Healing from Traumatic Births
Midwifery can be an all-consuming profession, and we have previously discussed how midwives need to learn to “turn it off” and engage in self-care. An aspect worthy of a deeper dive is healing from secondary trauma acquired as a result of attending traumatic births. These may be related to unexpected outcome, birth emergencies, or even loss of control over the actions of other practitioners, especially during a transport or referral to higher level care. One study of secondary traumatic stress in midwives found symptoms such as intrusive thoughts, avoidance and numbness, sleep disturbance, loss of interest, and other symptoms shared by people with PTSD. It also found that traumatizing events could lead to the loss of belief in birth as a normal process, with a significant percentage of midwives who had experienced secondary trauma leaving clinical practice all together.
The first step to healing is acknowledging that secondary trauma occurs; that not all outcomes are going to result in a healthy mother and baby, and this can be devastating for the provider as well as for the family. The second step is recognizing where you as a midwife has control or agency over a situation and where you do not. This can often be difficult, especially given how midwifery practice encourages intimate support and collaboration with our clients. Whereas other professionals are encouraged to set clear emotional boundaries with their clients, this is much more difficult in midwifery care. Set out by establishing what you truly have control over – your actions based on education and experience – and what you do not.
Perform a self-assessment of your emotional baseline, including overall beliefs, coping mechanisms, and your support system before trauma occurs. Are you so consumed by midwifery that you avoid connecting with others? Or have you built a framework for resilience? Midwives who are emotionally stable prior to any traumatic event tend to be the ones who heal in the healthiest manner. Build social supports and relationships that are meaningful outside of your work.
Examine your own past. Many midwives have their own traumatic histories, and while this can spur the passion they bring to their practice, it can also make them more at risk for having a severe reaction to a client’s traumatic childbirth event. If this resonates with you, find a path to your own healing via counseling and guidance. Doing it now will make you resilient in the face of whatever experiences come your way. And having the connection to a counselor will help should a bad outcome lead to feelings of inadequacy, or cause you any negative psychological (or physical) effects.
Most of all, take care of yourself. Midwives existing on coffee and sleep deprivation are at risk of both burnout and secondary trauma. Eat well, take vacation days, spend time with friends and family, enjoy outside pursuits. A career in midwifery is a marathon, not a sprint.
Beck, C. T., LoGiudice, J., & Gable, R. K. (2015). A mixed‐methods study of secondary traumatic stress in certified nurse‐midwives: shaken belief in the birth process. Journal of midwifery & women’s health, 60(1), 16-23.