*Please note: These two full-day sessions, A1 and B1, address the impact of Childhood Sexual Abuse. Join us for one or both days.

Maternity caregivers (physicians, midwives, nurses, doulas, counselors, educators, social workers, perinatal psychotherapists and others) will learn to recognize symptoms and behaviors that may be exhibited during pregnancy, labor and birth, breastfeeding or early parenting. They will learn how specific actions and events during the perinatal period may be triggers for the symptoms, activating memories of abuse and interfering with the birth or new infant care. We will discuss special interview methods to engage parents in exploring their own concerns about protecting the baby. Participants will learn specific interventions and counseling strategies to help survivors during this vulnerable time to reduce fears, minimize triggers, prepare for the events of labor, birth and breastfeeding; effectuate healing and enhance bonding.

A number of short-term helpful clinical therapeutic and counseling approaches will be discussed in relationship to the time-limited period before and at the birth, as well as longer-term postpartum methods.

Course Plan:

1. Recognize the impact of childhood sexual abuse on the adult woman. This includes physical, medical, psychosocial, psychological (mental health problems) and sexual impacts.
2. Identify symptoms and behaviors that may be exhibited during pregnancy, birth and postpartum by survivors of childhood sexual abuse.
3. Recognize events or actions that may trigger anxiety or adverse reactions during childbirth, and cause concern for women regarding breastfeeding and the postpartum period.
4. Learn how to interview the survivor to build emotional safety and rapport, explore how her history may impact the birth, and develop ways to lessen anxiety and her fears, give her sense of control and create a plan to meet her needs.
5. Learn how to separate her real baby from her "inner child" self of the past.
6. Develop sensitive counseling methods to reduce distressing symptoms of pregnancy.
7. Understand methods to help her heal previous birth trauma.
8. List specific ways maternity caregivers can help survivors during pregnancy, labor and postpartum to reduce triggers during the many common events of childbirth.
9. Learn some methods to help in stalled labor, handling strong emotions, difficulty in putting baby to breast, etc.
10. Learn specific interventions and counseling strategies to help survivors manage common difficulties (e.g., panic attacks, containing distressing thoughts and others).
11. Learn methods for interviewing couples, taking a full, sensitive psychosocial prenatal interview that explores their beliefs about parenting and any effects of past trauma. Interview to include:
    1. present circumstances
    2. current relationship issues
    3. present pregnancy course
    4. past childbirth experiences
    5. developmental and family history as appropriate
    6. significant stresses, losses, traumatic events, as well as strengths
    7. history of emotional, sexual or physical abuse
    8. sensitive manner to ask questions, and appropriate responses
12. Learn ways to engage parents to see infant as individual who needs them for comfort and security in order to reduce potential of child abuse.

This first day will also include ways for the caregiver to avoid vicarious traumatization when hearing the stories or pain their clients have experienced. In addition, self-care is essential to avoid burnout.

We will practice particular interviewing methods to find the balance between learning what a caregiver needs to know to help through the events of birth and avoiding being intrusive.

Perinatal therapists will also learn how to safely engage survivors to explore the meaning of symptoms during pregnancy in order to alleviate or reduce them. One goal of any counseling or therapeutic method is not only to uncover or explore the meaning of the distress but also to find a way to heal it or to contain it until such time that the issue can be worked with. This is especially important when birth is imminent.

Participants will have experiential exercises with cases to learn how to work with the survivor to plan for, cope with, or avoid the triggers that might occur during the intense efforts of labor.

Participants will also learn how to manage a situation when meeting the survivor for the first time in labor as well as specific ways to work with emotional fears that impede labor.

*Please note: These two full-day sessions, A2 and B2, cover psychosocial issues in the childbearing year. Join us for one or both days.

On Day 1, Penny will review the state of maternity care today, and show that while US obstetrics emphasizes and relies increasingly on technological and surgical approaches to improve chances of healthy outcomes for mother and baby, we are now actually seeing a worsening of these outcomes: increasing prematurity, increasing maternal mortality, increasing neonatal and infant mortality. Have we reached the “Tipping Point”? What will it take to reverse this trend? Penny proposes that huge improvements in the psychosocial care of mothers and babies is the answer.

She will begin with a talk on “Early childhood influences on a woman's later childbearing,” with a literature review of early life incidents that can have lasting positive and negative psychosocial effects and case studies from her own counseling practice. She will also show how prenatal, intrapartum and immediate postpartum care can reveal and reduce some of the psychosocial risk factors.

Lastly, she will review factors that contribute to resilience and success in adults who were born under very adverse circumstances. This will be followed by discussion and practice on counseling for pregnant women who disclose fear and anxiety about their upcoming birth.

This day will end with a discussion of fear, pain and trauma during birth—“When pain becomes suffering during labor.” This includes descriptions of pain theories, including the Neuromatrix Theory, which provides an excellent framework for the topic. She will describe some ways to prevent suffering during labor, how to recognize if a woman is suffering during labor and how to deal with it, with the intention of preventing PTSD after childbirth.

