them, and as I'm calling them today? The first is the medical discourse of birth. It includes things like terminology that's used more in a medical birth setting, it tends to take place in a medical scene: in a hospital, or during pregnancy and the physician's clinic. Terms are used, such as dilation, effacement, contraction, pain level, fetal tracings, amniotic sac, gestation, amniotomy cervical change, and lots of others. Many more complex and jargon-y than the ones that I that I listed. It also comes with other contextual factors: scrubs, a hospital, a hospital bed, hospital equipment, interventions that are commonly used in this setting, such as epidurals, such as amniohooks to break water, such as fetal and contraction monitors for tracing fetal heart tones and intensity and frequency of contractions. Along with this Discourse—this package—comes beliefs. About when the intervention is good or needed. The role of a care provider in relation to the patient who, in this situation a birthgiver is positioned often as a patient in this discourse. There are beliefs, also, that tend to come in this package, about the ability of the birthgiver to birth without intervention, who is in a position of authority and what is the nature of birth. And I'm not going to spell out what each of those beliefs might be, because they are unique to each individual practicing within this Discourse. And it's not necessarily true that they come as a package and each care provider has all of them. But the language used in this discourse often reflects the prominent beliefs and values that are found within this discourse, and which this discourse tends to see birth more as a medical condition that needs to be treated. (And I want to thank Dr. Stephen Roushar of FLOW chiropractic in Lehi, for his help with this terminology that differentiates between these two Discourses.) The medical Discourse, again, is the Discourse which sees pregnancy and birth as a medical condition to be treated. Whereas the other Discourse that I've been referring to is a physiological Discourse, which sees pregnancy and birth as a physiological process to be supported, in contrast to that condition to be treated. So moving on to this second Discourse, physiological birth. There are terms that come along with this Discourse. And again, these terms are not used by everyone within the Discourse, and there's a lot of variability, but terms like wave and surge instead of contraction often are found in this Discourse. Sometimes people in this Discourse speak of opening rather than dilation, as it has a more natural connotation. And some within this Discourse, we tend to differentiate, differentiate between the intense and powerful sensations felt during labor and pain. They don't identify the uterus's contractions or waves or surges as pain but rather as pressure, intensity. And something that's acknowledging that the body is doing the work that it needs to do, whereas pain tends to convey the opposite message about what's going on in the body. Pain is normally indicative of something being wrong in the body, something that needs to be fixed, whereas, in the birth process physiologically, pain is—the intensity of those feelings—is not an indication that something's going wrong, but rather that the body is working just as it should, in this process. Also, within this Discourse, it comes along with other contextual factors. Scrubs are not worn as often, maybe more of just layman's clothes, and birth can take place in the hospital and this Discourse can be used. But often this Discourse is found in a home birth or a birth center birth. And there may still be some of the same equipment and interventions, but not many of the same. And there are different beliefs within this Discourse about intervention and its role, when it's good when it's needed. There are different beliefs about the role of a care provider in relation to the client, as they're normally called, in this scenario, in this Discourse. And there are different beliefs about the ability of the birth giver to give birth without intervention, who is in a position of authority, and what is in what is the nature of birth. So, these two Discourses operate in a parallel way, they also intersect all the time. The two Discourses can exist in the same place at the same time, and sometimes even in the same person. Or a person may subconsciously, without realizing it, be speaking the language of one Discourse while identifying themselves or finding their beliefs within the other Discourse. So, throughout this podcast, we'll come back to this concept of Discourse. And we'll keep thinking about what our language reveals about our underlying beliefs. And what how we position birth givers and what the role of authority figures is. And so I'm excited to keep going with you on this journey as we look at language and birth. See you next week.

This episode takes a critical look at the term "failure to progress."

REFERENCES:

Dekker, R. (n.d.). Evidence On: Failure to Progress. Retrieved February 29, 2020, from https://evidencebasedbirth.com/wp-content/uploads/2018/01/Failure-to-Progress-Handout.pdf

Dekker, R. (2017, April 26). Evidence on: Failure to Progress. Retrieved February 29, 2020, from https://evidencebasedbirth.com/friedmans-curve-and-failure-to-progress-a-leading-cause-of-unplanned-c-sections/

Other recommended resources:

https://evidencebasedbirth.com/prolonged-second-stage-of-labor/

https://evidencebasedbirth.com/real-life-stories-failure-progress/

This week's episode is taking us back to the Birth Words basics. A rebroadcast of episode 2, this episode summarizes what linguistics is and how it intersects with birth.

For this week's episode, I interview my friend Katherine Grande about her birth experiences. Katherine had a meaningful impact on my perspective on birth during my first pregnancy and beyond. She spoke about birth using positive, glowing terms--a way I'd never heard women speak about birth before! In this interview, Katherine tells how she drew on her faith to shape her beautiful birth experiences.

In this episode, Sara digs into an excerpt of the common pregnancy book, What to Expect When You're Expecting. Through her analysis, she reveals the assumptions, perspective, and effect of the text.

In this week's episode, therapist Sarah Adelmann of Resilient Birth shares guidelines about how to mindfully choose our words as part of giving trauma-informed care to survivors of trauma and abuse.

Learn more about Resilient Birth at https://www.resilientbirth.com/

TRANSCRIPT:

Sara P.:

Sarah is an advocate, counselor and educator whose focus is on supporting those with grief and trauma. She specializes in working with survivors of sexual and intimate partner violence in the perinatal period. Sarah has an MA in counseling psychology from Boston College, and a certification in traumatic stress studies from the Justice Resource Institute. She co-founded Resilient Birth, which provides strength-based and trauma-informed care and education for birthing people and providers. Sarah, welcome.

