| Chapter 1: | Maternal Expectations in 21st-Century U.S. Birth Culture |
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of maternal experiences. From a psychological perspective, however, better understanding the match between expected and lived childbirth experiences is critical because mismatches between the two can result in increased postpartum maternal distress (e.g., Ayers & Pickering, 2005; Crowe & von Baeyer, 1989); early postpartum distress can, in turn, result in more difficult mother–newborn interactions and longer term relationship difficulties (Cicchetti, Rogosch, & Toth, 1998; van Doesum, Riksen-Walraven, Hosman, & Hoefnagels, 2008).
On a broader scale, amplifying the maternal voice is essential in addressing a pervasive and powerful contemporary cultural childbirth message that a healthy newborn’s arrival should erase any maternal misgivings about whatever toll labor and delivery take, a notion perfectly reflected in one mother’s words, “Hello—your baby’s healthy! We’re all shooting for the end product here. So what if you didn’t push it out and got a c-section?” Sadly, the “end product,” no matter how healthy or perfect, cannot undo what came before, and childbirth memories, good and bad, last for years (Simkin, 1992; Waldenstrom, 2003) and influence subsequent childbearing plans and experiences (Gottvall & Waldenstrom, 2002; Hildingsson, Radestad, Rubertsoon, & Waldenstrom, 2002; Pang, Leung, Lan, & Hang Chung, 2008). Evidencing the persistence of childbirth memories, another study mother, whose baby arrived healthy, said of her planned cesarean delivery followed by abysmal postoperative care: “If this had been my first experience … I would have been like, ‘Oh my gosh, don’t ever let me have any more kids’ if this is what it means.” Giving voice to how mothers’ experiences of childbirth may align with or stray from expectations acknowledges their perspectives as worthy, valid, and as central to ongoing discourse surrounding maternal needs and quality care.
Features of Contemporary U.S. Birth Culture Influencing Maternal Expectations
Over 99% of 21st-century U.S. women deliver their newborns in traditional hospitals (Martin et al., 2010). Physicians, whose training