Knowledge is Power vs. Ignorance is Bliss: Finding Balance in Pregnancy to Keep You Sane

Host Katie O'Brien explores two opposing mindsets in pregnancy: chasing every piece of information available versus opting out of some tests and research altogether. Using relatable analogies, she breaks down when knowledge genuinely helps you control outcomes versus when it just breeds anxiety without changing anything. She digs into the guilt culture around pregnancy outcomes in the U.S., reminding listeners that pregnancy and birth can't be fully controlled — only your response to them can be. The episode closes with seven practical tips for couples: talking openly about testing decisions, avoiding "Dr. Google/ChatGPT," building a real support network, and recognizing "artificial urgency" (like obsessively checking lab portals) that fuels unnecessary stress.

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Hello and welcome to Calm, Collected, and Consented. I'm your host, Katie O'Brien. In this episode, we're gonna talk about whether the pregnancy slogan should be "knowledge is power" or "ignorance is bliss." What I mean by this is, is it better to know all the things in pregnancy, to do all the tests, and to seek as much information as possible? Or is it better to go through pregnancy without stressing about all of this, not doing all the testing, and not trying to find out everything you can, in this episode, we're gonna look at both mentalities, and then I'm gonna talk about why both have their place, and also how to go through pregnancy as a partnership with both of these thought processes Okay, let's get started with knowledge is power. We're gonna go over a couple of reasons why that might be a good slogan in pregnancy. Okay, one, most times knowing more helps you make better decisions. For example, you need to buy a car. You've researched this at length. You've found out the safety ratings, the financing, read reviews, and you feel reasonably reassured that you made the right decision. Now, here's a pregnancy example. You've researched the C-section rate of a hospital, you've researched the ratings, and you've picked the right provider to avoid a C-section. Sounds like a good plan, right? All right. Reason two that knowledge might be power If you know about something, then you can work on fixing it, right? For example, let's say you don't do well on a test. You find out what that grade is, and you study harder the next time. In pregnancy, an example might be before you get pregnant, you get your hormones checked, and you research the best diet and the best workout plan and how to keep your stress in check, and you fix the obvious concerns that you have about your health going into trying to get pregnant. Reason three: the more you know and plan, the less can surprise you. For example, you're going on vacation to Europe. You research all the places you will be going ahead of time, and you also have contingency plans in case those things don't work out. Pregnancy example would be you do all of the carrier screening, that's the genetic screening on yourself, to find out what possible genetic variations you have so you can be prepared with the information. Okay, now let's take those examples and talk about it from the perspective of ignorance is bliss. Same first example. You're buying that car. But instead of researching, you talk to your friends, and you get the car that they have 'cause it worked well for them, right? The pregnancy example. You choose to go to the hospital that's closest to you. You don't really research it, you just say, "Oh, well it's the closest, I'm gonna go there." Problem or reason number two. If you know about something, then you can work on fixing it, right? Well, the ignorance is bliss would say, "Well, if you don't know about something, then you might not have to fix something that's not broken," right? So instead of finding out the grade on that test, you just say, "Hey, I think I did okay. I don't feel like looking at the grade. I don't wanna even know. I'm just gonna study harder next time." Or you study exactly the same The pregnancy example for that would be you don't check your hormones, you don't do any research trying to get pregnant. You just say, "Hey, I'm going off my birth control, and I'm just gonna see how this goes All right, example three. The more you know and plan, the less can surprise you. Here's the example, ignorance is bliss You're going on that same vacation to Europe, but instead of researching any of it, you get a plane ticket and you get a hotel, and otherwise you go and you just figure things out on the fly As far as the pregnancy example, you don't do any of the carrier screening because you don't want to find out any of the genetic variations because you're not going to do anything different anyway With those examples, you can see how there are different ways to look at the same scenarios from a knowledge is power or ignorance is bliss standpoint In pregnancy, both mentalities can have a time and a place. A balance is usually best. Why is that? Because pregnancy is unpredictable and can't be repeated. You can't go back and do it again with the same variables and see if there is a different outcome. In fact, a second pregnancy on the same person can be completely different This