Sarah A:

Thank you so much for having me, Sara.

Sara P.:

I'm looking forward to chatting with you. And so will you just start by introducing yourself to our listeners? What is your background with birth work and how did you get involved?

Sarah A.:

My experience postpartum, actually, is what led me into birth work. And I was an educator and a mental health counselor, but was completely caught off guard by the postpartum period with my first child. There's no support, no check-ins. And I was basically on my own trying to figure things out. And trying to figure out how to take care of a newborn after having a C-section. And I was so sure that as a mental health counselor, I would be able to see the signs, or if I was struggling, advocate for myself, as I did tell my clients to do, but that is not how my experience went at all.

And looking back, I realized I was suffering from postpartum anxiety. But I didn't realize how debilitating that was. Until this distinct moment that stands out to me, where this like shift happened, which then sent me on this trajectory of birth work. I was lying in bed and, you know, another sleepless night of a newborn, which I know many birthing people and parents have experienced, and I just wanted to sleep. And I thought at this point that I actually might die if I didn't get sleep. And then the very next thought that was in my head was like, but if you were dead, you'd be sleeping. So. And that's when I had a pausing moment. And I realized that what I was experiencing wasn't normal. And that I needed to take that step back and find the care and support for myself. And I had no intention of wanting to leave my child or leave my family. And I feel like it was my mind's way of reminding me that I existed, and that I mattered. And that was my catalyst where I saw my own counseling and I saw my own support.

And before I had given birth and became a mother, my counseling work was centered around trauma and grief, and I particularly work supporting survivors of violence in my counseling practice. And after this experience, my counseling work shifted to perinatal mental health and wanting to be that advocate, and that supporter that my counselor was to me, and give them a healthy mind and a healthy body and a healthy spirit as they went into this journey.

And then I had the blessing of meeting Justine Leach. And she and I came together to create Resilient Birth, which then mirrored both my passions of trauma and grief and supporting survivors with this new identity of being a mom. And our work centers around how do we support survivors who are in birth, pregnancy, postpartum, or anybody who's experienced a trauma in their past lives, because we all have stories, and they all come out to play in this incredible shift that we experience when we give birth. And this company supports people in finding what they need, learning what they might need and learning how the stories may come up in birth. And we also work with providers, and how do you help people who are coming in with stories and give them the most healing, best ideal birth that you can, by being more trauma-informed, and coming at it from the strength-based model. So that's how I got to this work, was through my own needing of healing.

Sara P.:

I think… I just love the beauty of your story. Because as you tell it, I can just feel your heart just reaching out to all of these survivors and those who have experienced trauma and new parents trying to figure this all out. And I just love the work that you do and what you do with Justine, having been at your session at the conference, at Evidence Based Birth, and then following you on social Media, I know that you both are just like these huge-hearted women that reach out to people that really have a need for that huge heart to just wrap around them. So I'm so grateful for the work that you're doing and that I get to talk with you tonight about it.

Sarah A.:

And thank you for your kind words, it makes my heart feel so full. Because this work is so valuable. You provide this gift of bringing this knowledge like why our words and our language are powerful. So I'm like blessed to be out here to like, express my passion through your work.

Sara P.:

Well, awesome. Let's talk about that. So you told us in your background, that you're really passionate about helping birth professionals be informed about caring for birthgivers in a way that is sensitive to the trauma they've faced. You're passionate about supporting parents through that journey as well. Talk to us about why being conscientious about our language is so important in that space.

Sarah A.:

Being thoughtful and conscious about the language you're using is just so vitally important to survivors. Research is showing us that the care provider relationship is so impactful for what the birthing person walks away with in the experience of their birth, more so than medical interventions, or what type of birth, the relationship with a provider has the greatest impact on whether or not the person experiences their birth as traumatic. And that's really powerful that these relationships are that important. Survivors who had experienced a traumatic birth as a result of a fractured care provider relationship, describe their birth experience as feeling disconnected, helpless and isolated in their birth, which are really haunting feelings to have because that mirrors a lot of what they've experienced in their trauma. And here now they're coming up again in this birth experience. Probably unexpected. And another big predictor of whether or not birthing person may experience postpartum depression, anxiety or postpartum PTSD is again this, this care provider relationship. And communication is such a huge part of this relationship and the safety of survivors in their experience. I'm gonna be a little vulnerable here and share a bit about my own birth because I think it's a good example of the power of language to both rupture and to both also heal all in the same moment.

I was… I am a survivor myself, and so I brought into my birth anxiety and was blessed with a very easy pregnancy and seemed to be journey down to like the ideal birth center birth you know, that I was looking for. It came in hot on Christmas day thinking I was about to give birth and I had to do a stress test and they noticed that my son had decelerations. And so I was transferred across the road to the hospital. So already my birth had shifted, but I was fine. I just want to be monitored and all that kind of stuff. But the decelerations became greater and his heart rate got lower, and at one point in my birth, we lost his heartbeat all together.

And I remember this nurse just coming barreling into the room full of panic and full of anxiety. And I just started to then panic myself, because if she was that scared, and overwhelmed, something must be really wrong. And I remember her moving my body all around, manipulating me trying to find his heartbeat again. And we did we found it on all fours, and it was a blessing to hear this again. But no sooner did we find it, than she asked me to lay back down in my back. And in my head, I'm thinking, I just found my son's heartbeat. I lost it when I was on my back. There's no way that I'm going back on my back right now.

