23. "They Wouldn't Let Me": The Birth Language That's Working Against You

"They wouldn't let me go past 40 weeks."
"They made me get an injection."
"I had to have a C-section."

This is the language of permission and it's so normal in birth culture that most of us don't even notice it.

In this episode, we're talking about how the words we use around birth quietly shape what we believe about our role in it. And our role in our birth is not a small thing.

Here's what we get into:

• Why language is never neutral including in birth
• What "let," "made," and "had to" are really communicating about your autonomy
• The legal principle of informed consent and why permission language doesn't reflect it
• How this starts in prenatal care, long before labor
• What ownership language sounds like in practice, with real examples
• Why this matters before, during, and after your birth, including what the research says about birth trauma and perceived control
• Why none of this is about going adversarial with your care team

This episode is for every pregnant woman, regardless of where or how she plans to give birth.

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Transcript

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You're listening to Rise, a Christian birth podcast for encouragement, education, and biblical truth for birth without fear. I'm your host, Mana, childbirth educator, doula, and mom of three, here to help you rise above fear and prepare for a faith-filled birth. There is a language pattern so common in birth culture that most of us don't even notice it. It's the language of permission. And once you hear it, you cannot unhear it. I kind of mentally cringe whenever I hear this now. Not because it's wrong, but because I know how it feels to think that way, and it doesn't really reflect the legal reality of the situation. Words are not neutral. The language that we use shapes what we believe, and what we believe shapes how we show up, shapes how we make decisions. It's not just a communication principle, it's a biblical one. Proverbs 18, 21 says that the tongue has the power of life and death. James devotes almost an entire chapter, James 3, to the weight of our words. The way that we talk about something tells us and everyone listening what we actually believe to be true about it. And the language that you use around your pregnancy and your labor shapes what you believe about your role in it. And your role in your birth is not a small thing. You are not a passive participant. You are the one who makes decisions about your own body and your own baby. There's a way of talking about birth that has just become so normal when we're telling birth stories or talking about our appointments that we don't even necessarily notice it. And it sounds something like these statements. Let, made, had to. These are permission words. They position your provider as the one who grants or withholds or permits or requires, and you as the one who receives whatever is decided on your behalf. That language is not reflective of the legal reality of the provider-patient relationship. No provider can make you do anything. No provider lets you do anything. Your medical team can advise, recommend, strongly urge, and apply pressure. And yes, of course, sometimes they can be coercive or they might even present things as if it's not your decision to make. They cannot legally make a medical decision for your body without your consent. That is your legal right as a patient, firmly established in medical ethics and law. The principle behind all of this is called informed consent. It's kind of a buzzword in the birth world. You've probably heard me talk about it on this podcast before. But before any procedure, tests, intervention, you have the right to understand what is being proposed, why it is being proposed, what the risks and benefits are, what the alternatives are, and what would happen if you choose to decline. And then you have the right to say yes or no every single time. It's not like a natural birth philosophy. It's a fundamental principle of medical ethics that applies to every patient in every setting, including pregnancy and labor and birth. And when we say they wouldn't let me, we're describing a situation where we had a choice as if we had no choice at all. This starts in prenatal care. It's not just in the context of labor and delivery, it starts long before that. It starts at your first prenatal appointment. If a nurse tells you that something is required without explaining why, it shows up when you're scheduled for a test and nobody asks whether you want it. It shows up when recommendations are made in a tone that suggests that the decision has already been made for you. I've had in the last like month, I've had multiple clients tell me that they had additional ultrasounds scheduled for them in the third trimester, and they don't know why they're getting those additional ultrasounds. So permission language takes root prenatally, and then by the time you're in labor, potentially exhausted, potentially in pain, potentially in a vulnerable moment, it's already kind of become your default mental model. You've been walking through pregnancy as a passenger in your own care, and that posture doesn't suddenly just flip on its head once you're in the delivery room. So getting aware of this language and kind of choosing to practice different language is something to start during pregnancy. It's not, it's not just labor prep, it's like every prenatal appointment is an opportunity to show up as an active participant rather than someone being managed. And all of this is just part of taking responsibility for your birth and for your baby. And if you have been using this language, you know, they wouldn't let me. I had to, you're not doing anything wrong. You're just speaking the language of birth culture. It's