By Jen Soriano
In February 2014, I was six months pregnant and already looking like I was about to pop. My husband and I had just moved from Puerto Rico to Seattle, and one of my tasks – besides continuing to work full time and adjusting to a whole new city and climate at the opposite corner of the hemisphere – was to learn how to do this thing called giving birth.
I googled “childbirth classes in Seattle” and found one that lasted an afternoon, and another that lasted eight weeks. I chose the eight week class. I needed as much help as I could get. But the eight week class was full. So I put myself on the waitlist, and resigned myself to doing the crash course class in one afternoon.
When I was six years old I thought babies practically materialized out of thin air. I had watched a movie called the Blue Lagoon, in which Brooke Shields goes from being pregnant to having a newborn baby in her hands with no blood, sweat or a hair out of place, like she just dove into the lagoon and fished the kid out.
For most of the rest of my life I heard the messages that childbirth was “natural” and “easy” and “something women were born to do.” While these natural childbirth mantras served the important purpose of countering unnecessary medical interventions, they also obscured the fact that childbirth is not something that comes naturally to all who want to have kids.
As I write in my book NERVOUS, my process of getting pregnant, carrying a child, and preparing for birth was one that was fraught with both physical and mental health challenges. I suffered from a little-known phenomenon called tokophobia, which is a pathological fear of pregnancy and birth. I carried phantoms of transgenerational trauma from my ancestors’ experiences with war and colonization. I experienced delusions that I might harm or even crush and suffocate my baby during labor.
Thankfully, I got expert help to deal with all these challenges. And this help came in the form of the eight-week childbirth class and its teacher, Penny Simkin. By some miracle that I will always be thankful for, one person dropped out of the class and we were first on the waitlist. And so my journey toward a trauma-informed birth began. What I didn’t know at the time was that Penny Simkin, the teacher, was a nationally-known leader in gentle birthing and a founder of the modern doula movement.
On the first day of class, Penny introduced us to her velvet vagina puppet to teach us how to help the baby crown.
“See the baby’s head, it comes out through here!” she said gleefully. A plush baby head popped out from between the velvet labia and moved around as Penny waved her hand.
We all laughed.
“I want you all to repeat after me,” Penny said. “Pa, pa, pa.”
“Pa, pa, pa,” we all complied.
“You’ve seen what birth looks like on TV, right?” Penny asked. “All that teeth grinding and primal screaming and the doctor yelling at the mom to push?”
We nodded.
“That’s hogwash,” Penny said. “When the baby’s head crowns and you’re in transition, it’s time to stop pushing. Your contractions have gotten you that far, and it’s time to ride the wave. Try it again: pa, pa, pa.”
“Pa, pa, pa!”
“Saying this will help you remember to stop pushing, and the breathing that comes with the syllables will allow your inner muscles to do the work. Trust that you have already done most of the labor.”
I, for one, had been ready to push and scream until my guts came out. But this gem of knowledge helped me prevent severe vaginal tearing, which in itself can be a form of trauma.
What I was more worried about than vaginal tears was how the psychological trauma I carried would affect my baby. When I shared this with Penny, she volunteered her time to work with us to create a trauma-informed birthing plan. She helped me translate my fears into practical requests for the medical staff at the hospital where I was to give birth. The plan explained what I might not be able to share in words during labor, for example:
- I may have strong emotional reactions, so I will need help breathing, moving, staying warm, and feeling nurtured and supported.
- I’m more worried about emotional triggering than I am about physical pain. I want my birth team to not mistake any emotional reactions I might have (like crying or even sobbing, shaking, etc.) as a sign that I need pain medications, and to instead let me move through the emotions with support.
If you’re interested in the full story, I hope you’ll consider reading my book, NERVOUS. To fast forward here, I’m happy to report that thanks in large part to this birth plan, I had the birth of my dreams. Not a Blue Lagoon birth, but a hard and honest labor in which I was allowed to move through my emotions as well as move through different physical positions, and which resulted in a healthy crier of an infant child.
Penny recently passed away, leaving a legacy of 53+ years of working for birth justice. I am one of the more than 15,000 birthing people she has helped in her lifetime, and my son one of the more than 15,000 children she has helped bring into the world. She was a key part of our journey of trying to break cycles of generational trauma at the source.
Starting a birthing plan:
For everyone who wants to carry a child and give birth, I recommend finding a doula who can help you carry out your birth plan and who can provide physical and emotional support during labor. If you can’t afford to pay a doula, see if a friend can volunteer to act as your labor companion.
Managing tokophobia:
For anyone who feels they may be experiencing tokophobia, I recommend finding a mental health professional to talk to, and also a midwife or doula who specializes in trauma-informed birth, perhaps even one of the hundreds trained by Penny Simkin.
Combatting biases with your plan:
For people of color, people with lower income, and LGBTQI+ people especially, institutional biases and discrimination make it even more important to have a trauma-informed birth plan. Until we can transform these systems to address racial, gender, and class disparities, a trauma-informed birth plan and a supportive birthing team can make the difference between birth as a moment of perpetuating trauma, and birth as a moment to break cycles of trauma and usher in well-being and joy.
Jen Soriano is an award-winning Filipinx writer, scholar, multidisciplinary performer and mental health advocate. based in Seattle. She is the author of Nervous: Essays on Heritage and Healing and co-editor of Closer to Liberation: A Pina/xy Activist Anthology. Nervous was recognized by TIME, GLAMOUR, The Atlantic, Poets&Writers, and other outlets as a notable book of 2023.