And so I, with all I can, you know, muster, I just say "no," like loudly like, "no." And she again repeats me, "I want you to lie down on your back, it's the safe… it's the best way we can hear the baby's heartbeat." And I couldn't voice anything really. After that moment, I was just taken aback. And she started to move me to that position. And here I was, in another moment in my life where someone has dishonored my voice, not listening to my choice or what I want to do with my body, and it's bringing me back to a place where I did not want to have that come into my birth space. And as a survivor, I don't do well with confrontation or conflict. And so the best thing that I've learned to keep me safe is to comply. So I was ready to comply with her ask.

The beauty of the story is that I didn't have to comply, because there was another voice in that room. And it was through my midwife Karen's voice, where I regained my birth. She put her hand on my back and said, I believe she just said, No. And then she looked down at me and got at my level, because I'm looking down at the bed because I don't want to make eye contact with someone. Now that there is this contentiousness in the room. So I'm just looking at the bed, just blank white sheet. And she gets down next to me. She's like, "Sarah, would you like to stay in this position? Would that make you feel better?" And I just whispered, "Yes." And I nodded my head. And she said, "okay, you stay here as long as you are comfortable, and you can move to another position, if you feel necessary, when you're comfortable to do so."

And that restatement of what I wanted, gave me back control of my birth. And it was in that position on all fours that I remember speaking to my son and saying to him, "Are you ready to come now?" And I said, "is a C-section going to be what is the best birth for you?" And we connected in this moment. And I knew, and he knew, and I knew that this was our journey. This was our ideal birth. This is what was meant to be. But because she gave me the path, and she gave me the time to reflect and find out what I really needed, that I had my choice and my agency back. So when I look back on my birth of my son, it's a beautiful one, because that was what our journey was meant to be on. But it was all by giving the gift of communication. When someone honored my words, spoken again, and then followed through with my request, her communication repaired a birth that I've got could have gone very differently. I'll be forever grateful for her gift. She's my angel. I tell her, like, you are my angel.

So I just, I want to share that because that's why I'm… Language is important words can rupture a relationship, but they can also heal. And coming at our communication from on the more trauma-informed approach, we can reduce the risk of re-traumatization of someone else. And we also have a chance to show someone what a healing relationship with communication can look like. Because sometimes you're working with a survivor who's never had someone who communicates with them in a healthy way, who honors their voice, who listens to them, and they can provide that to them. Providers can give them the gift of healing through this trauma-informed communication approach that they would love survivors to take on and as part of their practice, because I think giving survivors agency and their birth and pregnancy postpartum is going to give them the best mental health, overall health and well-being while they transition into the most impactful journey that they're ever going to go on, I believe, in their life.

Sara P.:

Thank you. Thank you so much. For being vulnerable and sharing your story, because I think that it will benefit many people. And thank you for sharing it. That was beautiful.

So, yeah, so given your feelings you expressed so beautifully about providers, giving that space and honoring with their words, the choice of survivors and the experiences and the voice of survivors, what guidelines would you give for birth professionals working in that space about how to make sure their language honors the choice and the voice of survivors?

Sarah A.:

This is a tough question because there's so much that people can do to shift their language, have language that is healing and holds space. And so I wanted to… I just came up with three things… three takeaways that someone could do and implement like tomorrow, if they wanted to, that would have a dramatic shift. And then, if anyone's interested or more, we can connect on that later. But I want someone to walk away with something practical, I guess.

And time and time again, I've heard from working with survivors, how important eye contact can be in a relationship of the care provider. So not looking down at your paper, taking notes, not typing on your computer, while they're answering, having eye contact with them.

And there are different reasons why this is so important to them. It helps them know that they're being heard, which is very important, because their voices have been not honored. And so knowing that you're, you're there, and you're present, and you're hearing them is very important. It lets them know that you are engaged because when you're typing or when something else is happening, they're wondering, "have you missed part of my story? Are you really listening?" You know, what… "are they thinking about the next question?" But if you're making that eye contact, they know that you're engaged.

But most importantly, eye contact gives them a sense of safety. If you're looking at them, they can read your body language, they can read your facial expressions, they can predict how you might be thinking or feeling, which gives them a feeling of safety. Because then they can have… they can read the situation and tell if it's an emotionally safe one or not. And if they should keep sharing, or not. So that's one of the gifts this eye contact gives them is the ability to like read the other person and understand, Can I still continue to talk about this? Or do I need to shut it down? So that's one simple shift.

Sara P.:

Yeah… communication is so much more than just the words, right? The gestures and the body language and the interpersonal contact.

Sarah A.:

Totally, and I think we forget how powerful that nonverbal is. And even if eye contact doesn't feel comfortable to the provider, because—I get it. I'm a clinician and I, you know, don't always feel comfortable, like looking directly or staring at my client, especially when they're staring something emotional, you know—but it's still having that open body language towards them. You know, even if you like, look off for a moment or that sort of thing, just creating that openness with your body that you're listening, you're hearing, you're honoring them.

Another simple thing that I think practitioners can implement in their practice is do a brief paraphrase of what is being said after someone finishes sharing, reflecting that back to them and then saying, "is that correct? Is that what you're sharing with me?" And then also asking, "Is there anything else you want to share?" And the reason why this is so important for survivors is that when emotions are triggered, as a result of the trauma, their language shuts down, that part of their brain shuts down. And so they are feeling emotively, they may not be able to find the words in that moment to be able to express their thoughts and feelings fully. So if you give them that chance to rethink, "Is that really what I wanted to say?" that disconnects that from them emotion for a bit, which gives their brain a chance to process and pull back out that language that has been shut off potentially by their trauma experience. I mean, that… there's a clear example of that in my own story that I just shared earlier.

