• Hannah

What do I mean by "trauma-informed care"?

I recently finished a training for perinatal professionals on the fundamentals of trauma-informed care put on by the wonderful Justine Leach and Sarah Adelmann of Resilient Birth and it has left me with a lot to think about...and feel about! A lot of us have heard the term "trauma-informed" but I don't think that necessarily means we are all talking about the same thing when we say it, so I want to share with you very honestly about what it means to me, and why I place it at the centre of my practice.

Some would say it is a big no-no to talk about my personal reasons for becoming a doula to my clients - and I agree, if I am there to help YOU then it would be disrespectful and poor service providing for me to turn the conversation to myself and put you in a position of feeling like you have to do emotional labour to make ME feel comfortable - but here and now in this blog post I want to be very real with you so that you can understand exactly where my knowledge and wisdom is coming from, because it has been hard-won.

The truth is that, like so many professionals in so many fields, I am becoming the helper/healer that I myself so desperately needed when I was down. I am a doula because it brings me a sense of joy and accomplishment to have taken the hardest experiences of my life and alchemized them into the ability to make things better for the next people. I have combined my personal experiences and my own profound healing journey with lots of research and education because I know that there is a danger of me seeing myself in everyone and projecting my old pain into their situations. I have done the personal work to know that I am truly ready to hold space for others, and I take full responsibility for taking care of myself on an ongoing basis and entering each client interaction from a place where I am truly well enough to hold their experience with them. I know from the bottom of my heart how important it is to feel seen, heard, held, and respected as we navigate the wild, wonderful, frustrating, painful, incredible, gross, funny, beautiful, bumpy, windy, alienating journey of carrying a womb and living in a body that cycles and changes in ways that our culture does not do a very good job of accommodating, let alone honouring.

Too many people are either traumatized or re-traumatized within their experiences trying to access reproductive health care. Sometimes the situation is unavoidable, a biological reality, but too often it is a result of the fact that the medical system does not properly train people to compassionately care for people in their most vulnerable conditions, nor does it provide them with the time and resources necessary to be able to offer the best quality of care to each and every patient. Care providers with the absolute best of intentions are often running on empty and simply do not have the capacity to meet all of their professional responsibilities AND do it in the kindest and most sensitive way possible. Add to this the fact that racism, sexism, classism and fatphobia are baked into the system (more on just how racist the system is in an upcoming post), and that many of the people seeking care are walking in carrying existing traumas, and you will begin to see why it is so important to consider trauma when providing reproductive care. Especially around birth, when there are at least two people there in their most open and vulnerable states, who will be supremely impacted by this day whether it is positive or negative (or both, often both).

Our bodies contain the records of our lives. Trauma can be thought of as undigested experiences. It scrambles time, appears in fragments, the pieces don't fit together. If it can't move through us, it gets stuck in our bodies somewhere. Our pelvic cradle is often a place that ends up holding our deepest, most vulnerable feelings and memories. Sexual assault, miscarriage, reproductive health struggles and negative medical experiences, our connections to our own mothers, inherited greif, fear, and resentment, abortions - these are all things that might be living as "emotional scar tissue" in our womb spaces and may need loving attention and gentle care. Any type of handling from care providers that is gruff, surprising, confusing, painful, unwanted, done without asking, or just "off" can trigger the emotional and physiological state of trauma. When we are in an activated trauma space, our brains change. We lose the ability to use language, we lose the ability to track events coherently, we move in to fight, flight, fawn, or freeze. And then we get stuck there. It becomes very hard to down-regulate, and find a feeling of safety in your body, even to find a feeling of being in your body at all.

So how do I offer trauma-informed care?

Well first off, ubiquitously. We all carry things. You do not have to disclose a previous trauma to me for me to careful and considerate with you, your life, your story. If somebody tells me that they do have reason to be concerned that trauma might make an unwelcome appearance at their birth, I will begin by suggesting that we break the work that we need to do into two, potentially three, parts.

The first part is education and preparation around doing everything that we can to minimize the likelihood of anything bad, scary, or unwanted happening.

The second part is about doing everything we can do to ensure that no matter what happens, you will be okay.

The third part, which is completely optional, is to try to work with some of the existing trauma and do some healing work for you before the birth. Only you will know if it is the right time for you to do this, it may feel like too much at a time that is already fragile, and that is completely okay. It is totally valid to just leave it in a box in a safe corner of your mind and tend to it when you are ready.

Human beings, like all living things, have a natural tendency for healing. Like flowers, we grow towards the light. If you have the supports you need, the good soil to ground in, you will figure it out. If not now then later.

Addressing and healing the pain and injustices that befall female bodies, defending their sacredness, is my passion and my life's work. So many of us feel alone and unseen on these journeys. Let's change that with us so it can be different for the next generation.


Resilient Birth

The Body Keeps the Score by Bessel van der Kolk

When Survivors Give Birth by Penny Simkin

The Fourth Trimester by Kimberly Ann Johnson

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