Trauma-informed Care for Midwives
Midwifery Today, Issue 146, Summer 2023.
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Imagine being a survivor of trauma, seeking medical care or social services and being met with indifference, insensitivity, or hostility. Unfortunately, this scenario is all too common for many individuals who have experienced trauma. That’s why trauma-informed care is so important. It acknowledges the profound impact that trauma can have on a person’s life and wellbeing and provides health care and social service providers with a roadmap for creating a safe, supportive environment for those who have experienced trauma.
Trauma-informed care is not just a buzzword. It is a set of principles and practices that promote healing and recovery and are especially important for vulnerable populations such as children, veterans, survivors of sexual violence, and those experiencing poverty or homelessness. By prioritizing safety, building trust, and empowering patients to make informed decisions about their care, health care providers can help reduce the negative impact of trauma on individuals and communities.
As a midwife, providing trauma-informed care is especially important during pregnancy, birth, and postpartum. Birth trauma can have lasting effects on both mother and baby, and it is often caused by a lack of support and control over the birth process. By creating a safe, supportive, and inclusive environment for pregnant women, midwives can help ease the stress and anxiety surrounding childbirth.
To achieve this, midwives can prioritize safety by providing a quiet and private space for clients to share their experiences and use trauma-sensitive language.
Some examples of trauma-sensitive language for midwives are:
- Instead of asking, “Did you have a normal delivery?” try asking, “Can you tell me about your childbirth experience?”
- Instead of using medical jargon or technical terms, use plain language that is easy to understand.
- Instead of saying, “You need to do this,” try saying, “Would you like to consider doing this?”
- Instead of assuming that you know how the woman feels, ask open-ended questions and listen to her responses without judgment.
Use positive and empowering language that reinforces the individual’s strengths and resilience. Respect her boundaries and preferences, and avoid using language or actions that may be perceived as controlling or intrusive. Acknowledge and validate the woman’s experiences and emotions, and offer support and resources to help her cope. Trauma-sensitive language can help midwives create a safe and supportive environment for individuals who have experienced trauma, and can contribute to better health outcomes and improved trust between health care providers and patients.
Midwives must ensure that staff are trained in de-escalation techniques to prevent triggering or retraumatizing patients. Trustworthiness and transparency are also vital components of practice. Midwives aim to build trust with clients by being open and honest about policies and procedures and communicating respectfully throughout their care journey. They involve clients in decision-making about their care, provide clear explanations of treatment options, and openly discuss potential risks and benefits.
Peer support is important to help clients connect with others who have had similar experiences. Midwives offer access to support groups, peer mentors, and other peer-led services to help their clients through the challenges of pregnancy and childbirth. Additionally, they collaborate with clients and empower them to feel in control of their lives by providing education about trauma and its effects, identifying their strengths and goals, and supporting their efforts to achieve those goals.
Cultural, historical, and gender issues may also be important considerations when providing trauma-informed care. Midwives work to recognize and address the impact of systemic oppression and marginalization, understand the unique needs of different cultural groups, and address the impact of gender-based violence. Providing care that is respectful and inclusive of all clients, regardless of their background or experiences, is essential to creating a compassionate care environment.
Besides caring for clients, another important aspect of midwifery care is caring for ourselves. As midwives who have experienced trauma, we understand the emotional toll it can take. Providing trauma-informed care requires us to not only be attuned to our clients’ needs but to our own emotions and experiences. Hearing stories from clients that resonate with our own trauma can be difficult and can trigger intense emotional responses. Therefore, midwives must recognize when they are being retraumatized and take steps to prioritize their mental health and wellbeing. This can involve developing a self-care plan, seeking support from a therapist or counselor, practicing self-compassion, and engaging in activities that bring joy and relaxation.
In conclusion, trauma-informed care is about seeing the person behind the patient and acknowledging the impact that trauma can have on her life. It is about being sensitive, compassionate, and responsive to her unique needs and challenges and is essential for promoting healing and recovery. Let’s commit to making trauma-informed care a priority in health care and social services, and help to create a world where all individuals feel safe, supported, and empowered to thrive.
Resources on Trauma informed Care and How to Help
- The National Child Traumatic Stress Network: www.nctsn.org/
- The Substance Abuse and Mental Health Services Administration: www.samhsa.gov/
- The American College of Nurse-Midwives: www.midwife.org/
- The National Center on Domestic Violence, Trauma & Mental Health: www.nationalcenterdvtraumamh.org/
- The Adverse Childhood Experiences (ACE) Study: www.cdc.gov/violenceprevention/aces/index.html