So giving them that break, giving them that chance, but also why this check in of "Is there anything else there? Is that correct?" is so important is because of the power dynamic that in a relationship between a care provider and a survivor. Survivors often want to be the best patient, the good patient, and they might be scared to bring up something that they forgot to say earlier or something that they didn't agree with their, with their providers, if they think something differently. Because of that dynamic, they may worry what that disruption might mean for them. And the number one thing that disruption might mean for them is the chance of reduced safety for their baby or for themselves.

So they're more likely going to comply or not voice themselves again, unless it is modeled by the provider by asking for that feedback from them, and giving them that chance to reflect, because that teaches them that their provider honors their feedback, wants to hear it, and appreciates it. So that simple paraphrasing and check-in gives the gifts that they can be this safety in that relationship with them.

And one of the other one that I want to share is how information can be really helpful to survivors: it can help them know what to expect--what's gonna come next. And a story I want to share just one more story about An experience of survivor had she, this was not her first pregnancy. And so she's going in for dating ultrasound, to just look at baby heartbeat and that sort of thing. But she also had had previous c-section. So she didn't understand how that might have impacted her ultrasound. And so she's getting the ultrasound and the technician is pushing really hard, and it's causing her pain because it's right on top of her scarring. And she's sitting there in pain. And she's like, well, I don't know if I can say something because they're probably not intending to cause any pain and they might be needing to do this. I'm going to sit here and take it. And as she sat there, she just is processing with pain. And its pain that she had no control over. And she said it was pain that was being inflicted on her by another person. And she found herself being dragged back into her past her pain had been lifted on her before by a partner. And she remembers that the first time she heard her being heartbeat now meshed with this other memory, one that she never wanted to be brought into the room.

Sarah A:

And when given a chance to reflect on this moment, later on, she realized all this could have shifted. If the clinician that had said to her, "Because of your previous c-section, there might be scarring that's harder to get through. So we might have to push a little harder. And if it's painful, you can let me know. And we can stop. We can take a break. But I just wanted to make you aware that this may be what you experienced as a result of your previous surgery." That would have shifted that moment. And she said, if the if the technician had done that, she would have been able to hear her son's heartbeat, without the ghost of her past being brought into the space. A simple gift of communicating what could be the experience and giving her information, but then also giving her the choice on whether or not she could say to stop or to continue" or "Can you take a break?" That could have shifted her whole experiencing that ultrasound? Simple things we can do.

Sara P.:

Right? Yes. I love the guidelines that you gave. They're simple, but so powerful. So thank you for sharing them. Well, let's ask the final question. If you had to summarize your feelings on this topic in just one word, what word would it be?

Sarah A.:

This was the hardest thing ever. The word I came up with was impactful. Impactful, language is impactful.

Sara P.:

Yeah. Especially in the space that were we've been talking about. I really so appreciate, Sarah, you taking the time to share your experiences and your perspectives and your expertise. And I know that our listeners will really benefit from the things that you shared tonight. And I really, like I said at the beginning, so appreciate the heart-driven work that you're doing. And thank you so much for joining me.

Sarah A.:

It was a great pleasure. Really honored to. Thank you so much.

Sara P.:

I'm so happy to have you. How can our listeners connect with you online on social media?

Sarah A.:

Yeah, they can. First, check out our website at resilientbirth.com, if they want to learn more about services and what we can provide to both providers across the country. Or if you have any survivors you're working with, just someone to talk to. They can also follow @resilient.birth on Instagram, and on Facebook (Resilient Birth). And we also have just recently created a private Facebook group called Trauma-Informed Perinatal Professionals. And this is where we dive deep into topics around trauma and birth and postpartum. And it's really a community where members can ask questions, share their own stories, and impart their own wisdom and a community where we collectively come together. The similar mission of helping people have the birth that they want, no matter what their story is.

Sara P.:

Yeah, that's a beautiful community. I always appreciate your posts. there and being part of it. Thank you. Thank you again for joining me. I hope you have a great night.

Sarah A.:

All right, you too. Take care.

Thank you for joining us on today's episode. As we wrap up, I want to remind you head over to birth words calm. Check out the Classes tab. I now have on there, the recorded webinar that I did for the Evidence Based Birth Virtual Experience following the conference. And that is available now there on the website for you for purchase. Use the promo code PODCAST for 15% off. so head on over there and check it out: birthwords.com/classes

Did words play an important role in your birth experience? If you're interested in sharing your story on the podcast, go to www.birthwords.com. If you're liking what you hear on the podcast, please leave a review on your podcast app. For more resources about harnessing the power of words. to benefit the birth experience, visit birthwords.com

Transcribed by https://otter.ai

In this episode, I discuss how to say "give birth" in French, Spanish, and Italian

REFERENCES:

Google Books NGram Viewer. Retrieved from: https://books.google.com/ngrams/graph?content=dar+a+luz&year_start=1500&year_end=2008&corpus=21&smoothing=3&share=&direct_url=t1%3B%2Cdar%20a%20luz%3B%2Cc0

Google Books NGram Viewer. Retrieved from: https://books.google.com/ngrams/graph?content=dare+alla+luce&year_start=1400&year_end=2019&corpus=22&smoothing=3&share=&direct_url=t1%3B%2Cdare%20alla%20luce%3B%2Cc0

Lindsay, L. (n.d.) Tag: Italian translation to give birth. Retrieved from https://leslielindsay.com/tag/italian-translation-to-give-birth/

Schmermund, E. (April 17, 2017) . French expressions: Pregnancy and childbirth. Retrieved from https://blogs.transparent.com/french/french-expressions-pregnancy-and-childbirth/

What is the origin of "dar a luz", referring to giving birth? (April 29, 2017). Retrieved from: https://spanish.stackexchange.com/questions/20723/what-is-the-origin-of-dar-a-luz-referring-to-giving-birth

In this episode, I talk with Jenessa Berg. She shares her thoughts about motherhood as a creative process, birth-related terms that can be taken multiple ways, and the circle of support during birth.