everywhere. It's in the birth stories that we're reading and conversations with family. It's definitely in the way that providers themselves often phrase things. And it it kind of makes sense that when you're in a medical setting, it it can genuinely feel like you're a guest in someone else's house. You're in their building, you're wearing their hospital gown, surrounded by their equipment. And so there is an interesting kind of power dynamic that I can understand. Like that, that is a real feeling. So of course it can feel like things are just happening to you. But there's a difference between the feeling and the reality. And if you can understand that difference, it's going to change how you prepare and how you show up in your appointments and how you most importantly, and this is what I really want to get to, how you process your birth afterward. I I learned this the hard way. You know, after my first birth, I spent a long time using this exact language. Um, you know, they never told me XYZ, nobody asked me about this, they said that I had to do this. And it really felt true because it felt like things had just happened to me. I wasn't consulted, I felt kind of powerless at times, um, and I felt like the system had failed me. And all those statements were part of me trying to pin the blame on someone. It was me trying to figure out whose fault is it that all this stuff happened to me and that I had such a hard time. And I acknowledge that some of that was real. Part of it came from the way that the system is set up and the way that I do believe some providers are taught to administer care is to not necessarily present all the options and not make it sound like you have a lot of choices. I wasn't always communicated with well, and those things really did happen. But also, and here's what took me a long time to sit with: I also had not taken ownership. I had not prepared, I hadn't researched, I had not asked questions. I walked in kind of expecting everyone in the room to take care of me and do right by me. And so when that didn't fully happen, I didn't really have a leg to stand on. And the hardest part of processing my first birth wasn't recognizing that my providers had been imperfect. It was recognizing my own role that I had kind of handed over my autonomy because I had never understood that it was mine to hold on to in the first place. And that was not easy. But until I could see that, honestly, I couldn't prepare any differently for my next birth. I couldn't walk into my second birth with clarity and ownership until I recognized the role that I played in my own first experience. This so this is not an invitation to feel guilt or shame. It's not about blaming yourself. It's just an invitation into a different framework in order to actually give you something back that was always yours that you might not have realized. So, what ownership language can sound like in practice, permission language would be they wouldn't let me go past 40 weeks. Ownership language. My provider recommended induction at 40 weeks, we discussed it, and I decided to accept. Or we discussed it and I decided to decline. Permission language, they made me get a rogue injection. Ownership language, my provider recommended a rogue injection, and I agreed after learning more about it. Or you know, or it could be I agreed, I didn't really need to know any more about it, because I trust my provider. Or I declined. Those would be ownership language statements. Permission language, I had to get a c-section. Ownership language. A c-section was the best choice for me to make given my circumstances. And sometimes ownership language means acknowledging that you didn't ask questions, and that's okay. You're at this point, the goal is just to own it. Permission language, they had to break my water. Ownership language, they said they needed to break my water. I didn't ask questions at the time. I did what seemed best in the moment, and I just let them do it. So ownership language is just honest. It doesn't require that every decision you made was perfect. It doesn't mean that you don't now wish that you had made a different decision than you did at the time. It just requires that you understand and see yourself as the one who made that decision. This might sound really nitpicky if you've never kind of sat and thought about all of this. Um, I know that someone is probably listening to this thinking, well, you know, what about a real emergency? What if you have uh, say, a prolapse cord or something like that, and your provider says your baby needs to be born right now. And yes, under those circumstances, virtually everyone would agree you quote unquote had to have a C-section. Okay, I get that. But there are so, so many decisions that are made in pregnancy, labor, and birth that are a lot more nuanced than that and that aren't as obvious. And maybe you have a whole group of people who said let's take breach birth, okay? You've got a whole community of people out there who says breach birth is dangerous 100% of the time, C-section every time for for a breach baby. Um, but you also have a whole community of people out there who say, Nope, if you have sufficient training and experience, breach birth is just a variation of normal, and it can be perfectly safe if you have an experienced provider, and it's just another normal way to give birth. And it literally just depends on who your provider is, which side of that coin they fall on, right? So, so there's nuance there. In a situation like that, who decides? You you do a personal risk evaluation and decide what you are comfortable with and what sounds riskier to you. Would you rather have the risks of a C-section or the risks of a vaginal breach birth? And there's no right or wrong answer, you know? So things like a provider recommending induction at 40 weeks, because that's