doesn't translate the same as life events. For example, let's go back to that European trip. You can go back to Europe and you can decide that the way you went the first time wasn't the way you want to do it the second time, and you pretty much can repeat and see if you succeed. But in pregnancy, you're never going to have the same variables another time and you can't go back and repeat that same pregnancy for a different outcome You can't study your way into guaranteed success. You can do everything right and not have the outcome you were hoping for in pregnancy. Women have come a long way in the workplace and college attendance. We have been taught that if you study, you can have control and you can have a good outcome. You can have a career. We, in fact, reward perfectionism and control. But pregnancy doesn't work like that. It doesn't always matter how hard you've worked and how much you've wanted something. It cannot be controlled. Some women do everything wrong and still have healthy babies and healthy outcomes, and that's the crazy part My mentor used to say it's like a card game. You can study, you can practice, but you still have to wait for the cards to be dealt to see what your hand is, and some hands are better than others Because of this, neither scenario of operating completely in the knowledge is power or ignorance is bliss works well in pregnancy There are things that knowledge can help with. For example, diabetes, since you won't have symptoms if you are diabetic. But there are other things you can't control, such as preeclampsia, and focusing on it too much will add unnecessary anxiety and possibly guilt One of the things that most upsets me about our American culture and birth is the intense guilt we place on mothers-to-be and new moms. Everything I have mentioned so far leads to this. In the US, if there is a bad outcome in pregnancy, if things don't go perfectly, we immediately think there must be an explanation. There must be someone to blame, and oftentimes it is the person that had that thing happen to them. This isn't just birth. It stems from our desire to control and make sure we don't have the same thing happen to us. But in birth, it shows up in so many unhelpful ways: a C-section you didn't want, diabetes, preeclampsia, even a stillbirth or miscarriage. There must be something that could have been done different, right? We must be able to control the outcome, right? What did that woman do wrong? What can I do better? This couldn't be less helpful. It makes me sad when I see a woman and her family have guilt because they believed they could have controlled something that in my professional opinion was uncontrollable. The guilt they have, it's misplaced, and it delays healing. You can't control pregnancy, you can't control labor, you can't control postpartum. I'll say this again. You can't control pregnancy, you can't control labor, and you can't control postpartum. All you can do is control your response. And controlling your response does start with learning usuals and norms and finding out the information that you feel is important to you. But it doesn't start with approaching pregnancy and birth from a, "I must know and must control" standpoint A good way to look at decisions in pregnancy and labor and raising your children is once you have all the information you can have or want to have, it's to say to yourself or yourselves if making the decision as a couple, "This is all the information I have. I am making this decision in this moment with this information, and I am believing in myself and my partner that I did what I thought was best. I will not look back on this decision with 20/20 vision and feel guilty about the decision I made because I will not get to go back to that moment. Guilt will not serve us." So make a decision and understand that the decision that you made, you made with all the information you have, and that it was the right decision at that time So what does all of this mean in practical terms for pregnancy care and preparation of childbirth and postpartum? I'm gonna give you seven pointers on how to use this practically. Number one, discuss with your partner whether or not you feel testing is necessary interestingly, with every test, procedure, et cetera, in pregnancy, you might not feel the same about whether or not you want that information. It's good to talk about this and to get on the same page about why you are coming to that conclusion. Respect that you both can have valid feelings about this test and that it might take more than one quick conversation to get on the same page. A really great example of this is actually whether or not you're gonna find out the sex of your baby Some people feel very strongly about this and it's always interesting if you're not on the same page. But I've seen many couples work through this specific example even if they're not in agreement on finding out or not? Number two, do not underestimate the risk of anxiety that more information in pregnancy can create. Example, things like carrier screening don't give you a definitive answer as to whether or not your baby will have this. There might be some very good reasons to do this testing, including you just wanna know the information. But if you are a carrier of something, this can cause anxiety