Birth Trauma: Caring & Coping #061

In this episode, we are diving deep into the way that trauma shows up in birth and in the perinatal period.  We are discussing a lot of the complicated dynamics that exists when someone experiences trauma during their birth. This is something that impacts certainly birthing people, their families, and their other support.  It also impacts those of us who work in birth.

Our guest today. Kayleigh Summers of The Birth Trauma Mama is a therapist and birth trauma survivor herself. As she shares parts of her story, her healing, her experiences, you will have your eyes opened to so much of the nuance that exists when we talk about trauma in birth.

Kayleigh explains how this plays out in the immediate postpartum period, and in the weeks, months and years that follow.  We also have a very raw conversation about how we support. birth trauma in the hospital.

What are the things that those of us who are involved in birth care, particularly in the hospital setting, can do to be more aware of our practices?  How can family and other loved ones actually provide support?

Listen in for more on:
~Recognizing that healing is non-linear
~The importance of open conversations acknowledging trauma
~Creating practices that support healing in the immediate postpartum period
~Why we need the human element instead of factory-run hospital care
~Fears around acknowledging trauma and litigation
~Myth busting around birth trauma and birth expectations
~Supportive language for birth trauma survivors

Learn more about Kayleigh in her guest profile!

Transcript

Maggie, RNC-OB  0:03  
Welcome to your birth partners, the podcast identifying gaps, acknowledging biases, and co-creating a trauma informed standard of birth care with change agents across the spectrum of birth work. I'm your host, Maggie Runyon. I'm a birth nurse, educator and advocate who has been searching since 2010. The answers to how to provide better care during pregnancy, birth and postpartum. Through my own pregnancies and supporting births in home and hospitals around the country. I've seen firsthand many the systemic flaws that exist in perinatal care. Through these conversations, I'm thrilled to share with you insights and inspiration as we work collectively to transform birth care.

In this episode of the podcast, we are diving deep into the way that trauma shows up in birth and in the perinatal period. And really going into a lot of the complicated dynamics that exist when someone experiences trauma during their birth. This is something that impacts certainly birthing people, their families, their other support. And it also impacts those of us who work in in birth and support and provide care through it. Our guest today, Kayleigh Summers is a therapist and birth trauma survivor herself. As she shares parts of her story, her healing her experiences, you have your eyes open to so much of the nuance that exists when we talk about trauma in birth, it can be easy to spout back statistics, throw these numbers around. And Kayleigh does an exceptional job of reining in all of those, putting a story to it, explaining how that plays out, both in in the immediate postpartum period. And in the weeks, months, and years that follow. And we also have a very raw conversation about how we support birth trauma in the hospital. What are the things that those of us who are involved in birth care particularly in a hospital setting? What can we do to be more aware of our practices, how they play out? When we look to support and discuss with someone? What has happened in their birth? How do we coach and frame expectations around birth? How was that weaponized against folks, if they end up experiencing trauma, I am so grateful to share this space with you. As you reflect on your understanding of birth trauma, ways that it is preventable, when it is not how we support how we talk to folks about trauma that they've experienced, and how we think about and process our own misconceptions and preconceived notions about who needs support, and what constitutes trauma onto the show. 

Oh, well, welcome Kayleigh. I'm just so thrilled to have you here to share more about your story and your work with us if you would just tell our audience a little bit about yourself and how you're involved in perineal. Care.

Kayleigh, Therapist  3:28  
Sure. Thank you so much for having me. I really appreciate it. Yeah, so I'm a therapist, and I'm actually currently working at a boarding school. So I work with adolescents. But this space that I run here on Instagram is dedicated to birth trauma, support awareness and education. I had a traumatic birth two and a half years ago with my son. And since then I've been really passionate about raising awareness for all sorts of birth trauma, as well as supporting this community to try to find healing through all of this. Yeah.

Maggie, RNC-OB  4:03  
Tell me a little bit did you have experience with like in the birth trauma, kind of perineal trauma space as a therapist before your birth?

Kayleigh, Therapist  4:10  
I did not; no.

Maggie, RNC-OB  4:12  
So I think that's interesting. In that, I think for so many of us, even folks who are like involved in healing arts and caring relationships, therapy, nurses, physicians, what have you. There are so many aspects of our own, like personal experience that can really, yeah, catch us significantly off guard, even when we feel like we kind of have like a baseline. I'm wondering if you can share a little bit about how did you balance out kind of in your experience and you're able to share as you know, as much detail as you want, how you balanced out kind of the analytical piece of your brain that therapists piece with the like, wow, I'm a real person who just went through this really traumatic event. How did that play out for you?