TRANSCRIPT:

Sara:

On today's podcast, I will be talking with my friend Jenessa Berg. Jenessa is the mother to three children, a dancer and dance teacher, and an aspiring birth worker. Welcome, Jenessa to the Birth Words podcast.

Jenessa:

Thank you. I'm so excited to be here.

Sara:

I'm really looking forward to hearing your perspective and sharing it with our listeners today. So, I was really interested when we were messaging before that you mentioned that you see motherhood as an artistic and creative process. So tell me more about that.

Jenessa:

Yeah, okay. So I think it might help to tell a little bit about my, my story. I started going to BYU a few years ago as a freshman and I was in the nursing program. And I, I was thinking, you know, I really want to be a nurse and probably a midwife later, I was really interested in you know, science and, and I like math and I was like, this seems like you know, like a good thing for me and, but then as I started getting more into it, I just felt like that wasn't going to be the best use of my talents. And like I could maybe be a good nurse, but that wasn't what I was supposed to do.

And I'm a praying person and I prayed a lot about it, and I ended up switching to dance, which is a very different thing and part of me was like embarrassed because I thought that people were going to think that like, I wasn't smart or something. But as I got more involved in the arts, I experienced a lot of healing and, and my health got a lot better than it had been. And it was an interesting shift going from, you know, being you know, in this medical world to this artistic world, and my health was so much better.

So now I've had I've had three children and as I've had my kids, I've recognized that yes, it is. It is. There is a lot of it that is medical. There's there's a lot of math and science involved in how it all works. But it's also so much more than that. And so, I've realized that you can move beyond the statistics and the evidence and everything and it's, and it's your story, and you get to create it.

It's not just you know, you just have to live something out. Like it's, it's something that you get to be a very active part of, if you choose to be. And you can make it into something really beautiful. So I've started kind of thinking of, I guess over the past three births. I've come to think of the whole process is more of a, you know, this is my story that we're creating. And, and these are moments that I get to choose. You know, I don't get to choose everything but I get to choose. I get to choose quite a lot actually. And it is a creative process and trying to make your life and the life that you're bringing into the world, making it all a beautiful process.

Sara:

Love that. So how do you think that that perspective comes out when you're interacting with other parents in your community?

Jenessa:

Yeah, so that's an interesting question. Um, I think that it's very common to kind of just stop at the, "you know, this is what happened to me. And these are the, these are the are, these are the facts or this is how it worked, or this is how it happened" instead of really taking it a step further and saying, but this is my story, and I choose how it plays out. And so, a lot of times when I have conversations with people, you know, you hear a story and sometimes a birth story is like, well, I went to the hospital and then I and then I had this intervention in this intervention and then my baby was born. And I guess I, I just want people to have stories that they're proud of. And so that's part of why I've become more passionate about birth is because, you know, my first birth I kind of did that, you know. I just kind of, well, you know, I'll just go in and, you know, do what all the experts are telling me here and we'll see how it goes. And it didn't go very well.

And when I kind of took things into my own hands and said, "You know, this is my story, and I'm the hero of the story. I'm going to make this a good story." Yeah, it's just so much better when I've when I've changed that. And so when I when I interact with other people now I, I guess I try to help other people to recognize that it's their story and that they get to choose how it is. And that it's not just, you know, you just have to live it out whatever happens to you.

Sara:

Yeah, I love that. So we're kind of jumping all over the place. We have it just a short amount of time, but you had so many good ideas that I was like, Yes, we have to talk about all of them. But only for a few minutes each.

Jenessa:

We'll have to have another session where you just talk… can be a sleepover.

Sara:

Sounds good. Okay, so when you reached out to me, you mentioned that a topic that interests you, is that different words or phrases have very different connotations for different people. So can you give some examples of that?

Jenessa:

Yeah. So, um, since I originally kind of had this idea that I shared with you, I've been making a list, so I'm just going to kind of read through and just give a little blurb about them. So one thing is, when people say, "we're pregnant," instead of "I'm pregnant." Some people think that that's like, a really great way of looking at it like "yes, I am the husband. We're pregnant, and we're doing this together and working together," and some people take a lot of offense. "Yeah, excuse me. You don't have heartburn. You don't have to, you know, you don't have hemorrhoids. You you're not dealing with this. You're not carrying this baby around all the time. Like, how dare you say that?" You know, "we're pregnant."

Sara:

But yeah, some people are totally like, this is a dual process. And that's how I'm going to express it. So that's very…

Jenessa:

Right. And for some people, I think that's a good thing for them.

Sara:

Yeah. It's good to know where you fit in.

Jenessa:

Yeah.

