It’s Not the Job of the Pregnant Person to Be More Trusting—It’s the Job of the System to Be More Trustworthy
Pregnancy and birth are among the most transformative experiences in a person’s life. They require immense strength, resilience, and vulnerability. Yet, in a system that often prioritizes efficiency over individualized care, many expectant parents are told to simply “trust” their providers, institutions, and protocols—despite a long history of medical mistreatment, systemic racism, and dismissal of patient concerns.
But here’s the truth: It is not the job of the pregnant person to be more trusting; it is the job of the system to be more trustworthy.
The Problem with “Just Trust Us”
Too often, pregnant individuals are expected to override their instincts, ignore red flags, and place unwavering faith in a system that has historically failed many of them. They’re told to “trust the process” when their concerns are brushed aside, to “trust the experts” even when their voices are drowned out, and to “trust the system” despite glaring inequities in maternal care.
This expectation is especially harmful for marginalized groups. Black and Indigenous women, for example, experience significantly higher maternal mortality rates in the U.S. due to systemic bias and inadequate care. Rather than addressing these failures, the burden is frequently placed on the patient to trust more, comply more, and question less.
What Does a Trustworthy System Look Like?
A truly trustworthy system is one that earns trust, rather than demanding it. This means:
Listening to Pregnant People: Respecting their autonomy, honoring their birth plans, and taking their concerns seriously.
Providing Informed Consent: Ensuring that all medical decisions are based on shared decision-making rather than coercion or fear tactics.
Addressing Bias and Disparities: Acknowledging systemic inequities and actively working to eliminate them.
Prioritizing Physiological Birth When Possible: Understanding that birth is not inherently a medical emergency and supporting low-intervention options when appropriate.
Ensuring Continuity of Care: Creating a model of care that allows pregnant people to build trusting relationships with their providers instead of cycling through a rotating system of unfamiliar faces.
The Role of Birth Workers and Advocates
As doulas, midwives, educators, and advocates, we have a responsibility to push for a birth system that is worthy of trust. We do this by amplifying the voices of birthing people, demanding systemic changes, and ensuring that expectant parents feel supported and informed rather than dismissed or pressured.
Pregnant people should never have to fight for respect or reassurance in a system that is supposed to serve them. Trust must be built through transparency, accountability, and compassion. The onus is not on them to be more trusting—it’s on the system to prove it deserves their trust.
