On Feeling Abandoned in Childbirth

by Pam England

Abandonment is frequently described in birth story sessions. When examining its causes and consequences, we discover an intricate web of influences and meanings. Whether it is an underlying piece or the centerpiece of a birth story, the experience of abandonment occurs when a storyteller feels unseen, disbelieved, or judged; when her questions, emotional, physical, or comfort needs go unnoticed or are unmet; or when she was left alone in an unfamiliar environment or a situation that felt lonely or scary.

People with a history of being abandoned or neglected in childhood often have life-long apprehension about not being seen, accepted, or genuinely cared about. On the one hand, they want to be special and looked after; on the other, they don’t expect to be, believing they are unworthy. And yet, during labor, postpartum, and hospitalization, in general, we should expect, depend on, and feel deserving of respect and empathy. Still, it is difficult for people with abandonment trauma to trust that people will show up for them or to ask for—and be comfortable accepting what they need.  

The difficulty asking for more help and support in labor is compounded by three factors: One, being on foreign turf with stranger-caregivers who are busy and with whom there is little established rapport (versus being in their own home with chosen midwives). Another is how the non-verbal trance and fatigue of labor interferes with trying to put into words—between contractions—what is needed. And finally, for adults who were conditioned in childhood to be stoic, e.g., resigned or passive, or not to be needy, dependent, or take up too much time—the gap between the need and being deserving or capable of engaging help is wider. 

Feelings of neglect and disappointment could matter more when the person who didn’t “show up” as expected (or fantasized) was someone the storyteller knew, trusted, and needed. A partner, birth attendant, or doula can be physically, even dutifully present, but emotionally absent (for any number of reasons). 

Abandoning Ourselves: Making Meaning

The meanings storytellers often give to feeling invisible or unmet are along the lines of, “I am not important,” “I don’t matter,” or “It’s my fault because I did not ask for what I needed.”

Too often a birth storyteller, usually the mom, blames herself for not getting what she needed because she did not ask for it. (Does this come from the oft-repeated canned advice to “just ask for what you need”?)  How true is the popular maxim, “Everything women need to know is within them?“  Can an uninitiated woman always know what she will need, or needs in labor or postpartum? (I was a nurse-midwife when I was in labor. As a mother in-labor, versus at a labor, I discovered I did not know everything.)

A recent increase in abandonment trauma during childbirth

The Covid-19 pandemic (2020-2022), many women and couples experienced feeling lonely and isolated when hospitals’ infection-control protocols determined that partners and labor companions could not accompany parents to prenatal appointments. During labor, typically only one person was allowed to go into the hospital with the mom (but they could not leave the room and come back in); this meant that in the event of prolonged labor or postpartum, a fresh backup labor companion could not relieve the exhausted primary support to provide continuous ongoing support.1  Women everywhere reported the stress of isolation and lack of support during their childbearing year, including cancelled baby showers or blessingways, not having their chosen birth companion in labor or postpartum, and having to cancel relatives’ flights from other islands or the mainland.3 The absence of empathic and informed support, in addition to the stress of covid isolation, contributed to postpartum depression.  

What follows the emotional, hurtful disturbance and 
disappointment of feeling unseen, unmet, or abandoned? 
What are some new ways of thinking about this, or reframing this story?

Let’s look in the Medicine Cabinet!

As long as the storyteller stays in the emotionally charged (subjective) story (with themself or a listener), they’ll continue to identify with their Orphan-Victim feelings, beliefs, and perceptions. We have more than one internal voice telling our stories at any given telling; each describes a particular perspective. The Victim/Orphan voices pair with the Judge; see the Victim-Judge or Orphan-Judge as two sides of a coin, two voices engaged in an inner dialogue. The Victim version tells the story of feeling small, unheard, unseen, unworthy, and powerless. When this part of us is active, we cannot hear, see, or validate ourselves, so we need someone else to do this for us—and if that someone else also does not do it, we really feel alone and abandoned (and or we blame the other for not showing up for us). 

Then the Judge answers our Victim and blames us for being needy or not asking for what we needed (even though during the initiation of labor and early postpartum, it is not always possible to do). And this is how we get stuck in the revolving story door in our mind!

The Judge-Orphan’s inner dialogue inevitably perpetuates our “abandoning ourselves.” We do this by blaming, judging, shaming, and in various ways punishing ourselves for being neglected, for not being seen. We tell ourselves and believe that it is our fault we were not seen and cared for (we did not ask for what we needed); it is because we “don’t matter” or are “unworthy,” or that there is something inherently wrong with us made people not care for us.

