The Hidden Realities of Pregnancy, Birth & Postpartum | Nicole Banwell

Jul 2

As physicians, we spend a lot of time preparing people for major moments in their lives. We explain risks, walk through plans, discuss expectations, and try to help people feel ready for whatever comes next. In orthopedics, I do this every day before surgeries and procedures. We talk about recovery timelines, rehabilitation, setbacks, and all of the things people can expect after an injury changes the course of what they thought life would look like.

But one thing medicine has taught me over the years is that preparation and predictability are not the same thing.

No matter how much information someone has, no matter how carefully they plan, life still has a way of unfolding on its own terms.

I found myself thinking about that during my conversation with Nicole (Camardo) Banwell, certified nurse midwife and Doctor of Nursing Practice. We talked about pregnancy, postpartum care, healthcare disparities, and what it means to support women during some of the most transformative moments of their lives. While the conversation covered a wide range of topics, I kept coming back to something that felt much larger than birth itself.

I kept thinking about expectations.

The Pressure to Get It Right

There are few experiences that seem to carry more expectations than pregnancy and motherhood. Women are expected to prepare for birth, prepare for postpartum, prepare for breastfeeding, prepare for work-life balance, prepare for sleep deprivation, and somehow prepare for all of the unknowns that come with bringing another human being into the world. There is an entire culture built around preparing women to do motherhood well.

And yet despite all of that preparation, many women still walk away feeling like they somehow got it wrong.

Nicole spoke openly about seeing women place enormous pressure on themselves to have a perfect birth experience. If labor does not unfold according to the birth plan, if interventions become necessary, if recovery feels harder than expected, or if breastfeeding becomes challenging, many women immediately turn inward and wonder what they should have done differently.

As I listened, I realized this is not unique to pregnancy.

I see versions of this all the time in medicine. Patients often believe that if they followed every recommendation perfectly, exercised enough, stretched enough, ate differently, or prepared more carefully, outcomes should naturally follow. When reality does not align with expectations, many people instinctively assume responsibility for circumstances that may have been completely outside of their control.

We are incredibly good at personalizing things that were never personal failures to begin with.

The Part We Often Forget After Birth

One of the things Nicole said that stayed with me throughout our conversation was a simple statement:

"Mothers need to be mothered too."

The more I thought about it, the more I realized how often we overlook that reality.

During pregnancy, there is so much focus on reaching delivery day. We track milestones, appointments, ultrasounds, and plans for labor. Then suddenly the baby arrives, everyone celebrates, and there can almost be an assumption that the difficult part is over.

But for many women, an entirely different chapter is just beginning.

The physical recovery alone can be demanding. Add sleep deprivation, hormonal changes, feeding challenges, work responsibilities, and the emotional adjustment that comes with caring for another person, and it becomes difficult to imagine how we ever decided this should be something women navigate with so little support.

Listening to Nicole talk about postpartum care made me think about how much of our healthcare system focuses on moments instead of transitions. Birth is treated like an event, but motherhood is a process.

And processes require support.

Rethinking What Strength Looks Like

Nicole also talked about how many women feel pressure to handle everything independently and how difficult it can be for people to accept help even when it is offered.

I thought that distinction was important because we often define strength very narrowly. We tend to think strength means handling everything yourself, pushing through exhaustion, and proving that you can carry more.

But maybe strength looks different than that.

Maybe strength means letting someone bring dinner over when they offer.

Maybe it means saying you are struggling.

Maybe it means asking more questions.

Maybe it means allowing someone else to carry part of the weight for a while.

As physicians, we often witness people during the moments when life becomes heavier than expected. Whether I am helping someone recover after surgery or listening to stories about pregnancy and postpartum experiences, I continue to come back to the same realization: people tend to do better when they feel supported.

Not because support removes the difficult parts.

But because support reminds us that we were never meant to carry all of it alone.

Final Thoughts

What stayed with me after speaking with Nicole is that motherhood asks women to navigate one of the biggest transitions of their lives while often expecting them to do it seamlessly.

Maybe resilience has less to do with proving how much we can carry and more to do with recognizing when we need support.

Because strength matters.

But feeling supported matters too.