just the policy of the practice. Everybody delivers by 40 weeks. Um, an offer to break your water to speed things along, a suggestion to start Pitocin, a cervical check that you didn't ask for, any one of those could be appropriate and agreeable to you or not. They're they're just recommendations. But if you don't recognize that it is your choice to agree or disagree or accept or decline any of those things, then you end up feeling like a passenger. This is not about just sort of wielding power over your providers, right? None of this is about going into your appointments adversarially or treating your care team like the enemy. We we hire medical professionals to consult with us. We want their expertise, we want their training, we want their clinical judgment that's genuinely valuable and worth taking seriously. And a good provider relationship is collaborative. You know, I think all of this is part of why it's so important and beneficial to have a provider that you really, really trust to have your best interests in mind, so that when those suggestions come up, you can either really confidently and comfortably agree and say, yes, I I know this provider, I know they know me, and I'm good with that, or very confidently and comfortably decline because you know that they respect your autonomy. You bring your goals and your values and your knowledge of your own body, they bring the clinical expertise, and together you make better decisions than either one of you would have alone, right? So it's not about just going in guns blazing and and being ready to just say no to everything and you're in charge of everything and all of that. What this is about is using language that reflects the actual nature of that relationship, which is that your provider is a consultant. They give recommendations, they offer professional judgment, they explain what they believe is safest and best, they have their own biases just like you have your own biases, and then you make the decision. Your doctor is not your baby's parent. You are your baby's parent. Your provider, while I hope that they are a good steward of your care and of your birth, they are not the primary steward of your baby. You are. Before birth, the language that you use shapes how you prepare. If you believe that your provider is the one that makes all the decisions, you're less likely to ask questions, you're less likely to research your options and to really carefully think through your preferences. If you can, I would encourage you to show up a little bit differently. I would encourage you to show up with questions, with curiosity, and with the understanding that you are the one who ultimately decides. During birth, this concept actually, I really believe comes out in physiological ways. If you've listened to the podcast, you've probably heard me talk about oxytocin. It's this really important hormone that kind of drives your labor and also helps you to stay comfortable and helps you to cope with pain and all of that stuff. And oxytocin is inhibited when you feel emotions such as being rushed, being threatened, feeling unsafe, feeling unheard. All of those things actually keep your body from making the oxytocin that your labor literally needs to move forward, and also the oxytocin that helps you to produce endorphins, which helps you to cope with what's happening. So those are real impacts that all that stuff genuinely can have on how your labor actually goes. And then after birth, and this I think is what I really would emphasize to you is this concept shapes how you process your experience. If you come out of it feeling like things were just done to you and you didn't have any say in anything, you can come out feeling powerless, even if every decision that was made was a good and necessary decision, even then. But if you can come out and say, I made the best decisions that I could with the information that I had, and I made each choice and did what felt right at that moment. That's such a fundamentally different internal experience. The research that we have on birth trauma identifies a perceived lack of control as one of the primary drivers of traumatic birth experiences. So even more often than like actual medical emergencies, more often than that, birth trauma has to do with the mom being made to feel like she was out of control, didn't have any say in what was going on, didn't have control over what was happening to her. This is about whether you felt like a participant or a bystander. And advocating for yourself in birth does not always have to look super dramatic. It can it can look like just asking, you know, what are my options? It can look like saying, I need a few minutes to think about this. Um, it looks like going into your appointments, having done your homework and being ready to have a real conversation and ask real questions. Not that you're gonna know every single thing every single time. I don't expect you to like go to med school before you give birth, but you can do what you can. And the language that you use reinforces that posture or quietly undermines it. So words that position you as a recipient of decisions are just inaccurate. They're they don't reflect the legal reality of your situation, and they're slowly shaping a mindset that makes advocacy harder. So let the language that you use reflect what is actually true. You are not waiting to be allowed or made or forced. You are deciding, you are choosing, you are the steward of this birth. And if you want help with this, learning how to navigate conversations with your care team, how to ask the right questions, how to go into your birth feeling prepared to make your own decisions that you can really take ownership of. My Autonomous Birth Workshop is exactly for all of that. The link to that will be in the show notes. Thank you for listening, and I will see you next time.