Kayleigh, Therapist  4:52  
Yeah, that's a great question. I really struggled with it honestly, because I felt like okay, I'm a therapist. I have all the tools I know what I'm doing. And I can handle this. And to realize that I very much could not, quote unquote, handle this was hard. I think there were some advantages and some disadvantages to having a background in mental health before this happened, and I think one of the advantages was when I got discharged from the hospital, which I spent two weeks in the ICU, I'm gonna discharged. I was like, I feel okay, that this is a messed up situation. So I'm gonna start therapy now. Sort of like anticipating that this wasn't just gonna go away. And that definitely, definitely changed the course of my healing, going into therapy with a perinatal mental health specialist, so early on. But again, it's through that therapy, I would often be like, but I should be here, I should be healed. I shouldn't all of these shoulds of where I should be on my journey, because I get this because I'm a therapist. And that's just not how trauma works. Not even close.

Maggie, RNC-OB  6:05  
Yeah, yeah, I feel like well, obviously, we'll keep diving into this throughout the whole episode. But I think that piece of it that, where does awareness, perhaps versus like, action kind of weighed into this? I think, as we've been talking about this, and certainly like with your platform, and with so many others who are doing so much work to educate and inform about birth trauma, sometimes as birth workers, when we have this conversation, it feels like, okay, so we know, we're aware of the issue. We're tracking it for our own births for tracking for clients. And then traumatic births still happens. Yeah. What has been like the biggest maybe challenge that you've read about when you are talking particularly to birth workers, about birth trauma, and how it kind of shows up?

Kayleigh, Therapist  6:47  
Yeah, I think the biggest issues are for me. So there's a certain amount of birth trauma that we can prevent, let me say that there was like a threshold of belief that we could do a much better job at preventing in the medical system than we currently are. And that will limit birth trauma. And there's ways that I want to talk about to do that. And then there's also this piece of, there will be complications like mine, and we are fluid embolism that will, unfortunately, until we have more research, things like that exist. And so that will leave people vulnerable to being traumatized, because complications are scary, like threatening cetera. So there is a piece here for birth workers where they can help to actually mitigate that trauma, they're not necessarily going to take it away, you're not necessarily going to like heal someone in that moment. But being able to be open to a conversation around Wow, that birth did not go the way that you had planned that must have been really scary for you. Do you want to talk about it? What sort of questions do you have? What answers Can I offer you? What support Can I offer you in this moment?

Maggie, RNC-OB  7:59  
Yeah, you know, we're framing this whole podcast is around change making? How do we kind of step into our role as change agents? How do we find those moments, the flaws, and there are many in you know, in our birth care system and Perinatal health, where where we can make changes both as individuals and us as pieces of this, you know, bigger system. I think one of the things that just came up through what'd you say that is that piece of Savior ism. We've talked about that on the podcast before. And I think it definitely comes up in this space where we feel like, okay, if I know enough, I can do all these preventative things I can, I can fix it. And so I wonder if you could just delve a little bit more deeply into that, because I think that is, especially for those of us who are so aware, it's really challenging when we still find, yes, difficult situations come up.

Kayleigh, Therapist  8:43  
Yes, there was nothing anyone could have ever done. In my situation, to make me not experienced the trauma of what happened to me. However, my medical team, my birth team did so much to make the impact of that trauma less. And that's the key. It can be very helpless feeling. And I eat a lot of us hate feeling helpless, as a birth worker when you know, like, oh my god, I'm watching a trauma unfold in front of me. And there's nothing I can do about it. And while there's nothing you can maybe do about the physical trauma that is occurring, or if it's an interaction, even if there's if there's an interaction happening between the birth team and your patient as a birth worker, and you feel like you can't step into that moment, and you feel helpless. You're not actually helpless to mitigating the trauma, because there's a back end of that process that I cannot tell you how healing it can be for someone who has experienced a traumatic birth to step in after the fact and say, I'm so sorry. And to just feel seen and heard that what you just experienced shouldn't have happened and was awful.