Sara:

And where your partner fits in, so that you're not…

Jenessa:

Definitely. So the next one here, and this is one that you've talked about before, especially with Rebecca Decker, from Evidence Based Birth: delivery or deliver in birth. Um, some people just don't even think of that as a word that could be offensive. And some people are really upset by it because they think my baby is delivered from me like, right? No, my baby is like, it's not taken from me to free me of it or you know, so there's that one.

Sometimes there's just words that are just…it's like they started out meaning one thing and then just got confused. So the word postpartum? It means the time period after birth, but a lot of people use it to refer to postpartum depression, right? Which can make it confusing. Yeah, like after I had my baby a few months ago, um, I had a friend and she was like, "Hey, how are you doing?" And I was like, "Oh, you know, just the, you know, postpartum is crazy." And she was like, "Oh my gosh, like, let me come and like, help you out. Like I had postpartum depression too." And like she… And I was like, you know, like, I'm, I'm.. I appreciate your concern and help but that's not what I was saying.

Sara:

Yeah, it's interesting, because I think that it means that we have an increased awareness of it. But then we have this conflation of this term that just means like, yeah, time after baby's born and I'm adjusting to real life as a mother.

Jenessa:

Yeah, yeah. Interesting. So, Oh, here's a here's a phrase that yo some can be very comforting and to some just makes you very angry. And it's, "there's no trophy."

Sara:

Oh!

Jenessa:

And I think most people have feelings about that

Sara:

Right! Some people probably feel like, "Oh, you're right, that means I can do it my way. This is my story it doesn't matter, there's no prize!"

Jenessa:

Exactly, right, like, I don't have to worry about other people. And other people are like, "you think that I did that for a trophy? Like how shallow do you think I am? You know, like that's usually that's a—you know—phrase it's usually used in like, whether someone got an epidural or not. And, like of course it's not about a trophy, but some people can get… some people take great comfort from that phrase and other people, it just kind of lights a fire underneath them..

Another one very similar to that is, "you don't have to be a hero."

Sara:

MmmHmm.

Jenessa:

Um, this one I thought was interesting. I heard a woman recently who had had a stillborn baby and she was really upset when people used the term "angel baby" and talking about her "angel baby" because she doesn't believe in God. And she doesn't have that belief. And she felt like people were always like giving her false hope. Like, no, like,

Sara:

Not validating her grief.

Jenessa:

Yeah, right. Exactly. Not validating her grief.

Another phrase is, "leave it to the experts." usually referring to medical professionals.

Just the phrase, or the word "natural."

Sara:

Yeah. That one can be so controversial.

Jenessa:

Yeah. And it's funny because like, you know, they're just words, but we attach these meanings to them. And when we come at them from different directions, they can be hurtful or they can be… anyway, they can just have such different meanings.

Sara:

You have such a good list. Can I like…?

Jenessa:

Yeah, I'll send it to.

Sara:

And maybe piggyback off of it for future episodes?

Jenessa:

Yeah, totally. Totally.

Sara:

You've got such a good list.

Jenessa:

Yeah, I got another one. And this one, I also got from listening to this podcast—such a good podcast—when The VBAC Link was on here, and they talked about belly births, and how, you know, some women like that phrase and like, "Oh, yeah, like my cesarean birth was also a birth" and some people feel like "no, my cesearean birth was not a birth. That was something that I was robbed of."

Sara:

Right.

Jenessa:

So yeah, it's interesting, like you wanna you just want to validate people, but sometimes the words that we use, they actually get some harm.

Sara:

Yeah, because they come… and the words that I use or that you use They're symbols that represent all of our lived experience relating to that concept, right? And like for you, and for me, we have totally different lived experiences. A lot of similarities, a lot of differences… and one little word, just a few letters packaged together can mean so much. Something so different to me than it does to you, than somebody in another state, another country, especially as we get into a wider circle.

Jenessa:

Definitely. A couple more. There's when people say "easy way out." And this is another one that's sometimes with the cesarean section where people will say like, "No, that wasn't the easy way out, you know, like, how dare you say that?" And the interesting thing that I have noticed without phrases that I usually hear it in people who haven't given birth before, and they usually say it.. and it's just because they just don't know they just think "oh, like, I've heard that labor is terrible. So a cesarean section seems like the easy way out, so she must have chosen the easy way out."

You've had a C-section.

Sara:

No, it's not the easy way out! I had labor and a c-section, so…

Jenessa:

Yeah, but just don't ever, I think pretty much don't ever tell a woman that she took the easy way ever.

Sara:

Yeah. Or any person ever.

Jenessa:

The easy way… I had I have an aunt who adopted three children. And someone told her once, "Oh, you went…you took it the easy way." Because, you know, she didn't have pregnancy or labor, but she was like, okay, like all the years of therapy, like the years of waiting the years of infertility, all of the you know, like, what about the time where I thought that I was going to have a baby and I went and I met him and then his birth mother decided to keep him and you know, like that all this heartbreak years and years of heartbreak? Like, no, that was not the easy way. Ah, anyway, so that was really hurtful to her. And yeah, so I don't know. I don't know that that phrase is really helpful to anyone

Sara:

It's not a two-way think, it's just a "Don't say that!"

Jenessa:

But I think that that it is good to recognize though that a lot of people don't realize that got that that phrase can be so upsetting.

Sara:

Wow. Okay. You've given me lots of things to think about over the coming weeks and months. I'm excited. Um, another topic… was that positions of authority in the birth experience. That's important to you. So what's your perspective about who is or who are the authority figures in birth and what responsibilities does an authority figure have?

