There are a lot of things blogger and activist Katie Vigos wishes she’d known before giving birth to her first child.

“My whole life, birth was celebrated as something I should look forward to as a woman, but was never discussed openly,” Vigos, who was raised Mormon, said. “In the midst of a 22-hour labor, I realized I had no idea what was going on, I had no idea what this was actually supposed to be like.”

Most of her impressions about childbirth came from TV and movies, so all Vigos says she really knew was to be afraid.

“I thought I had a good handle on it,” said Vigos, who gave birth in 2007 at the age of 21. “The only reference I had was what I’d been exposed to in the media, and they’re all alike — a woman on her back, screaming.”

The reality was quite different. Vigos says she was overwhelmed by the length of the process and felt embarrassed that she hadn't known more.

Today, as a mother of three healthy children, Vigos is the founder of Empowered Birth Project, which aims to educate women about the process of childbirth so others won’t be taken off-guard, as she was.

“What I needed was more education. More depictions (of childbirth) would help with that,” she said. “These unrealistic portrayals create expectations around birth: Birth is something women hate to do, it’s terrifying, it makes the woman horrible to be around. With these depictions, we’re risking a continuation of unrealistic expectations among birthing women and families.”

Vigos’ experience isn’t unique. A 2015 University of Cincinnati study found that movies and television hugely impacted women’s perceptions of pregnancy and childbirth in overt and subliminal ways.

Many women who watched reality birth shows like TLC’s “A Baby Story” or “Birth Day,” (about 44 percent of those surveyed) said they considered such shows an educational resource about birth.

That’s troubling, lead study author Danielle Bessett said at the time the University of Cincinnati study was released, because despite its name, reality TV is often scripted or edited for drama.

“There is a strong sense that what women are getting from those reality shows is a more skewed and medicalized view,” Besset told the American Sociological Association.

TV and movie depictions of childbirth that overdramatize the act are dangerous, experts say, because they impart one message to the viewer: fear.

“The more we view something, the more we normalize it and the media inundates us with images that tell us the same thing: Birth is fearful,” Canadian parenting expert and blogger Tracy Cassels said. “When we go into (childbirth) with fear, it changes the whole physiological process. It makes the negative outcomes we fear much more likely to happen.”

Damaging depictions

It can be hard for some people to believe that a fictional interpretation of childbirth on TV or in a movie can so profoundly impact what women believe about birth.

But Cassels says people underestimate the media’s impact on how they see the world.

“People are supremely unaware of how our exposure to things that aren’t real informs our views of things,” Cassels said. “But that’s good TV because you’re engaged in it. Some part of you is treating it as real.”

Her theory is backed by the University of Cincinnati study, which found that the majority of women surveyed — even those who reported not watching the reality TV birthing shows or claimed the shows had no influence over them — traced their perceptions about birth back to specific TV episodes or movie scenes, citing them as “just the way it is.”

On sitcoms and “mommy reality” shows like TLC’s “A Baby Story,” birth is often depicted as mercifully fast, with the soon-to-be mother’s reactions played for laughs. On the other end of the spectrum, childbirth is a life-threatening endeavor straight out of Stephen King; if not a near-death experience, as is often the case with Discovery Channel’s “I Didn’t Know I Was Pregnant,” then a slow, excruciating death on other shows like “The Walking Dead.”

When a woman internalizes either stereotype — that birth is easy and blissful or dangerous and deadly — the reality of giving birth is bound to be frightening. For some women, who maybe grew up witnessing live births or who exhaustively research the act ahead of time, the prospect may be less scary.

But for many women, Cassels says unrealistic birth expectations can have serious consequences like postpartum depression or postpartum PTSD — a new and growing concern for doctors.

While it’s only been an area of research since about 2006, postpartum PTSD is estimated to affect roughly 17 percent of new mothers, with an estimated 25 percent exhibiting some symptoms of the condition.

If that number doesn’t seem especially significant, consider this: The U.S. Department of Veterans Affairs estimates similar rates of PTSD (between 11 and 20 percent) among soldiers returning from conflicts, including Operation Iraqi Freedom, Desert Storm and Vietnam.

Dangerous double-standard

So if more accurate or respectful depictions of childbirth in TV and movies would help women normalize birth and alleviate fear, what would that look like? Even a show Cassels applauds for its accuracy and realistic portrayals of childbirth — PBS’ “Call the Midwife” — is limited to a one-hour time slot and eschews nudity.

Vigos says showing the concrete physical details of a birth is less important than showing how normal giving birth is, while also recognizing that each birth is different, with its own nuances and, sometimes, complications — something “Midwife” excels at.

“The more we show things how they really are, the more we normalize something that really shouldn’t have to be normalized,” Vigos said. “We’ve drifted so far from having an understanding of what birth is like that we now have to normalize it again.”

This, Cassels says, is the problem with media depictions of childbirth in their current state: Childbirth is often lumped in with gratuitous violence, deemed “too graphic” to be shown. But that’s a cop-out, Cassels says, when millions of Americans tune into shows like HBO’s “Game of Thrones” to watch rape, torture, murder or mutilation any given Sunday night.

“We pull out the excuse that it’s too gross or too graphic and ignore the fact that we’re quite happy with beheadings and zombies eating people,” Cassels said. “We love to compartmentalize.”

It’s a gross double-standard that exasperates author Pamela Erens. Erens wrote her new novel, “Eleven Hours,” a story of two women told over the course of one woman’s labor, to address that double-standard and the dearth of childbirth depictions in literature.

“It’s very strange that we’re more comfortable with gruesome violence than depictions of childbirth. It’s a life-affirming moment, whereas violence is so destructive,” Erens said. “It’s not so much that we need clinical details, this is about what it means to be a woman. Scenes of labor and birth are opportunities to do what fiction does best, which is to show human nature.”

Where this double-standard comes from isn’t immediately clear, but Cassels theorizes that pornography has something to do with it.

“For an entire culture that’s sexualized the female body across all media, seeing (the female body) in its natural use can be very disconcerting and difficult to overcome, because you’re not supposed to think about pregnant women that way,” Cassels said. “There’s an amazing contrast right now between the puritanical views of how our bodies should be used and the explosion of pornographic material sexualizing the female body.”

It’s naive to think that the problems that arise from misleading depictions of childbirth can be corrected with a few well-executed TV episodes. But activists like Cassels, Vigos and others hope that the media that’s created these damaging stereotypes can also help reverse them.

“It perplexes me beyond measure. I don’t know why people are so offended by their own origins,” Vigos said. “I want to see childbirth depicted as something other than just scary and painful, because there are so many aspects of birth that aren’t that. We have everything to gain by doing it.”


Twitter: ChandraMJohnson