Maggie, RNC-OB  10:03  
Yeah, yeah. It's so powerful. I think for all of us who we've talked so much about burnout, and how hard it is to fight back and see systems, how overwhelming can be. So I appreciate you just saying that for all of us who feel sometimes like it's insurmountable. These are still those individual. You know, we've talked about, like, kind of the Savers with peace of like, there's individual actions, I am responsible for my individual actions. I am not responsible for others actions, because I can't control them. And I am not responsible for the outcome. Because both I can't control it. So ultimately, what happens, it doesn't always feel like it flows right from my actions, but remembering that piece of what we can do the ways we can step in, yes.

Kayleigh, Therapist  10:41  
And you know, it's just, there's so many tiny small things that can be advocated for. And again, I know my situation is a rare, very complicated one. But and I did not have a doula or support person outside of my family. But I can imagine this space that they could exist in where they're, you know, advocating for my VB to be brought down into the ICU like he was right away for skinning the skin, while I was still on the way support, like they can advocate for whatever's going on with breastfeeding. That seemed kind of like a cluster F. Honestly, when it came to being in the ICU and trying to figure out like, are we pumping her? Are we not? Does she want to be pumped? He's unconscious? We don't know. Yeah. And sort of, there's such a place for, again, the mitigation of trauma, it's not going to take it away. But there are so many things that happened in my story that set me up to heal much easier and much faster than if those things hadn't happened.

Maggie, RNC-OB  11:42  
I think what's also really interesting about your situation, and you've talked about it before, you know, we've talked well connected like this is like obviously a big T trauma like anyone watching your poster is going to agree that was a setup for a traumatic birth, it was a traumatic experience to have a medical emergency during your birth. And so thinking about how, you know, What actions did your birth care team take? Did your family take your support system take with that knowledge that like this is absolutely traumatic? These are the things we need to do to do to help alleviate some of that to support Kaylee through this. How can we take that and shift it to these other situations that are maybe not as obviously in quotes, traumatic, that don't like set up all of those alarm bells in our head that like this is traumatic? How can we be more like in tune to those and still apply that same framework for all births, making sure that we're doing all of those things to set up folks to to heal and to have, you know, some closure in their birth situation to feel cared for?

Kayleigh, Therapist  12:42  
Yeah, I mean, so much of it is about autonomy, and at least like a perceived control, right, and a shared decision making and to be made to feel like you are the captain of the ship, so to speak, in your birth. And so often, that doesn't happen. And I think, in my situation, again, a bit different, not being conscious for like a week, there were a lot of decisions that had to be made. But I will say that they did their best to make those decisions, keeping in mind, like what my wants, were like, I wanted to breastfeed, that was what I had told everyone, so they promised me while I was unconscious, because I wouldn't have been able to even try without that. So and they did everything, they kept record of everything they took, I had over like 1000s of videos and pictures, from the time that I was unconscious of me and my son do a skin to skin like so thinking about what the birthing person could potentially be missing out on. Even again, if it's a smaller complication, if someone misses that time with their baby, that golden hour and that we always talk about, like what can we do to mitigate that? What can we can we have someone down there with a phone FaceTiming? Like what what can we possibly do to mitigate the pain of that person not getting that skin to skin moment that they pictured for nine months?

Maggie, RNC-OB  14:11  
Yeah. Oh, that's so good. And I think you know, sometimes people can kind of be dismissive of how, in this day and age, we have access to cameras, video cameras everywhere, right? You know, everyone's got a cell phone, everyone's got a camera. But and so certainly many of us take maybe more pictures than we'd really need there's this piece of being present in a moment versus trying to capture it yada yada but in this situation, like I have always been so touched, when I'm you know, looking at your social media, the pictures, the videos you've shared, like the thoughtfulness that was so apparent in your support team and how they wanted to make sure like, we're going to document everything. If Kayleigh doesn't want it later on but do whatever you want with that fine, never have to look at it, whatever. But you know, setting that up that again, that was about your that was about your choice and your ability to then choose, you know what you want to do with that.