Jenessa:

Perfect. Okay, so um, I think that our society's general view of looking at birth and authority figures is kind of a hierarchy. And you have doctors up at the top, and then midwives because like, they're still pretty smart, but they're not doctors. And then underneath that, you have nurses. And then underneath that you have doulas and then at the bottom is mothers.

And I heard someone say something recently about like if we're going to make any change in our maternity care, then it's got to start from the bottom—like you mothers—and I was like you've got to you've…you're at the bottom? …. Like I understood the point, but I was kind of bothered by that because, like—wait, mothers are at the bottom of the maternity care system?

Sara:

Right, I have life inside of my body!

Jenessa:

There would be no maternity care system without the mothers! Anyway. So like, I think that we need to stop with the whole hierarchy thing. And I'm not saying that we should switch it either. I'm not saying like mothers at the top and everybody else just bow to them. Because it's not quite that either. So I think like if… I'm a really visual person, so like… the way I like to think about it is more like the mother is the center. Everybody else… we're all on the same standing. Right? We're all people, we're all humans, we're all important. And birth professionals certainly have, you know, they're doing great work and they are important. It's not like you know, like they don't matter all. But the mother is in the center because she's the one that is bringing the life into the world and everyone else is surrounding her. It's a circle. A circle of support…

Sara

Do you want to like draw…? I think we can all probably imagine a circle. I love that visual. That's really powerful.

Jenessa:

Yeah, I thought of that visual. Mostly… Well, as I was thinking about this, like, I just had this visual from when I was watching, when I was recently watching the video of my most recent birth, yeah. And Sara was my doula. You were my doula for that. And I also had, like, my mom was there and, and I had my midwife, my husband, and right at the part where it was just the very most difficult and I was like, Yeah, "oh, man, like, why am I doing this? Can I really do this? I don't think I can do this!" when I was in that moment. I was surrounded.

Sara:

That's beautiful

Jenessa:

There were literally people you know, like there was someone holding each hand, there was someone behind me doing counter pressure. My midwife was there getting ready to catch the baby… like it was it was literally…and someone else was… I had like the nurse was, you know, checking for the fetal heart rate, and it was just really, like that felt right, you know, to be in the center of a circle.

Sara:

It was beautiful to be on the outside of the circle too supporting you. Your birth was so beautiful. I love that too. Because so your videographer from that birth, Sarah Asay, also has a website and social media platform called Birth Circle. And that is the metaphor that she uses so much. And I've been doing some business training with her. She talks so much about we don't…this hierarchy is all wrong in…

Jenessa:

It's just silly.

Sara:

Yeah. Not just in the birth space. But if we think about businesses working that way, that's just not how we support one another. And I love the circle that she's creating of support for women and that she so beautifully took a video of so that you could see that visual. That's… Yes. Thank you for sharing. Yeah, I love all of this. Thanks so much for being on the podcast today. If you had to summarize your feelings about birth, pregnancy, postpartum in one… and I don't mean depression, just the postpartum experience… In one word, what word would you choose?

Jenessa:

Birth is sacred.

Sara:

I love that. I really think that's beautiful. I agree. Thank you.

Jenessa:

Thank you.

Outro:

Did words play an important role in your birth experience? If you're interested in sharing your story on the podcast, go to www.birthwords.com. If you're liking what you hear on the podcast, please leave a review on your podcast app. For more resources about harnessing the power of words to benefit the birth experience, visit birthwords.com

Transcribed by https://otter.ai

In this episode, I revew key points made by Rachel Naomi Remen in her essay, "Helping, Fixing, or Serving?" I consider their application to birth and the importance of viewing all in the birth space as whole.

TRANSCRIPT:

Welcome to today's episode. So today I want to have a conversation about an article that I read years ago that was very influential for me. It was written by Dr. Rachel Naomi Remen. She is an Associate Clinical Professor of Family and Community Medicine UCSF Medical School and the co-founder and medical director of the Commonwealth Cancer Help program. She's also author of the bestseller Kitchen Table Wisdom: Stories That Heal. And she wrote an essay several years ago called "Helping, Fixing or Serving?" that has really impacted the way that I think about the work that I do in different arenas in my life, from volunteer work that I've done, to my work as a teacher, as a mother, as a neighbor, friend, and as a doula. So as we talk about it today, I invite you to consider whatever role you're serving in and think about how it applies.

I'm going to kind of give a summary of her work through reading meaningful summative quotes and then thinking about how they apply to birth work. So, Rachel Naomi Remen says, "Helping, fixing and serving represent three different ways of seeing life. When you help, you see life as weak. When you fix, you see life as broken. When you serve, you see life as whole. Fixing and helping maybe the work of the ego, and service the work of the soul."

So my thought about how this applies to birth work, is that the term doula was first used in 1969. In an anthropological study conducted by Dana Raphael, and she was talking just about the role of doulas, she said, in most species, it's normal for a female of the same species to be part of childbirth. And she derived the term doula from modern Greek--borrowed it as a word to describe the role of a birth support person that was kind of coming into being more in that time, around 1969. And doula, from the modern Greek, means servant woman or woman who serves. And so this term is a re-appropriation of a modern Greek [word] that includes bondage. The term actually implies bondage, serving, even slavery, but like we talked about in Episode 24, we can turn terms around sometimes, and re-appropriate them for our own usage and re-imbue it with power. And so Raphael's coining of the term doula is used to mean a woman who serves. So I believe that doulas are re-appropriating this term, focusing on the aspects of service. And like Rachel Remen says, "service is the work of the soul," seeing life as whole.

