Birthworkers: Buffering Stress and Trauma First Aid
woman in rich, green forest touching the ground
Undeniably there are aspects of our work that puts us in contact with joy and celebration, but equally true is that birthworkers have high rates of exposure to trauma. We experience bias, racism, and disrespect ourselves, and witness it impacting those we serve. We hold the emotional experience of perinatal loss, birth trauma, and even the past experiences of our clients as they tell us about their histories. We often have our own traumas that lead us to do this work, and we know that operating FROM that trauma isn't helpful but we all know how it can surface unexpectedly.
In this blog, we’re going to look at why doulas, midwives and others who work with pregnant and parenting people need to have a deep system of support to remain resilient, effective, and available to the people who need us, as we share what we can do to prevent the risk of burnout in our field.
7 ways we encounter stress and trauma in Birthwork
Our Own Histories.
I know few people who are in this work that don’t have a powerful reason why they are doing it. For some, it’s the personal power they found claiming their own body’s awesome capacity as they experienced pregnancy and birth. For others, their commitment to empowering others arose from their own lived experiences with gaps in our care systems, lack of care, respect, or compassion, their experiences with complications or adverse outcomes, and quite often, all of the above.
2. Unexpected Complications.
Birthworkers frequently encounter complications and witness trauma. Physicians, midwives, and doulas all have different pressures to support the needs of pregnant people. As doulas we may experience that our purpose is to create a space of safety, and trust in the process, and a difficult outcome can be particularly shattering. If you’re the clinician, despite all your training and experience, it’s easy to second guess decisions.
3. Infant Loss.
If you do this work long enough, you’ll encounter loss. Stillbirths and neonatal deaths are devastating losses for families and birthworkers are not immune to the emotional toll. The grief and helplessness felt in these moments can linger long after the event. We often need to find a balance between grieving with, and being available to, the families experiencing the loss.
4. Maternal Mortality and Morbidity.
We are in a maternal health crisis. Many birthworkers and health equity activists live and breathe the statistics, and the lived stories behind them, of preventable maternal deaths. We are passionately working to improve these outcomes and to speak the truth about the impacts of racism and bias that lead to tragic outcomes. But with awareness comes repetitive exposure to the reality that women are dying from pregnancy related causes. Even reading about loss in the news or in our journal articles can trigger immense helplessness and grief and many of our community are sitting on Maternal Mortality Review Boards or actively involved in supporting survivors of loss or near misses.
5. Unpredictable Hours, Sleep Deprivation and Hypervigilance.
The fast-paced and unpredictable nature of childbirth and the on-call lifestyle can lead to chronic stress. Long hours, sleep deprivation, and the constant need to be alert contribute to mental fatigue and burnout, making it harder to cope with traumatic experiences. We may feel that we never can fully relax or unplug.
6. Vicarious Trauma.
As birthworkers, we are empathetic by nature, which can make us susceptible to vicarious trauma. Hearing about and witnessing traumatic events repeatedly can lead to symptoms similar to those experienced by direct victims of trauma. Quite frankly, we live in a world that is inundated with violence and harm and our nervous systems aren’t well equipped to take it in so constantly as we do with social media and other media forms.
7. Isolation.
Let’s face it. Not everyone understands our work and we can’t always talk about the most challenging aspects of it. Our schedules can keep us from having regular contact with our loved ones, and we are vulnerable to over-identifying with our work and letting go of things we also enjoy doing, if only because our on-call schedules make it difficult to take that weekly yoga class or getaway trips.
Impact of Trauma on Birthworkers
The exposure to trauma can have significant and varied impacts on birthworkers, affecting both our professional and personal lives:
Mental Health Issues: Prolonged exposure to trauma can lead to anxiety, depression, and post-traumatic stress disorder (PTSD). Birthworkers may experience flashbacks, nightmares, and intrusive thoughts related to traumatic events they have witnessed.
Burnout and Compassion Fatigue: The emotional exhaustion from dealing with stress, trauma, and the pressure of advocacy can lead to burnout and compassion fatigue. This can result in decreased sense of purpose or effectiveness, a sense of defeat or helplessness, loss of joy in the work, reduced quality of care, and ultimately, a desire to leave the profession.
Strained Relationships: The stress and emotional toll of the job can strain relationships with family and friends. Birthworkers may find it difficult to communicate their experiences and emotions, leading to feelings of isolation and loneliness.
Physical Health Issues: Chronic stress and trauma can manifest physically, contributing to health problems such as high blood pressure, heart disease, and weakened immune systems. Over time, stress exposures contribute to weathering, and premature aging.
Addressing Trauma in Birthwork
So where do we go and what can we do? Ignoring the risks of exposure isn’t helpful. This work asks of us to be committed to radical self-care.
Mental Health Support: We need access to mental health resources. Counseling and support groups are effective in supporting health workers and activists in general to process their experiences and develop healthy coping mechanisms.
Education and Training: How well can we recognize signs of trauma? Do we have access to tools and community to manage stress? We need to take proactive steps in maintaining our mental health.
Peer Support Networks: Peer support, in an intentional and safe space, can allow birthworkers to share our experiences and support each other. Peer support is known to reduce isolation and build resiliency.
Organizational Support: As organization leaders, we can prioritize the well-being of our staff by implementing policies that promote work-life balance, such as flexible scheduling, adequate rest periods, and access to mental health resources.
Self-Care Practices: What are meaningful self-care practices to you and what can be maintained in our unpredictable schedules? Accessing mindfulness, exercise, and engaging in activities that bring us joy and allow us to unplug from our work, helps us to manage stress and prevent burnout.
Let’s take action
A healthy, supported birthworker ultimately benefits the entire community.
Because we often work in small community-based organizations, collectives, or even in solo practices, we often lack access to these critical resources or budgets to build and to provide trauma first aid and other resources. Okkanti is surveying birthworkers to identify solutions to this challenge in our industry and will be offering trauma first aid support based on our findings. Please take a moment to let us know more about your needs in a brief anonymous survey or sign up here to be notified of upcoming free or low cost support opportunities.
Our nervous systems don't detect the difference between real and current threats. The more exposures we have, the more cumulative harm we hold. We don't get 'better' at holding it or shutting it out, we don't get 'used to it.' We can, however, build practices that support a healthy, and even healing response to it by supporting the completion and 'exhaustion' of the stress response. When we talk about 'exhaustion' it means a reset of our activation response- what happens when we can shake off the threat and experience (relative) safety again.
We need ways to respond skillfully when we experience trauma exposures, ideally in the moment or shortly after, if possible, to allow this completion to take place.
This is Trauma First Aid.
And we're building our Trauma First Aid Response team together.
We're excited to announce that our community is coming together to provide a safety net and support system for birthworkers so that compassionate, informed, and evidence-based care is available when you need it.
Please complete the survey, or sign up below to be notified of upcoming events or services.