Kayleigh, Therapist  14:55  
Exactly, exactly that I think that choice is so important and And I think I get a lot of pushback isn't the right word. But I get a lot of questions, curiosity from especially, like medical professionals around like, well, we could get in trouble for that. Or you could and I get it like I 100% can empathize with that. And I think this is like the biggest issue when it comes to the medical system, and patients, which is this clashing of I could get in trouble for that. And what if I do something wrong? Like when we're talking about things like continuous monitoring, or whatever it is, there's this anxiety of and it's valid, it is valid, like there are things that can happen. But where's the balance? Right? Like where and I've bundled both nurses talks about this a lot on their page, how do we get people to be less liability litigious, next to Yes? How do we get that? Like, how do we protect the professionals more so that they can do things that actually give their patient more autonomy, and feel less risky? And how much of this litigious concern is valid, and how much of it is conjured up, and, again, bulls valid, but I, again, I get a lot of pushback, like I had a lot of perspective on this, I had a nurse record, my baby for me in the NICU, when he was first born. No one's gonna be for like, no one in my family for like, five hours. And not because he was in the NICU, but because, like, I was dying, and they were all sort of just like, the baby, everyone was like, the baby's fine. The baby's taking care of the worry about the baby. And so no one's off him for a while. So a nurse sent a video to my family being like, look, he's totally fine. Look how well he's doing. Like she literally that there's a video on my Instagram. It's like, the 10 fingers 10 toes, like look at them all. Like they're all and like, the comfort that that gave my family to be able to focus on me. And what's happening with me is just the greatest gift. And the issue is like, I have nurses being like, I could get fired if I did that. We can't record things like that. And that's that I know, I know. And yet, that was such a like having that video now of my son an hour after he was born. Is it makes me teary like I can to hear nurses and being like, you're okay, buddy. Everything's okay, Mommy's gonna be killed. Like it chokes me up every time and to think that I wouldn't have that because of concerns about liability is so hard.

Maggie, RNC-OB  17:55  
Yeah, that's a perfect segue into like, my next question. I've kind of been about that piece of that how, especially in the hospital setting, because Absolutely. You said there's different relationships with you know, doulas community birth workers, you know, folks, there's a different relationship, you know, established there for those of us who, you know, work are employed by a hospital, you know, certainly there's a lot of rules written around written about our conduct what's expected of us. And I was thinking about how so often the cultural narrative within, like, work here is this, this whole absolute liability concerns, trying to do everything like by the book, so we can say, you know, we did x and then y, and then z. And I was recently gave a presentation referring to a case study where someone had a traumatic birth, who had an infant with a poor outcome. And the first documented note in her chart addressing her emotional mental well being was four days postpartum.

Kayleigh, Therapist  18:51  
Crashing, right.

Maggie, RNC-OB  18:53  
And so much that you think like, again, that's systems issue on like, eight different levels. But you know, part of you think like, right, did they did they not feel like they could were they told by management, this was a bad outcome stuff went wrong, don't say anything, cover yourself, just, you know, you kind of like, if you don't say it, there's nothing to go back on. They can't say that you said you were sorry about something or that you took responsibility for something or that This shouldn't have happened because that imply somehow we were you know, liable, that there's someone to blame. All of that piece that is so antithetical to trauma informed care, it is so on patient centered is not human centered, like that is not how we are meant to be in relation with people. Not not, and, you know, on top of that, like so, you know, that's it. Maybe they were told that maybe they weren't, maybe they just felt completely, they were completely unaware of how to approach this. How do I say, I'm sorry? How do I talk about my trauma from going through this with you without making it like about me? How do you know how do they navigate this whole situation? That doesn't make it seem like you're trying to make yourself feel better? On and on and on. But what we've seen, I mean, we've seen this over and over in in research, we see it in outcomes from from lawsuits from the instead of not going well, how much better people feel when their healthcare providers took that time to connect with them. That obviously there are exceptions to every rule, certainly, but people are looking for they're looking for connection, they are looking for understanding. In the midst that trauma, taking a moment to just be human with each other is trying to keep these like rigid roles we have about what we're supposed to do. It has to happen. We have to divest from some of that concern, where if you were to get, you know, called into your manager's office and say, Hey, you did a video of a baby, you know, you're not allowed to do that on your personal device, that you're standing strong. The fact that absolutely, I send it to the family, I then deleted it from mine. I didn't share it on social media, I didn't share it with anyone else. That was something for the family that like, you can feel confident that you were doing something that it's patient centered, that the family wanted that, like all of those pieces that backup that Yeah, that might not be like written in the handbook. But as healthcare workers, as you know, birth care workers as humans, I knew that was the right thing to do is that I've ranted at you that wasn't so much of a question.

