#MindrMama Ilana Stanger-Ross is a Canada-based midwife and author who has set out to turn 14 years of witnessing hundreds of births and listening to thousands of stories into the book she wished she'd had when she was pregnant. We caught up with Ilana to learn more about what makes for a positive birth experience, what “Jane the Virgin” got so right, and her hopes for A for Advice (Of the Reassuring Kind), which hits shelves on March 26th.

What do you think makes for a "good" birth experience? How can women best set themselves up for this kind of experience?

This is such an important question. Sometimes, as medical professionals, we assume that a “good” birth is any birth that isn’t clinically complicated. “That was straightforward,” we might think, assuming that just because it was textbook for us it was “good” for the laboring woman. But of course that isn’t always the case – the woman’s experience of birth may be completely different than that of her care providers: she might have been scared, or felt alone, or she might have even felt violated by the experience.

Birth is a medical event, but it is also so intimate, so primal, so personal. A woman’s experience of birth matters so much – ask the oldest woman you can find about the birth of her children and she will tell you her story, she will remember. It stays with her.

So: what makes a “good” birth for the person giving birth? The research is pretty clear on this, actually. Women who report the best birth experiences aren’t necessarily the ones who had the most clinically straightforward births, but rather those who felt that they understood all actions recommended and had a voice in any decisions.

Perhaps you were hoping for a fast, unmedicated birth at a birth center, and instead ended up having a Cesearan section following a long labor with the full gamut of interventions. But if you felt supported, if you felt safe, if you felt like you had a voice in saying, yes, this makes sense, I understand why this is happening in this way, then your experience of that birth will hopefully still feel “good” even if it’s not the birth you would have written for yourself in an ideal world.

Trust and communication are so important. Choose a care provider who takes the time to support your choices and talk through any decisions – it makes a real difference. 

You write about media portrayals of birth fueling the fear and doubt of expectant mothers. Can you recommend any shows or movies that depict labor and delivery in a more responsible and reassuring way?

My kids hate watching movie and television birth scenes with me, because I always end up yelling in frustration at the screen. But, there are some good ones out there. “Jane the Virgin” is pretty wonderful – well, up to the point where newborn Mateo gets kidnapped, at least! I also love the beginning of the birth scene in “Knocked Up,” when Katherine Heigl is laboring quietly in the tub at home, warning the Seth Rogan character not to “freak out” and to support her staying home during early labor. Also in that movie: when things do get a bit hairy, Rogan’s character questions the doctor to gain clarity around just how much of an emergency the emergency is.

There’s also a quirky Canadian show, ‘Being Erica,’ in which an OBGYN character has a lovely home water birth with Registered Midwives. Needless to say, that one is my very favorite. What these depictions have in common is that they normalize birth, allowing the drama to come from the event itself rather than from a medical emergency.

We love your philosophy that, although it is impossible to control your birth, "loss of control does not mean loss of consent." What advice do you have for women who are struggling to find their voice within what is often an overwhelming healthcare infrastructure?

Don’t give up. Keep struggling, keep asking. Reach out to other people who have had babies — see who and what they recommend. And if you can: get a doula. They are worth their weight in gold. It can absolutely be overwhelming to navigate the maternity system — especially since pregnancy can be such a vulnerable time. Having someone who is experienced with the kinds of questions and choices that may arise, who understands you and where you’re coming from, and who can rub your back while explaining where things are at, is nothing short of wonderful. I love working with doulas, and people who have doula support do report better birth experiences.

In your alphabet of advice, G is for Guilt. As you write, "We put a lot of pressure on ourselves: the perfect birth, the perfect baby, the perfect mother." Do you have advice for resisting this "mom-guilt," which can seem to begin the second we find out we are pregnant?

That’s a tough one, definitely. I think we all need a t-shirt that says just that, “Resist the mom-guilt.” Scratch that: make it a tattoo. Really though, I find that when I feel most inadequate as a mother it’s because of external pressures: I’m looking at someone else’s Instagram post of baking with their child, say, or teaching their child to read, and everything looks so picture-perfect that I immediately feel like a failure. And yet when I consider what my children really need, the clear answer is: love and security. All the rest is a kind of window-dressing.

What I’ve learned in midwifery is that women need to find the right kinds of support (including from one another) so that we feel confident in our own choices as mothers. As that confidence grows, the guilt ebbs. None of us is perfect, and perfection is not what children need, anyway. In the same way that we need to be gentle with our children, we need to be gentle with ourselves.  

What is your hope for this book and its impact on the world?

I hope that my book offers both reassurance and a kind of awakening. There’s so much pressure on pregnant people, and I do want to try to relieve some of that anxiety. At the same time, we all need to advocate for a better maternity system, prenatally and postpartum. Let’s take the pressure off ourselves, and let’s put it instead on our system. Let’s find, and demand, the support that we need and deserve.

Oh, and also: I really love the illustrations and hope others will too. 

A is for Advice is available for pre-order now on Amazon, and hits shelves at your favorite independent bookseller on March 26th.

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