By Megan Davidson, Ph.D.
To be empowered is to have the knowledge needed to make choices, the power and authority to have those choices respected, and the confidence in your own capacities to realize your desires.
Having an empowered pregnancy is a perfect example of this. Women can bring to pregnancy, birth, and motherhood their entire experience of their own bodies - both really positive feelings and experiences but also, negative feelings and experiences as well.
Struggling with infertility can heighten some of these feelings, as women navigate doctors and medical technologies throughout their journey to motherhood. Many women do not enter their pregnancies with a sense of themselves as empowered in their lives, and even for those who do, it is very common to feel disempowered during the process of pregnancy and birth.
Finding out you are pregnant can bring a flood of excitement, worry, and feverous planning. It can also bring on waves of exhaustion or nausea and leave many newly pregnant women feeling overwhelmed early on, as well as concerned about how they will handle what is to come. How can you tame this mixture of excitement and worry, of exhaustion and doubt, into a feeling of connection with your changing body and a belief in your own strength? How can you have an empowered pregnancy?
Throughout this article I will detail several strategies for helping to cultivate an empowered pregnancy and a positive birth experience.
While women with a history of infertility need to consider the specifics of their own pregnancy and health, the strategies detailed below can be applied to most pregnant women as they navigate their needs and personal choices for the birth experience. For all women, regardless of how they became pregnant or the choices they will need to make, being empowered in pregnancy is critical because it authorizes a women's own power in birthing, however she chooses to do so, and also continues to enhance the experience of motherhood.
1. Build a birth team to support you in your pregnancy, birth, and postpartum period. Your team can be made up of as few or as many people as you would like, but each person should be chosen because of their ability and willingness to empower you in your pregnancy and birth, and support you in your postpartum period. If you find you have included someone in your team who does not empower you, strongly consider reducing that person's role or changing your birth team to be inclusive of people who listen to your voice and help you to feel strong in your capacities.
Common members of a birth team include a husband or partner, an obstetrician and / or midwife, a doula, and family or friends. While their are many roads to motherhood, and some do not include having a partner, for many moms, a husband or partner is an important part of the birth team, offering support, encouragement, and shared decision making.
Selecting a care provider, either an obstetrician and / or a midwife, is also a central part of building your birth teams. Both obstetricians and midwives can support women in low risk pregnancies and birth, but only obstetricians are a viable choice if your pregnancy is classified as high risk. The decision of who you would like to assist you, and what that means about where you will be giving birth, is an important one.
Additionally, many mothers include a doula in their birth team to offer non-medical support. A doula is a professionally trained labor support person who offers physical, emotional, and educational support in pregnancy, who provides continuous support throughout labor and the initial postpartum period, and who follows up postpartum to help mentor new mothers, support breastfeeding, and care for new families in their transition. For women who have a lot of anxiety in pregnancy, working with a doula can be very calming.
Finally, many mothers also seek support in pregnancy and postpartum, and some also in their labor and birth, from other family members or friends including the support of your mother, close friends, and siblings, among others. It is important to make sure your support does not stop with birth - having great support in the early postpartum period can help you heal after birth, breast feed more successfully, and bond with your baby (while others do the dishes)!
2. Select a birth location that matches your desires for your birth. Different care providers assist women in a variety of birth contexts such as hospitals, birth centers, or at home. (Local laws might dictate some of your choices with regard to birth centers and homebirths - ask local midwives, childbirth educators, or doulas if you would like to find out more about these options again keeping in mind that these choices are not appropriate for pregnancies classified as high risk). While some women might feel most comfortable and secure in a hospital, others might feel most comfortable and secure in a birth center or at home - there is no one right place for all women to be. The decision of where to give birth is a personal choice and should be made based on what makes you feel the most safe, what you want access to. For example, epidurals are only available in the hospital and in many areas water births are only available at home or at a birth center, and what your own medical history and pregnancy health dictates. For example, having a previous c-section, getting pregnant through IVF, or carrying twins or triplets will change the options available to you and your sense of the ideal place to give birth.
When selecting a care provider and building your birth team, make sure that he or she will support you in a birth context that you will be comfortable in. Depending on the area you live in, obstetricians might be working out of multiple hospitals and you might find in researching these hospitals that you have a strong preference. In your search for a hospital, look for the ones with the "Baby Friendly" status. These are institutions that have made a strong commitment to supporting mother-baby bonding and breastfeeding and where you will likely get the most support from the staff in having skin-to-skin time with your baby and access to breastfeeding help.
Further, after selecting the place where you will give birth, also think about what you will want in your birth location to help you with your labor. Do you have preferences in terms of music or lights, are there smells you like (or strongly dislike), would you like to have a birthing ball, is having access to a bath tub important to you, will the sounds of the baby's heartbeat calm you (or distract you), are you a person who enjoys massage or touch, would you like to have people remind you of anything in specific or coach you in any way? No matter how you are giving birth, even if by a planned c-section, you can ask for the environment to be as soothing as possible for you and as supportive of mother-baby bonding. Remember to think through (and talk through with your birth team) all of your preferences so that everyone can assist you in realizing your desires in birth.
