When I tell people I feel ambivalent about being pregnant, I usually get one of two responses. A knowing smile and some version of “you’ll change your mind.” Or a quick reassurance, as though my hesitation were a problem to be fixed rather than a feeling worth understanding.
I noticed this pattern long before I could name it. Growing up, the stories I heard about pregnancy came in two flavors. The first was that it was a breeze and a beautiful miracle. The second was that it was painful, frightening, and sometimes traumatizing. Neither version left much room for nuance. And almost no one talked honestly about what happens on the inside: the grief, the loss of control, the strange feeling of becoming a stranger to yourself, and how difficult it can be to watch your body change rapidly.
As a therapist, I have come to believe that silence is not an accident. It is part of what depth psychology calls the shadow.
What we keep in the shadow
The shadow, as Carl Jung described it, is made up of the feelings and experiences we disown, the parts of ourselves a culture treats as too uncomfortable, too taboo, or too inconvenient to acknowledge. We push them out of view, individually and collectively. Around pregnancy, the shadow holds a great deal: ambivalence about becoming a mother, fear of losing your identity, anger, the real physical risks, and the parts of the experience that are not loving or glowing at all.
When something this big stays unspoken, it does not disappear. It goes underground and gathers force. Women are left to face it alone, often convinced that whatever they feel is shameful or abnormal. One mother described never having heard of perinatal depression before it happened to her, so when it arrived, “I thought I was losing my mind. It was the darkest time of my life, but since having a baby was all I have ever wanted, I beat myself up further for my ‘lack of gratitude’” (as cited in Today’s Parent, 2023). That self-blame is the shadow doing its work.
How pregnancy became a medical event
For most of human history, pregnancy and birth were guided by midwives. A midwife was a teacher and a guide who attended to a woman’s physical, emotional, mental, and spiritual care, surrounded by a community of other women who had been through it. This type of support has been proven to reduce the use of medications and interventions.
That began to change in the 1800s, when male physicians took a growing interest in childbirth. Their approach focused on the physical body and treated birth as a problem to be managed rather than a passage to be honored. Over time, control shifted from women and midwives to doctors and hospitals. Sociologists call this medicalization: the process by which an ordinary part of life gets redefined as something to be diagnosed and treated.
There is real good in modern obstetric care. Lives are saved every day. But something also got lost. When pregnancy became a condition to be monitored, the woman’s inner life stopped counting as part of the picture. As one researcher put it, a culture that defined women primarily as baby-makers ended up neglecting the rest of their health, and the rest of their humanity (Hamzelou).
The cost of not being heard
The consequences are not abstract. Maternal mortality in the United States is higher than in any other wealthy country, and it has been rising (American Medical Association, 2023). Black women are two to three times more likely to die in childbirth than white women, regardless of income or education (Abby Phillip, 2023). These numbers reflect a system that too often does not listen.
Labor and delivery nurses will tell you that birth trauma frequently has nothing to do with a medical emergency. It comes from not being listened to, not feeling prepared, not having things explained. When a woman is treated as a container for a baby rather than a person making decisions about her own body, the experience can wound her even when everything goes “fine” on the chart.
And the silencing starts long before the delivery room. Many women learn early to keep their real feelings to themselves. The psychologist Valerie Rein describes a set of quiet survival instructions women absorb under patriarchy: be seen and not heard, do not be too much, do not take up too much space. By the time pregnancy arrives, many of us have spent years overriding our own intuition. Then we are handed the most embodied experience of our lives and told, essentially, to defer.
Pregnancy as initiation
Here is the reframe that changed things for me. Pregnancy does not have to mean the loss of yourself. It can be an initiation, a passage that asks you to become more fully who you are.
Depth psychology calls this lifelong unfolding “individuation”: the process of differentiating who you authentically are from the expectations of family and culture, and moving toward what Jung called the Self, the deeper center of the personality that holds more than the ego knows. The Jungian analyst Nora Swan-Foster describes pregnancy as one of the most powerful feminine initiations precisely because it contains genuine ordeal: real risk, real danger, and a kind of psychological death of who you used to be. She writes about the “pregnant imagination,” the surge of dreams, images, and feelings that arrive as the body changes, and which carry meaning if a woman has somewhere safe to bring them.
This is where an archetype becomes useful. The Great Mother, the figure cultures have long associated with creation, is not only the nurturing vessel who contains and gives life. She is also the one who separates, who lets go, who is intimate with death. Patriarchal culture has kept the comforting half and exiled the rest into the collective shadow, which leaves women with an impossible standard: be endlessly giving, endlessly serene, never afraid. Recovering the fuller image gives women permission to feel the whole range of what this passage actually asks of them.
