The Doula Issue 39 Autumn 2020 - Flipbook - Page 19
People may experience flashbacks, or nightmares - these
may not be images, or verbal recollections, sometimes it’s
just a feeling.
You would expect to see some hypervigilance, such as
being a bit more jumpy than you might expect, and often
people are preoccupied with the safety of their baby. There
is a brilliant Scale - the City Birth Trauma Scale, which you
can use to establish whether birth trauma is present in a
client. Important to note too that it may be the partner who
has been traumatised by what they witnessed.
Do you think there is anything during antenatal
education that can prepare women for a more
positive experience of birth? Can we avoid Birth
Trauma before it happens?
I do think we can prevent birth trauma from happening
for many people, and there are many different strands
for this. Most important to me is about the individual and
their experience. Often people have already experienced
trauma in their lives which emerges when they are feeling
so vulnerable in late pregnancy and during birth, and it’s
really difficult to ascertain this beforehand unless you
really take the time to get to know someone - which is
why a relationship with a doula can be such a powerful
thing. It gives that foundation, then, to think with someone
about what they need to feel safe, and that is different
for everyone. Many people go into birth with a lot of fear,
and reassurance often isn’t enough. It can help to really
unpick where that fear is coming from and build alternative
narratives. For example, so few people have seen what
a peaceful birth looks like; thankfully we have YouTube
available to help to create the picture that birth doesn’t
have to be scary.
I also think that the narratives that exist for women at the
moment, the pressures we face, are really unhelpful when
it comes to birth. Being a ‘good girl’ and doing what we’re
told, having to cope alone without asking for help, that
birth is something we can ‘succeed’ or ‘fail’ at. This can
create false expectations. It’s important that we talk about
the realities of birth, that it can be beautiful but it is also
hard work, and messy, and surprising.
You must hear some heart-breaking stories from
families in your care. How do you stay ‘protected’ and
what self-care measures do you access for yourself?
I do, and it doesn’t get any easier. I have a brilliant
supervisor who I speak to at least once a month, more
if I need to, and I also turn to peers to debrief. I think
because when I am listening to birth stories I am listening
out for meaning and linking themes together, you do
keep a more objective stance in the room with someone
although obviously I’m often very moved by what I hear.
And shocked, on many occasions. But my role is to
contain their feelings about their experience, so it’s really
important to me that I don’t impose my own feelings on
to their experience. Their time with me has to be about
them, and them only - especially when they are telling me
about an experience that should have been about them
In terms of self-care, I have to make sure I have time to
decompress after a session and process what I’ve heard.
Often that would just look like me sitting in a chair staring
out of the window! But I’m careful to not hold on to trauma
in my own body and I do notice that I need to take time to
bring my own adrenaline down again sometimes.
I’ve spoken to others who work with trauma and we’ve
talked about how occasionally you do need a break
from that work, otherwise you can start to see the world
through dark-tinted glasses, so I try and also look for the
And if I notice I’m getting a bit angry and indignant about
the state of the world, and maternity care, I have a couple
of days away from it. We’re so lucky in the team at MBB
that we all give each other the space to do that and
someone is always happy to pick up a piece of work when
another team member needs space to breathe.
I think what makes it easier too is that I do truly believe
that we can make a difference. To individuals that I work
with, it is always incredible seeing a traumatic experience
lift away from someone and lose it’s power. And within
MBB, I do believe we can change things for the better.
I have to!
When a doula finds herself supporting a family
who have recently been through Birth Trauma or
are expecting a child after a previous traumatic
experience, what is the one thing we should try and
do? What is the one thing we should try NOT to do?!
One thing to try and do - Just LISTEN. Validate.
Empathise. And only then, plan for how they will feel safe
in the here and now.
One thing not to do - Reassure. So often reassurance is
heard as invalidation.
Okay, now we can mention Covid! Have you seen
an increase in birth trauma due to the stresses of
Not yet, but I think it’s coming. We are releasing the results
of the survey we did over lockdown, asking pregnant
women and professionals about their experiences of
maternity care over lockdown. 458 parents-to-be shared
their experience. They described feeling ‘Devastated’.
‘Frightened’. ‘Powerless’. ‘Helpless’. ‘Shocked’.
Over 90% of mothers told us that their maternity choices
had changed, and that information was often unclear,
which raised stress and anxiety. Most worryingly to me,
half of the women who responded who had been receiving
mental health support said that this had stopped. I feel
like we are in the waiting room at the moment, because
those women who had difficult experiences, who laboured
without birth partners present, who spent their postnatal
period alone, with little support - they might at present be
too shell-shocked to know how it has affected them, or
they might find it too difficult to find out how to access the
support they need. I think we will see the impact of this for
many months to come.
I’ve been lucky enough to hear you speak on several
occassions and now understand so much more about
the ripple effect of trauma on midwives and those
caring for birthing people. It can be the same for
doulas. Do you think this has gotten worse during
I think that professionals working with those who give birth
were already working in extremely difficult circumstances
before the pandemic, and they have often had to fill the
gap of birth partners during this time; and so reaching
deep to give more when their resources were already low.
© Doula UK | Autumn 2020 | The Doula 19