Self Help Tips for Parents

Change the Story You are Bringing to Birth

1. The more you imagine or hope for a certain thing to happen in the future, the more you risk idealizing it, and the more important it becomes to you—or about you. When it comes to preparation and being understood, you can write a birth plan but you can’t make others share your values or meet our expectations. 

So try this: Take a moment to Scale your Expectations to have or be given. For each of the following desires (or choose anything else you are feeling attached to or afraid you won’t get): (1) Your expectations to have your wishes or values respected; (2) to be given informed consent; and (3) to be met with empathy. The scale ranges from 0 (not important at all, wouldn’t notice if it didn’t happen) to 100 (extremely important for peace of mind and satisfaction). To give each rating you’ll have to close your eyes, see the situation, being met, then not met… and notice the importance you give it, the feeling in body and mind, what you are telling yourself it would mean—about you. That’s your Number.

a) Let’s say your Number is very low. If it’s low, consider why you may have such low expectations to have it. Do you feel unworthy? Are you trying to avoid being disappointed if you don’t experience it?  If you get an insight, try raising the importance, the deserving, the dare to have it. Pay attention to your imagination, changes in mood, and ask yourself, if there was one small thing that would increase my chances of having more connection with birth companions you know or just meet along the way, what would YOU do differently to let them know They matter and You matter.

b) Supposing your Number was very high, a very High Expectation. You might anticipate the higher it is the further you might fall into disappointment. The less likely anyone could meet and maintain a high number on the unpredictable day of labor.  So giving others a little wiggle room for spacing out, not being intuitive, or attentive, saying something stupid… drop the Number. For example, if your Number is 80 (you are gambling with your happiness), what happens if you consider living with a 52. Do you feel a little less anxious, a little more connected, accepting?

2. Another thing to consider: Any incident or comment perceived as neglectful or hurtful may not have been intentional; it may have resulted from misinterpreting your needs or the situation, a personality, or from a difference in values; values in childbirth in our culture are extremely varied and polarized. It will be helpful to set your emotions aside for a bit to practice the Second Agreement described in The Four Agreements by don Miguel Ruiz:

“Don’t take anything personally.”

“Whatever happens around you, don’t take it personally. Nothing other people do is because of you. It is because of themselves. All people live in their own dream, in their own mind; they are in a completely different world from the one we live in. When we take something personally, we make the assumption that they know what is in our world, and we try to impose our world on their world.

Even when a situation seems personal, even if others insult you directly, it has nothing to do with you. What they say, what they do, and the opinions they give are according to the agreements they have in their own minds. When you are immune to the opinions and actions of others, you won’t be the victim of needless suffering. Even the opinions you have about yourself are not necessarily true; therefore you don’t need to take whatever you hear in your own mind personally…Don’t take anything personally because by taking things personally you set yourself up to suffer for nothing….When we really see other people as they are without taking it personally, we can never be hurt by what they say or do. Even if others lie to you, it is okay. They are lying to you because they are afraid.”

Change the Story You are Bringing from Birth

3. I. strongly encourage you not to seek or be falsely comforted by listeners who commiserate with you or reinforce the early but limited story and beliefs of the Victim/Orphan and Judge. Keep your counsel. Don’t believe your Victim/Orphan/Judge story as Truth, or repeat it so often that it takes on meaning and possesses you. Instead, call on your inner Huntress to sustain a slow self-inquiry into what you tell yourself. The Huntress has the gift of Far-Seeing which helps you to examine your story in the morning light and candlelight from various perspectives and distances. Try not to “know” or assign meaning to why you did or did not do/say something or to explain what another did–because once you “know,” you stop the search.

And remember, you can always call for a private Birth Story Medicine Session.

Citations

1.  Eri TS, Blix E, Downe S, Vedeler C, Nilsen ABV. (June 2022). Giving birth and becoming a parent during the COVID-19 pandemic: A qualitative analysis of 806 women’s responses to three open-ended questions in an online survey. Midwifery. 109:103321. doi: 10.1016/j.midw.2022.103321. 

2.    Kelsey Q. Wright (May 25, 2022). “It changed the atmosphere surrounding the baby I did have”: Making sense of reproduction during the COVID-19 pandemic.

3.   Khara Jabola-Carolus and Tanya Smith-Johnson (October 27, 2020). Pushing through the Pandemic: Pregnant and Birthing during Covid-19 in Hawai’i.  Hawaiʻi State Commission on the Status of Women Department of Human Services. 

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