*Please note: These two days, sessions A3 and B3, are planned to help you add to your knowledge and skill base in these important areas of clinical practice. Join us for one or both days.

Think like an herbalist. Why does motherwort work on both the heart and the uterus? Why is peppermint useful for both the sinuses and the stomach? What are herbal actions and how can the knowledge of actions be applied to midwifery practice? In this class, we will learn how and why the herbs that have been friends of mothers and midwives throughout time nurture, nourish and give first aid during the childbirth year. We will learn some basic skills for preparing and formulating herbal medicines to treat common conditions, and learn to make infusions for internal and external applications. This class has more tips and remedies than most of us get in all of our schooling. Participants will receive an extensive reference book.

(All are welcome) Come learn how the story of Lazarus teaches us to be both healer and healed.

From earliest history, women have shared their personal experiences of strength and healing. Stories wrapped with love have transmitted wisdom and confidence to each generation. Come to share or just to listen.

*Please note: These two full-day sessions, A1 and B1, address the impact of Childhood Sexual Abuse. Join us for one or both days.

This day will focus on helping survivors with issues during postpartum, including the importance of immediate care needs, breastfeeding challenges and solutions, later counseling methods to help recover from any traumatic events at birth or previous births.

Discussion, exercises and case material will deal with understanding postpartum mood disorders that could manifest, fears about the baby and ability to cope, concerns about partner and family, and methods to counsel and heal from distress. Partners' needs will also be addressed.

Participants will learn the differences between counseling and psychotherapy methods through cases and detailed discussion of typical clients and their needs.

*Please note: These two full-day sessions, A2 and B2, cover psychosocial issues in the childbearing year. Join us for one or both days.

This day will begin with a discussion of counseling women after a traumatic childbirth. Penny will describe the use of the "Self-Assessment of maternal distress after a difficult childbirth," illustrated with case histories from her practice.

We will then explore and practice counseling techniques to help women resolve their traumatic births. This segment will include ways to counsel and prepare a pregnant woman whose previous birth was traumatic and who is terrified that the same things will happen with future births. Penny will discuss strategies to ensure that the same things will not happen in the next birth. She will use case studies to illustrate how women overcame their anxiety.

Lastly, Penny will explore factors (from earlier in life and from care during the time) that positively and negatively influence postpartum recovery, offering some practical solutions to ease the transition of a woman and her family into this unfamiliar phase of life.

Both days will be a combination of lecture and group interaction. The intention is to develop ways to help women who have been hurt to have fulfilling and empowering birth experiences and begin parenthood with a sense of confidence and competence.

*Please note: These two days, sessions A3 and B3, are planned to help you add to your knowledge and skill base in these important areas of clinical practice. Join us for one or both days.

This is your day to learn about midwifery and test whether it is the profession for you. You will learn the heart and joy of the calling, as well as the challenges. We will concentrate on normal, miraculous birth. Attend the rest of the conference to learn more about complications, sexual abuse, politics and love of practice.

We will discuss subjects such as use of herbs to prevent prolonged labor, to heal perineal tears, to help the slow-to-start baby and as an alternative to drugs. A round of tips for working respectfully with survivor moms will be included. This always is a much-appreciated session, for its sense of sisterhood as well as its information. “Worth at least two weeks of academic training,” said one participant.

Jan and Harriette will offer you a heartfelt welcome to the Hope and Healing conference with words, photos and wisdom.

Mickey will provide an orientation to our focus on “Survivor Moms,” including the evolution of the application of the midwifery lens to survivor issues, and an introduction to the variety of speakers and topics presented at this conference. She will discuss issues of confidentiality and the importance of boundaries, and outline opportunities for de-briefing and de-stressing while at the conference.

Julia will explain how trauma and posttraumatic stress are significant problems for childbearing women, but healing, posttraumatic growth and stopping the intergenerational cycle of trauma are possible. Julia also will outline how childbearing and mental health professionals can collaborate to foster such growth. She will provide an overview of posttraumatic stress, trauma and the evidence-based studies on the effects of sexual abuse on childbearing.

Learn what the contributors to the “Survivor Moms Speak Out” project have to say about being a survivor and a mother, all the way from before motherhood to being a grandmother.

A researcher who studies trauma and childbearing provides descriptions and evidence base for medications and psychotherapies related to trauma. Learn in a concise way about the state of the science as it relates to trauma and childbearing.

The importance of positioning, maternal sense of control and flexibility to approaches will be shared, as well as how to do an early diagnosis. Many cesareans occur due to posterior presentation. Prevent cesareans by understanding how to diagnose, prevent and fix posterior presentations. These intimate roundtables give the participant a chance to talk with each teacher individually. This fast-paced fun class will give you options for dealing with posterior presentation.

The midwifery way of continuity of care can last a lifetime! Midwifery intelligence and care are needed long after the baby is born. Learn how to weave natural healing modalities into your midwifery practice so that you can continue working with the families you love! Midwifery hospice care will also be discussed. From Janice: “I consider myself a Community Natural Health Care Provider. My massage and herb work are done much the same as midwifery, with home visits, individually prepared remedies made with locally grown herbs and massage that is tailored to the individual.”

