Letting Go of Control: Why Birth Demands More Than Protocols

I came across a post by Sara Wickham recently that stopped me in my tracks, as her words often do. She wrote:

"What I find harder to understand is why it’s so hard to get proponents of the technocratic approach to birth to accept that women, babies, in fact, all people, come in different shapes and sizes. That there is such a thing as individual variation. And that there are many shades of normal."

It’s a simple truth, but it still feels revolutionary to say it out loud: there are many shades of normal. Not just in birth, but in everything. No two people are the same, and no two births are the same. This isn’t some fluffy ideal; it’s biology, it’s physiology, it’s psychology, and it’s common sense.

So why is it still so hard for the mainstream maternity system to accept this?

Why does individual variation feel like such a threat?

Why are we still trying to force women’s bodies into predefined pathways, timelines, and expectations that, frankly, don’t fit the vast majority?

What would it take, not just for obstetricians and midwives, but for society as a whole, to truly get what birth is really about?

Why the Medical Model Resists Individual Variation

To understand why the idea of individual variation is met with such resistance in maternity care, we need to take a look at the system itself. Modern obstetrics is built on a foundation of measurement, prediction, and control. From the earliest scans to the final stitches, there’s a sense that everything can be planned, managed, and made safe through careful observation and timely intervention.

In some ways, this approach has its place. Of course, it’s a privilege to have access to medical expertise when complications arise. But the problem is that the system has taken what was meant for the few and applied it to the many.

Standardised care pathways are designed for efficiency, not individuality. Tick-boxes, risk categories, growth charts, time limits on labour, all of it comes from a desire to reduce variation so the system can keep functioning at scale.

But birth isn’t a factory process.

You can’t batch women and babies like products. You can’t measure normal in centimetres and minutes. And you certainly can’t understand someone’s emotional and physiological needs through a form.

What’s worse is that many of these measurements are based on outdated or biased data. “Normal” is often based on Western, white, middle-class bodies, even though maternity care is delivered to people from all backgrounds, histories, cultures, and shapes.

So when a woman falls outside of the ‘normal’ range, which, let’s face it, most do at some point, she’s no longer seen as just different. She’s seen as a problem to fix. And from that moment on, the focus shifts from supporting to managing.

That’s when birth becomes something that is done to someone, rather than something that unfolds within them.

What’s Really at the Heart of Birth?

Birth isn’t a mechanical process. It’s not just about muscles contracting and cervixes opening. It’s emotional, hormonal, spiritual, relational, and profoundly human.

At its heart, birth is a moment of deep surrender. It asks the birthing woman to go within, to listen to her body, to follow sensations that no one else can interpret for her. It asks her to let go of the need to please others, to be polite, to follow instructions. It asks her to trust in something ancient and wild and entirely her own.

That can’t be replicated in a hospital protocol or documented in a care plan.

When we try to control birth too tightly, we take away the very conditions that allow it to unfold. We disrupt the hormonal cocktail that fuels labour, oxytocin, endorphins, melatonin, and we interfere with the environment that allows women to feel safe and undisturbed. We replace it with bright lights, beeping machines, time pressures, and people watching the clock.

But what if we approached birth as something to hold, not something to manage?

What if we saw birth as a rite of passage, one that invites vulnerability, inner strength, and transformation, rather than a problem to solve or a risk to avoid?

This is the shift that so many doulas, midwives, and woman-centred practitioners are trying to make. But it bumps up against a system that is not just medically driven, it's culturally obsessed with control.

That brings us to something deeper. Something we can’t ignore.

Control, Fear, and the Illusion of Safety

It’s no surprise that control is prized in maternity care. In a system where outcomes are closely scrutinised, staff are overworked, and fear of litigation looms large, control offers the illusion of safety.

But that’s exactly what it is, an illusion.

Having a printed flow chart for every scenario might soothe the anxieties of a stretched unit, but it doesn’t guarantee a positive experience. Having the “right” monitoring in place might tick a box on a risk assessment, but it doesn’t ensure well-being. In fact, trying to control birth too much often introduces more risk, not less, whether that’s the risk of trauma, unnecessary intervention, or a complete loss of agency for the birthing woman.

But deeper than all of that is the truth that control is fear wearing a mask.

It says, “We don’t trust this. We don’t trust you. And we certainly don’t trust your body.”

It’s a system-wide anxiety response, one that tries to hold off the unpredictable by applying rigid structure.

The more we fear birth, the more we try to manage it.

But birth is not a problem to be managed. It’s a force to be supported, witnessed, and held.

Which brings us to something I believe has been missing in most conversations about maternity care, a concept deeply rooted in Buddhist practice and spiritual traditions around the world.

Surrender and the Truth of Uncertainty

In Buddhist practice, especially in meditation, there’s a concept that sits at the very core of transformation: surrender.

