As a birth worker, we know that birth almost always unfolds well. However, we also know that birth trauma is real. Whether the trauma is related to an unexpected and unavoidable complication or due to unnecessary poor treatment towards a birthing person, birth trauma is hard.
Secondary trauma as a birth doula, or any birth worker, is also very real. It is something that is important you address to remain the healthiest version of you. While every situation is unique, the tips below are meant to be a starting point to help navigate birth trauma.
What is Birth Trauma?
March of Dimes defines it as, “Birth trauma is any physical or emotional distress you may experience during or after childbirth. During the birth, you may feel afraid, helpless or unsupported by those around you. After the birth, you may be left feeling guilty or numb due to events beyond your control.”
Birth trauma is unfortunately common. The National Institutes of Health states up to 45% of birthing people experience birth trauma. This means that as a doula, it is unfortunately inevitable that you will eventually witness birth trauma.
It is also important to note that you may not see a birth as traumatic, but the birthing person will experience the birth as a trauma. How you experience it does not negate their experience. On the other hand, you may witness a birth that feels incredibly traumatic, but the birthing person may not process it that way. In that case, your experience is valid, but it is vital you do not color their perception in a negative way.
Navigating Birth Trauma
As a doula, it is important you process birth trauma. There are right ways to do so, and less than helpful ways to do so. The “right” ways are going to vary person to person. But things that are not helpful and you should avoid doing include:
- Telling the birthing person your perspective about how traumatic it was
- Publicly sharing the birthing person’s story without their permission
- Projecting your perspective of the birth onto the birthing person, their partner, or other attendants
- Expecting talking to the birthing person will be a way to process your experience.
It is extremely important you do not project or process with the birthing person. It is very possible that a birthing person retains a positive perception of their birth even if it seems traumatic to you. You never want to potentially change their positive perception to a negative one.
Ways you can process birth trauma include:
- Journaling
- Decompressing and processing with a fellow birth worker
- Speaking with a licensed therapist
- Participating in a peer review or case review with other birth workers
- Practicing self-care and rest
- Meeting with your mentor
- Sharing in a doula group to process – never using identifying information of course.
What If a Client Blames You For Birth Trauma?
When someone experiences a trauma, it is natural to try and process by finding what may have gone wrong. Unfortunately, it is not uncommon for people to seek a scapegoat. There are times, of course, when a person is responsible for birth trauma. However, given the nature of a doula’s scope of practice, it is very rare that a doula could truly cause trauma.
If a client was to blame you for a negative birth experience, it is helpful to briefly listen. Remember that it is not likely your fault. As long as they are not bad mouthing your business, making negative reviews, etc., there are times some doulas will simply accept the scapegoat role. In other circumstances, it can be helpful to reexplain your role, validate their trauma, and offer support if they desire.
Like many situations, an ounce of prevention can be worth a pound of cure. It is vital all clients fully understand your role. Be sure to explain what you offer (education, support, comfort measures, etc.) and that you encourage self-advocacy. Be sure they understand it is not within your scope to make any medical decisions for them, nor is it your role to advocate in a way that is fighting against providers.
There is a common misconception that a doula will “protect” against unwanted medical procedures by advocating on one’s behalf. However, the doula’s role is to remind clients and their partners their options and rights so they can make informed decisions for themselves.
It is also important to ensure that your contract is clear. State when you go on-call, when you can arrive, your limitations, your scope of practice, etc. And then be sure you always uphold your end of the contract.
What If a Client Feels Their Birth is Good But You Feel Traumatized?
As a birth worker, you are often well educated about physiological birth, benefits and risks, and all birth options. There are circumstances where clients make decisions we would not if we were in their shoes.
As doulas, it is not our role to encourage clients to birth how we would. It is important we support them in their birth experience.
At times, a birth can look very traumatic. Perhaps we see a hemorrhage caused by a lot of Pitocin following an elective induction. While the client may see their doctor stepping in and saving their life and being grateful for that.
Our clients do not benefit from us telling them they had a traumatic birth if they do not feel that way. If they ask questions, we can be honest about the basics, but we should not insert our emotions. We need to process how we view a birth outside of how the client views their birth.
Ultimately, be sure to process traumatic births and not hold onto the trauma.
Author: Aliza Juliette Bancoff
Aliza Juliette Bancoff is a well-known doula and doula trainer who has been providing doula services to families for over a decade. She is the founder of Main Line Doulas, a doula group providing doula support in the great Philadelphia area for the last decade, the International Doula Institute, which provides online doula training and lactation training and certification programs and the International Breastfeeding Institute which provides lactation training and certification. She is the co-founder of United Birth, a company devoted to increasing access to doulas across the country to make the perinatal time safer both physically and emotionally. “Every birthing person deserves access to quality doula support. And we are working to make that a reality across the country. The work we are doing to get doulas to every birthing person will decrease the black infant and maternal mortality rate significantly by 2030.” Says Bancoff. Aliza is known for her compassionate and empowering approach to doula work, and she has been featured in numerous media outlets, including United Nations Maternal Health Report, Parent Magazine, CafeMom, theBump and many more. Aliza's journey into doula work began when she gave birth to her first child and felt a strong calling...