throughout the pregnancy Three, do not confuse information gathering with the ability to change the outcome. There are a lot of interventions and testings that we do in pregnancy that do not necessarily lead to change in outcome. Going back to that genetic screening, it's not going to change the outcome. It's more likely going to change when you're able to find out about the information Number four, do understand that there are some things where knowledge is really helpful and can change outcomes. Gestational diabetes is an excellent example. Gestational diabetes does not have symptoms. Without testing, most women would not know they have it, but it can be very serious for the developing baby. The good news is that modifying diet and exercise really helps enough to keep the outcome similar to those without gestational diabetes. But if you don't know you have it, you won't have the capability to alter that outcome Five, most providers are open to discussing how important a test or procedure is with you personally. If you have questions about the necessity of testing, bring it up with your provider. Most providers are very good at tailoring the conversation to you and your particular risk factors and also what information you are hoping to gain. They are able to discuss with you the risk benefits of not doing or of doing the test. And frankly, if they aren't willing to discuss this, they might not be the right provider for you. Six, remember skills that you learn now during pregnancy to cope with anxiety are not just for this time. They will also serve you well as a parent. It's important to develop good coping strategies and a support system that does not involve asking ChatGPT for advice. I recently heard that part of our loneliness and breakdown in socialization is that we no longer inquire to other humans about things we need answers to. For example, you want to redo your bathroom. Now you just look it up on YouTube as opposed to going to your neighbor who's specialized in carpentry and could help you. We look up everything on our phones. In pregnancy, try not to do this. Try during pregnancy to start talking as partners about things and looking for answers together from other human beings. This will serve you well, especially in the postpartum time when you have developed a network of trusted advisors. I definitely got more questions 15 years ago from patients than I do now. I think that instant access to information keeps patients from coming into visits asking questions like, "What mattress should I get for my baby? What supplies do I need?" Instead, they look a lot of this up. They get information from social media, but this loses real human connection and it also makes it harder to develop trust and rapport with your care team. And by care team, I mean your providers, your friends, your family, and your community. So try hard to limit social media, Google, and ChatGPT. Seven. One more thing to talk about is artificial urgency. Artificial urgency is when something feels urgent, but it actually isn't. For example, phone notifications, text messages, et cetera. Pregnancy examples would be most lab results that you get through things like MyChart or your chart access. Artificial urgency is actually very stressful for our brains and significantly increases anxiety. Our brains don't do a good job distinguishing between artificial and real urgency. Try to limit your exposure to this. For example, unless they are truly life-altering, try to set restrictions on when you check your labs and when you message your providers. Keep it to the hours of, say, eight AM to two PM. You don't need to be pacing and anxious waiting for a response because you checked something at three AM. This is not good for you. This is artificial urgency. As partners, try not to endorse artificial urgency. Try to problem solve together on whether something is truly an emergency and needs to be checked on at this time, or whether it can wait until office hours or a naturally better time. What starts out as an innocent quick look can often spiral into unnecessary anxiety. Many lab results populate in as red or as abnormal when in pregnancy they're actually quite normal. The lab results that come into your charts that you have access to are not usually structured for pregnancy, so something can look abnormal when in fact for a pregnancy the value is quite normal So now I want you to go forward and talk to your partner about your tendencies. Are you a knowledge is power or an ignorance is bliss type of person? Do you differ in this or are you the same? If you differ, how are you going to show your empathy and understanding that the other person has a tendency that's different from you? And if you are the same, how will you seek balance? Remember, both are good and all of one thing is not It's a really good idea to start talking about this now because this will also show up in parenting. So this is great practice for the future Thank you for listening to this episode of Calm, Collected, and Consented Childbirth Now that we've done some of the more philosophical episodes, we're gonna get into more information-heavy topics. Next up is how to get your body prepared for labor And remember, if you haven't followed, please do so you keep getting notifications about these episodes