Not surrender as in giving up or being passive, but a deep letting go. A recognition that we cannot control everything, and that trying to do so only creates more suffering. In meditation, we learn to be with what is, rather than trying to change it. We practise non-attachment, acceptance, and the art of sitting with uncertainty.

Doesn’t that sound familiar?

Birth invites the same thing. It requires the same thing. Not just from the woman giving birth, but from everyone around her.

In many ways, birth is the ultimate moment of surrender. It strips away our identities, our routines, our social masks, and asks us to be fully present in what’s unfolding. The more we try to control it, the harder it becomes. But when we let go, when we drop into the body and trust the process, that’s when birth flows.

So what if we brought that Buddhist understanding into maternity care?

What if obstetricians and midwives were taught not just clinical skills, but emotional presence? What if the training included sitting with discomfort, allowing space for uncertainty, and trusting what they can’t always measure?

Because here’s the thing: certainty is not the same as safety. In fact, the more we chase certainty in birth, the more we disrupt the very conditions that allow it to unfold safely.

There is great wisdom in being still. In holding space. In not knowing.

That’s what most birth professionals aren’t trained in: how to hold space without trying to fix.

How Maternity Care Needs to Change

If we’re serious about changing birth for the better, we have to be honest about what’s missing, not just in the systems and structures, but in the very mindset that underpins maternity care.

Because the truth is, most obstetricians and midwives are not taught how to trust birth. They’re taught how to manage it, monitor it, and intervene when something doesn’t go according to plan. When the training is so deeply rooted in control and risk management, it’s no wonder that variation is treated as a threat.

But what if their training included a deep dive into the physiology of undisturbed birth? What if they were encouraged to explore not only the mechanics, but the emotions, beliefs, and cultural messages that shape each woman’s experience?

What if midwifery and obstetric education included:

• Trauma awareness – understanding how past experiences can affect the body during labour

• Emotional safety – how to create environments where women feel safe enough to let go

• Cultural humility – recognising how different people may need different things in birth

• The nervous system – how stress and adrenaline interfere with birth hormones

• Listening without agenda – how to support someone without trying to steer the outcome

• Spiritual and psychological understanding of birth – as a rite of passage, not just a clinical event

And above all, what if they were taught that not everything can (or should) be controlled?

Let’s be honest, that’s a tough ask in a system that feels under constant pressure. But it’s not impossible. It starts with the smallest shift: from managing birth to meeting the person in front of you.

What Birth Is Really Inviting Us to Remember

Birth, in its purest form, isn’t just about delivering a baby. It’s about transformation. It’s about shedding one identity and stepping into another. Whether someone becomes a mother for the first time or the fifth, something changes. There’s a vulnerability, a power, a reckoning.

Birth remembers who we are.

It calls us back to the truth that we are animals, not machines. That our bodies are wise, not faulty. That the deepest knowing doesn’t come from a textbook or a protocol, but from inside.

It seems like society has forgotten that.

We’ve built a world where we try to control everything: our bodies, our feelings, our outcomes. We reward certainty and punish messiness. We look for numbers instead of narratives. We forget that life is full of mystery, and birth is where that mystery comes through us.

What birth invites us to remember is that surrender isn’t failure. It’s a source of strength. Letting go is not weakness; it’s the gateway to transformation. Support isn’t about doing, it’s about being.

Doulas know this.

Many midwives know this, even if the system doesn’t always let them practise that way.

I believe many obstetricians would be open to knowing it, too, if only the system allowed room for more than the rules.

This is the invitation: to remember that the goal of birth is not just a healthy baby, but a whole woman. One who feels heard, held, and honoured. One who looks back on her birth experience not with trauma or shame, but with a sense of pride, healing, and inner power.

Trusting Birth, Trusting Women, Trusting Life

If we want to transform birth, we have to begin by transforming how we see birth.

We have to move away from the idea that it’s a problem to be solved and return to the truth that it is a process to be supported. Not managed. Not feared. Not controlled. Supported.

That starts with trusting women. It means listening when they say something doesn’t feel right. It means believing them when they ask for something different. It means recognising that every body is different, every story is different, and every birth is different, and that’s not a complication, it’s a reality.

It also means trusting birth itself. Not blindly or dogmatically, but with deep respect for its wisdom, its unpredictability, and its sacredness. Birth, like meditation, invites us to be present. To witness without interfering. To allow, rather than to force. To trust what is unfolding, even when it doesn’t match our expectations.

More than that, we need to trust life.

We live in a world that teaches us to fear pain, avoid risk, and strive for certainty. Birth teaches us something else. It teaches us to lean in. To open. To let go. Not just in birth, but in the rest of our lives.

The more we can learn to surrender to what is, in ourselves, in others, in the messiness of being human, the more we create space for compassion, connection, and growth.

Maybe that’s what birth is trying to teach us, if only we’d listen:

Life is not a protocol. It’s a process. The more we surrender to that truth, the freer and safer we become.