3. Find sources for accurate, evidence-based information to help you make the right choices for you and for your baby. In birth, women all want to make the best decisions for their own health and the health of their baby. Women who have struggled to become pregnant, and who might have a higher-risk pregnancy because of it can have even more concerns about these issues. That said, no one wants their commitment to having a healthy mother and baby to be used as leverage to change their birth plan when there is no clear evidence that such interventions are necessary. While c-sections, for example, are clearly life-saving surgeries that we are all thankful for when necessary, rising c-section rates in this country have many pregnant moms concerned about unnecessary interventions or elective procedures. Choosing carefully who you include in your birth team can greatly assist in finding accurate information and feeling knowledgeable and supported in your decision making. Working with a care provider who you trust and who empowers you is really valuable. Working with a care provider who does not have the same priorities or preferences in birth that you do can make getting accurate evidence-based information more difficult. Learning how to gather evidence-based information and make empowered choices for yourself and your baby is a skill that will continue to serve you well throughout your life and your child's life.
4. Listen to positive, empowered stories about pregnancy and birth. In pregnancy, many women find that they become the object of unwanted comments and the recipient of stories that feel scary or disempowering. While you might gain valuable information from other women's disempowering experiences with specific birth locations or care providers, hearing too many negative stories can make it difficult to create your own vision of a positive birth. Learning strategies early on for navigating these situations can be very helpful. You can choose to avoid the books, television shows, magazines or people who make you feel bad with their visions of how birth is or should be. Be honest with well-meaning strangers - tell them you would rather not hear birth stories while you are pregnant and politely decline to hear their story. Find alternative sources for positive stories that reflect the experiences of empowered women. Hearing positive stories can help bolster your own strength and commitments and these stories can help you create a narrative of what you would like from your own experiences.
5. Stay connected to your body. With all of the physical (and emotional) changes that pregnancy can bring, finding ways to stay really present in, and connected to, your body throughout your pregnancy can assist you in feeling strong, confident, and more connected to your baby. Many pregnant women find that maintaining a good level of physical activity is very helpful for staying calm and keeping your energy level up during pregnancy. While some types of activity might become too dangerous (like rock climbing or sparring), too physically awkward, or too taxing on your pregnant body, many women can maintain a good level of activity (in consultation with your care provider) through all 9 months. Prenatal yoga classes are a popular form of physical activity. Swimming is also a very comfortable form of exercise for many women throughout pregnancy. Daily walking is highly recommended and is a gentle way to continue being active. In addition to physical activity, staying connected to and present in your changing body can also be achieved through the practice of meditation; through various forms of body work such as acupuncture or prenatal massage; or even indulgences like a pedicure, a nap, or other things that make you feel good. Remember that when you feel good, you release hormones in your body that bath your baby in those good feelings as well. Laughing a lot, feeling happy and loved, and enjoying yourself in pregnancy is important!
6. Stay connected to your baby. Creating a connection to your growing baby can be deeply empowering for new mothers-to-be. Ways to connect can include rubbing your belly and feeling the shape of your baby as it moves around inside of you, imagining yourself with your baby after it is born, and singing to or talking to your baby, among others. As you feel movements in your belly and sense the position of the baby, you can begin to learn belly mapping - using the movements you feel and the shape of your belly to guide you in detecting the position of your baby.
Another option is to sing to your baby during pregnancy. Some mothers (or fathers) will sing to the baby inside their belly throughout pregnancy as a way of bonding with the baby and feeling connected to their pregnancy. If you sing a specific song to your baby as it grows, you can also sing this song at birth and postpartum as another familiar thing for your baby to hear as they transition out of your body and into the world. If singing is not for you, perhaps playing specific recorded music or playing an instrument for your baby could accomplish the same thing for you.
Finally, engaging with your baby through speech - as you will after they are born - is not only a great way to connect with your baby but also a way to begin experiencing yourself as a mother during pregnancy. Talking to your baby can help you create a calm environment for your baby, and your self, especially when you experience scary or stressful things. While unavoidable, your baby is exposed to the hormones released during scary or stressful events and talking about what is happening can help to calm both of you during these times. Explain what the situation, remind yourself and your baby that it will all be alright, and take some deep breathes. It can help to release fear and anxiety from your body.
While this is not an exhaustive list of the possibilities for how to achieve an empowered pregnancy, these strategies will help you to gain the knowledge, authority, and confidence needed to have an empowered pregnancy, birth, and transition to motherhood. Using pregnancy as a platform for becoming more confident in your self and more authorized to make your own decisions is a beautiful way to transition into motherhood. Exploring, strengthening and changing our understandings of ourselves and our capacities creates strong, educated, empowered mothers who model this strength to their children and who are ready to embrace the challenges of parenting with confidence.