So though service is etymologically tied most to doula work—the word doula implies service—it certainly applies to anyone in the birth space serving the birthgiver: the husband or partner, mothers or friends, nurses, doctors, midwives… This invitation to see life as whole, to truly serve, applies to anyone in the birth space. And both the life of the birthgiver and the life of the soon-to-be-born-baby—and all others in that space—really can be benefited and made whole when they are served in this way.

So again, Rachel Remen says, "When we serve, we know that we belong to life. And to that purpose, from the perspective of service, we are connected. All suffering is like my suffering. And all joy is like my joy. The impulse to serve emerges naturally and inevitably from this way of seeing." And I think that's where birth even comes from. The work that a birthgiver does in giving birth, recognizes the wholeness and the connectedness of life, as we use our own life to bring forth additional life.

So going on, Rachel Remen says, "Helping is not a relationship between equals. A helper may see others as weaker than they are, needier than they are. And people often feel this inequality. The danger in helping is that we may inadvertently take away from people more than we ever could get them. We may diminish their self-esteem, their status, worth, integrity or even wholeness." So I caution anyone in the birth space to really stay away from this mentality of helping—this perspective that puts people on two different playing fields, and the birthgiver on the lower playing field. I'm really cautious in the language that I use. When I talk about my role as a doula, because I've read Rachel Remen's essay, "Helping, Fixing or Serving?" so many times. I really am careful to never say that I help expectant families. I see the power and the strength and the ability and capability in the birth giver. She is not weak, in need of others' strength—mine or anyone else's. She is discovering the full extent of her own strength. And this needs no help. But benefits, surely, as we all do, from service.

Rachel Remen says, "When we help, we become aware of our own strength, but when we serve, we don't serve with our strength. We serve with our selves, and we draw from all of our experiences. Our limitations serve, our wounds serve. Even our darkness can serve. My pain is the source of my compassion. My woundedness is the key to my empathy." Going on, Rachel Remen says, "Serving makes us aware of our wholeness and its power. The wholeness in us serves the wholeness in others and the wholeness in life. The wholeness in you is the same as the wholeness in me. Service is a relationship between equals. Our service strengthens us as well as others. Fixing and helping are draining, and over time, we may burn out, but service is renewing. When we serve, our work itself will renew us. In helping, we may find a sense of satisfaction. In serving, we find a sense of gratitude."

I love this. When we consider the application to birth—seeing life as whole is especially important in the birth room, when sometimes birthgivers are identified by their contraction pattern, or cervical dilation. That does not honor her wholeness. We need, in the birth space, to recognize the wholeness of each person in that space. And as we serve in that space, find renewal and gratitude for the wholeness in the life of all those in that space—and the baby that is soon to enter that space.

Another summative quote from Rachel Freeman's essay is, "In fixing, we see others as broken and respond to this perception with our expertise. Fixers trust their own expertise, but may not see the wholeness in another person, or trust the integrity of the life in them. When we serve, we see and trust that wholeness. We respond to it and collaborate with it. And when we see the wholeness in another and we strengthen it, they may be then able to see it for themselves for the first time."

In her essay, Rachel Remen tells the story of an emergency physician who's assisting a woman as she gives birth to a baby. And Remen talks about the moment when this physician really realized the wholeness and life in a newborn baby that he had just assisted with the birth of, and how this moment was a wake-up call to him in his practice. Previously, he'd been very focused on using his expertise in response to situations and felt the thrill and the excitement of that fixing paradigm—of finding a problem, enacting his expertise, and solving the problem. But in this moment when he realized the wholeness of life of this newborn baby, he realized that there was so much more to the work that he was doing. And he previously missed out on so much, and he didn't have a full awareness of the wholeness of those that he was "fixing."

Rachel Remen goes on to say, "Fixing and helping create a distance between people—an experience of difference. We cannot serve at a distance. We can only serve that to which we are profoundly connected. That which we are willing to touch. Fixing and helping are strategies to repair life. We serve life, not because it is broken, but because it is holy."

So as a birthgiver, if that is your role, seek those who honor your wholeness, who serve you with proximity, who are willing to touch—physically, emotionally, mentally—to touch you and embrace you and your wholeness. Surround yourself with those who see you as whole and holy and not broken.

And Rachel Remen concludes with this moving quote: "Service is not an experience of strength or expertise. Service is an experience of mystery, surrender and awe. Helpers and fixers feel casual. Servers may experience, from time to time, a sense of being used by larger unknown forces. Those who serve have traded a sense of mastery for an experience of mystery, and in doing so, have transformed their work and their lives into practice."

I feel like this is applicable nowhere more than in the work surrounding birth, that we should serve in this space with mystery, surrender and awe. So I encourage you all to check out the show notes for today. I'll have a link to the full essay which I really suggest that you read time and time again. And I hope that you have taken something away from this conversation about helping, fixing and serving. Bye.

Did words play an important role in your birth experience? If you're interested in sharing your story on the podcast, go to www.birthwords.com.

If you're liking what you hear on the podcast, please leave a review on your podcast app. For more resources about harnessing the power of words to benefit the birth experience, visit birthwords.com.

Transcribed by https://otter.ai

REFERENCES:

Remen, R. N. (1999). Helping, Fixing or Serving?, Shambhala Sun, September. Retrieved from https://www.uc.edu/content/dam/uc/honors/docs/communityengagement/HelpingFixingServing.pdf

Oxford English Dictionary (2011). Doula. Retrieved from https://www-oed-com.erl.lib.byu.edu/view/Entry/248791?redirectedFrom=doula#eid#eid