Kayleigh, Therapist  21:18  
No, it makes a lot of sense. And I had such a great conversation on another podcast with an OB anesthesiologist about this exact dilemma because it was it was a whole podcasts about trauma informed care. And I asked more about like, tell me more about like the litigious piece of this, like what? Because my argument is, and she did give me a great answer. But my argument is, well, if you did something wrong, you did something wrong, and we make mistakes, and we are all human. And if the person did something wrong, then the patient has the right to pursue legal action, or whatever. And so saying, I'm sorry, this happened isn't going to all of a sudden create a situation where someone Sue's you, and to be fair, her responses like that they do. And even though it doesn't, it doesn't they don't win, right? It's it's so difficult to win a malpractice case even something does go very wrong. But it then drags that person through what is really a terrible process. But listening to you talk and my sort of feeling is that actually saying I'm sorry. And having that human connection, I that leads to a lot less outcomes where the person wants to take legal action against that doctor, again, not always. But I would hedge that. Going in making that personal connection saying you're sorry for what happened, not what you did. If you didn't do anything wrong, I'm not telling you to apologize for things that just were complications, but apologize for how that person had to go through their birthing process. That isn't you can apologize, people are so afraid to apologize. You can apologize for what they've had to experience. And that is not gonna that right, there is not going to be the thing that makes someone sue you in my opinion.

Maggie, RNC-OB  23:18  
Yes, you don't I mean, yeah, and I think separating that you know, like that fear. And they're great experts like Jen Atkisson and Irnise Williams are they both talk about, you know, various things, how this comes out, and how to really navigate and what's the what's the actual reality about lawsuits and the legal piece because that comes up with trauma, when we know something has gone wrong, and outcome was not ideal. Absolutely. There's that niggling in the back of our mind, like, oh, did I do something wrong? Were my actions, the cause of this? Is the person who's experiencing it, are they going to experience it that way? Whether that is truly, you know, factor fiction is going to be there, their experience of it? And then like, how is this going to impact the rest of my career and that, that doesn't make us selfish or self centered. The reality is, you're this is how you make a living. So your license, this is your you know, your work. So it's scary. It is scary. And I think So Felix, often we talk about just like part of the his this, it's having, it's having these conversations, it's reflecting, it's doing this work to understand like, how does that come up for you? When you're in that situation where you just had a question or outcome, you have someone who's having a bad experience? How are you able to separate those two things and show compassion, like you said, you know, saying, I am so sorry, this is so difficult for you right now. That's not code for it's my fault. It's difficult for you right now. It isn't, you know, it that's that's not how it's going to be interpreted. That is just you being compassionate to another human being. And, you know, we see this in, you know, when we talk about birth trauma statistics, and, you know, one in three folks find their birth was traumatic. Obviously, it goes without saying,

Kayleigh, Therapist  24:53  
birth workers

Maggie, RNC-OB  24:54  
do not think that one of the three births that they participated in was so there is this Huge. However, there's this huge disconnect we have with each other and understanding our patients experience. But when we're able to, like recognize some of these signs of trauma, when we're able to kind of like step away from it and see that sometimes it's our care whether that's just the routine stuff that we do every day that is traumatic. So know that learn about how that shows up. But also recognizing just to like, you just, I can't say it enough, we should be human. In this, I feel like so much when we talk about like changing healthcare, it's it, we set up birth care in hospitals to be like factory run versus not, it's not a factory product, not. And so we have set ourselves up for failure, we set ourselves up to act like we are robots in this, that doesn't feel good to us, it doesn't feel good to patients, hurts everyone involved in the process. So as we try to, like get out of that, get out of that situation, like, separate ourselves from it. We need to be willing to do things that go against the norm, but are appropriate, right? Like we're challenging preconceptions. We're challenging the fact that like, that might be policy, but it's wrong. So we need to change the policy. You know, like, this is not always about kowtow into the way we've always done stuff. So it's terrible, maybe? Yeah, huh. You know, one or two. So you I know you said like, you know, you'll get comments from you know, for work, especially on social media. I think social media is a nuanced way of providing education, it's hard sometimes to convey everything adequately. But have there been like, big misconceptions that you see show up in that and in comments and how people are expecting birth trauma to what it supposed to look like? Or I think maybe even more, so how you're supposed to heal from it, because I think you've done an amazing job of really speaking to like your journey posts that, you know, initial couple of weeks, as you kind of got used to everything.