When I stopped treating my own resistance as a character flaw and started treating it as information, something shifted. My fear was not really about whether I wanted to raise a child. It was about losing control of my body, my voice, and my choices inside a system that had not earned my trust.
Those are two different questions. Naming the difference gave me back some power.
What helps
If you are pregnant, considering it, or supporting someone who is, a few things tend to make a difference.
Treat ambivalence as normal, not dangerous. You can love the idea of a child and still feel afraid, resentful, or unsure about the process of pregnancy itself. Holding both is a sign of honesty, not a lack of love.
Listen to your body, not only your symptoms. Depth and somatic approaches work with the idea that the body is constantly communicating with us in both conscious and unconscious ways. The nausea, the exhaustion, the bracing feeling in your chest: these are physical, and they can also carry emotional meaning. Slowing down to ask what the body is expressing helps rebuild trust between mind and body during a time when both are changing fast.
Question the messages you have absorbed. A feminist lens in therapy helps separate what you actually want from what culture, family, or the medical system have told you to want. Once you can tell the difference, you can make genuinely informed choices about your care and your birth plan.
Advocate for yourself, and expect to be met. You are allowed to ask why a procedure is recommended, what the alternatives are, and what happens if you wait. Good care sounds like “this is what we recommend and why, and here are your options,” not “this is what we are going to do.”
Reclaiming the power
For generations, women relied on a motherline, knowledge passed from woman to woman, that the medical model quietly displaced. Reclaiming it does not mean rejecting modern medicine. It means refusing to be erased by it.
Pregnancy can be a breeze, or it can be the hardest thing you ever do, or, more likely, it can be both at once and a great deal in between. The goal is not to replace one tidy story with another. It is to make room for the whole truth, the nuance, including the parts we have agreed not to mention, so that women walk into this passage with their eyes open and their voices intact. Kind, compassionate medical care is possible when the mother’s psychological and emotional wellbeing is a priority.
To anyone who has ever been made to feel that what they felt was too much, or not enough: you are allowed to trust yourself.
I’m Anna Balliet, an associate marriage and family therapist who works with women navigating perfectionism, body image, and the questions surrounding pregnancy and motherhood. This piece is adapted from my master’s thesis in counseling psychology at Pacifica Graduate Institute. If it resonated, I’d love for you to subscribe, and feel free to share it with someone who might need it.
Sources and further reading
American Medical Association (2023), Alarming rise in U.S. maternal mortality signals need for change — https://www.ama-assn.org/delivering-care/population-care/alarming-rise-us-maternal-mortality-signals-need-change
Gunja, Gumas & Williams (2022), The U.S. maternal mortality crisis continues to worsen: An international comparison, The Commonwealth Fund — https://www.commonwealthfund.org/blog/2022/us-maternal-mortality-crisis-continues-worsen-international-comparison
Abby Phillip (2023), How I wound up giving birth at home, CNN — on Black maternal mortality
Maya Holcombe (2023), You can advocate for yourself in labor, and a nurse shares how, CNN — https://www.cnn.com/2023/10/16/health/labor-and-delivery-experience-wellness
Jessica Hamzelou (2020), How defining women as baby-makers backfired spectacularly on science, New Scientist
88 things nobody tells you about being pregnant, Today’s Parent (2023) — https://www.todaysparent.com/pregnancy/being-pregnant/things-nobody-tells-you-about-being-pregnant/
Nora Swan-Foster (2012), Pregnancy as a feminine initiation, Journal of Prenatal and Perinatal Psychology and Health, 26(4)
C. G. Jung (1968), Aion: Researches into the phenomenology of the Self, Princeton University Press (orig. 1951)
Sylvia Brinton Perera (1981), Descent to the Goddess: A Way of Initiation for Women, Inner City Books
Christine R. Page (2012), The Healing Power of the Sacred Woman, Bear & Company
Valerie Rein (2019), Patriarchy Stress Disorder, Lioncrest
Peter A. Levine (2022), Somatic Experiencing, Ergos Institute — https://www.somaticexperiencing.com/somatic-experiencing
Staci Boden (1998), Dancing with the Shadow: Transformational Pregnancy as Practice for Living Daily, California Institute of Integral Studies
Oregon Health & Science University, A Brief History of Midwifery in America — https://www.ohsu.edu/womens-health/brief-history-midwifery-america
Elena Neiterman (2013), Sharing bodies: The impact of the biomedical model of pregnancy, Healthcare Policy, 9
Gerald Corey (2009), Case Approach to Counseling and Psychotherapy (7th ed.), Thomson
Love this piece!
Brilliant!