Panel discussion by practitioners of various healing modalities, including details of how they work and presentation of case histories.

Topics and practitioners include:

Learn how to relate in a healthy way with clients to support effective communication, protect boundaries and minimize negative reactions or harmful behavior. This class is an introduction to important interpersonal practice concepts that will give you greater confidence when relating to challenging clients. Your own personal relationship issues (those that seem to get in the way of good client care or strain the midwifery or counseling team dynamic) will get a kickstart towards healing.

The relationship between midwife and client helps create a trusting birth experience. Learn how women's bodies function differently when trust exists. Learn the heart of care during the prenatal period. Elizabeth will explain how to prevent birth complications by helping women achieve physical, emotional and spiritual well-being.

Nurturing a woman in a hospital setting for a wholesome birth experience requires consistent attention to emotional and physical detail, compassion and an eye for sacred goals. All this can be accomplished among professional colleagues with varied backgrounds and the woman's close circle with plan strategies that create safety. Study all the issues in detail and join in the discussion of the obstacles, concerns and solutions arising from a planned or unexpected hospital birth.

Women want and need more from childbirth than a live baby and mother free of serious physical damage. The mother needs a sense of competence, confidence and emotional safety as well as a readiness to embrace and nurture her child and relish this time with her loved ones. Her child needs unhurried adjustment to this new world, being skin-to-skin with the mother, having the chance to hear, feel, smell, see and taste her. These basic human needs receive low priority in today's system of maternity care. This illustrated presentation reviews the changing social context and important trends in women's lives and in birth over the past 50 years to how we have arrived at our extremely medicalized approach to birth. Some bright and optimistic trends will also be described and discussed.

The faces of abuse are many, and we draw together now to heal ourselves as well as our clients. Let's journey as one on the “Healing Road.”

Do you have a dance, poem, song or act to share? Tell Janice and she will make a schedule. This is always a time of fun and relaxation. Let's share our talents.

A “potlatch” is a traditional giveaway practiced by Northwest Native Americans. Our potlatch plan is to have each conference participant bring a gift to give to another participant. We suggest something for midwifery practice or something from your heart or country. Bring a gift if you want to participate. Either way you are welcome to join us for the Cabaret.

The birth of a child is transformative. Birth is evocative of one's own life story. Birth is opening; it stretches one beyond one's thought of capacity. Yet childbirth creates vulnerability. Birth is a magnet for relationship and attachment issues. How a woman and partner are treated has long-lasting effects. Birth creates potential for change. This presentation explores the depth of changes that happen and those that need to occur for parents to take on their new infant, as well as the potential for healing during the openness of this time.

Having trauma survivors among your clients can be challenging. Gathering multiple professionals into a team can be useful to share the provision of care and contribute vital pieces from their expertise. This talk will discuss how to build your network and work out issues around confidentiality and coordination of care.

A discussion of what negative coping strategies survivors resort to, including substance use, focusing on how clinicians can support development of soothing and coping methods that are effective, healthful and useful for mothers of young infants.

Midwives are the protectors of normal birth. Keeping birth normal is the biggest challenge in childbirth today. Learn how nutrition, love, communication, continuity of care, intervention and other factors can affect the normal birth process. Learn why pregnancy care is essential for preventing complications.

How do we get a long labor to progress? Long labors may be associated with complications ranging from social or emotional issues to physical problems. We will learn different reasons for prolonged labor, as well as methods for helping women move along in labor. Analysis of myth and reality will also be discussed.

Learn from a private practice clinical social worker who trains clinicians and directs DangerTalk, a program to help reproductive health workers prevent compassion fatigue and vicarious trauma.

This workshop is an introduction to a psychoeducational intervention under development for use with pregnant survivors. The intervention focuses on managing posttraumatic stress reactions, soothing emotions and fostering positive interpersonal interactions.

In this session the midwifery way will be applied to counseling. As midwifery gives care that makes birth healthy, this counseling focuses on the efforts of people living the challenges of life and becoming who they were born to be. With trust in the inherent wisdom and longing to live one's potential, counseling in the midwifery way guides individuals through the lens of their own insights—to resolve tensions and problems and to seek their possibilities. This will be an interactive session of sharing ideas and insights.

Fear in pregnancy and birth can have many consequences for both family and healthcare provider. This class will help you define, understand and move through the fear that confronts us. Learn several ways of helping women, including midwives, turn fear into trust.

Culminating activity for the “Survivor Moms” track of the conference. Small groups rotate through five stations (20+ minutes each).

Attendees of the “Survivor Moms” classes get to apply what they've learned throughout the conference to six case scenarios presented by the guest faculty. Women, including midwives, turn fear into trust.

Small groups rotate through five stations (20+ minutes each)

This will have been a historically remarkable and, we hope, empowering event. It is possibly the first time in herstory that so many concerned professionals have come together to present the issue of sexual abuse and its effect on childbirth. We hope to have brought forward many solutions—personally, professionally and societally. This is a time of sharing what the week has meant to you.