Kayleigh, Therapist  26:50  
Yeah, there are so many misconceptions. I think some of the biggest are around how much this is supposed to affect you. Like a lot of people want a time stamp on it. And a lot of people want like, no, don't talk about an ever. Because when we talk about birth trauma, it's such a unique trauma, because unlike most others, not all but unlike most other traumas, they happen sort of randomly, birth trauma happens on a date, I was already full of expectation, and full of what should have been these beautiful moments. And even if your expectations are and this is a big thing, I get really frustrated, like birth trauma is not based on people having too high of expectations of their birth. That is not what most birth trauma hits. Yep. Even people when I find out, you know, someone had a C section and they say like, I didn't want it and that was traumatic. When I get down to why that was traumatic. It was the way in which the C section was communicated to them the way in which it happened. And again, a lack of just understanding and communication as to what was happening to the body. So that is not just an unmet expectation, causing trauma.

Maggie, RNC-OB  28:11  
Yeah, the unmet expectation is not a method of delivery, but the care that they received along the way.

Kayleigh, Therapist  28:16  
Yes, it becomes weaponized, just don't have expectations, and then you will be traumatized. You are expecting this to be the best day of your life. And just because it wasn't now your your so called traumatized. And having expectations for birth becomes weaponized is my issue. You get to have expectations for your birth. Yes, fact it to be a wonderful experience. And that is not the issue is an expectation for like appropriate human care. And empathy is not even something that should be on our like list of expectations, as you only mean like that sort of diet shouldn't need to be spelled out in your birth chart, Matt. Exactly. Exactly. And so I think, I think that's a big piece too, is people being told like, well, you, I love when people say like, you shouldn't have had expectations for your birth. Well, I wanted to live while my child was being born so...

Maggie, RNC-OB  29:10  
set yourself up for failure there. Kayleigh Right, exactly. It's I mean, it speaks to obviously we do it a lot in medicine. And it also speaks to like this bigger social concept we have about what people are allowed, I say in very heavy quotes allowed to want Yes, life. Yes. Like what a bizarre thing to to judge to accuse someone that like, Oh, you wanted the birth of your infant, which we all would agree is a major transformational experience. Oh, you want that to go? Well? Well, I was asking too much. Like what a bizarre thing to put on people. And we do it all the time, obviously. And I think it unfortunately goes back again, that we have had really difficult childbirth experiences. We have had a or care, we have normalized childbirth, just being traumatic. Truthfully, we've normalized that. And so then when people tried to call out and say like, but I didn't want that I didn't want my birth to be traumatic. They're met with so many other people who likely had that experience themselves had a traumatic birth, never addressed it never dealt with it. have hidden that right away. And they're just like, that's just how it is. We're the author of his traumatic Yeah, exactly. Oh, yeah. Well, that's just what Yep. Yeah, birth is trauma. Of course, it is. Like, of course, it's traumatic to have a baby cry to your body. What? No, no. And that, like we we as birth cover, can you be so part of changing that? Like, absolutely. When, whoever it is, when the mom, you know, the grandmother is sitting there and saying, like, Well, I told you, it's really hard. I had a terrible birth. We you, I don't know why you thought this would be different. Yeah, okay. Like, that's not okay. And we we do that we'd support people do a twist support quotes. And then that's, you know, our job to educate and say, like, I'm so sorry, you had a bad experience? And has that played into how you thought this would go? And I'm also really sorry that you're living through that right now. Like, that is not okay. It's not okay, that you had a heartburn experience. It's not okay, that your daughter is right now, either, you know, like, resetting our expectations of society that bursts is a major event, but a major event is not hidden negative connotation. It's

Kayleigh, Therapist  31:27  
no, there's no exactly what what, because it is a major life event transition. It leaves us even more vulnerable, to be traumatized, when the complications arise when the you know, care isn't appropriate, etc, etc. And that's another sort of uniqueness about birth trauma. And I think, going back to sort of what you've said, my biggest, I guess, hurdle is I am a big struggle for wine, right? Like I owe my life validly to hospital, to my medical team. In here, flood embolisms are not predictable, preventable, etc. And I also see the concerns and the issues. And I am like, I'm having these situations where I see people like inching forward like an old like the OB anesthesiologist reaching out doing a podcast about trauma informed care, that is amazing that those are the conversations like those are the people who are going to change the tides, because we can't all be homebirth and birthing center people, there are people who have to write and that's a great option for people who can do that. And we love to see that. And we'd love to see Low risk, low intervention here, when possible. And yet we have to somehow tie these two together. And that's where I've come up against a lot of just tension. And I've had a hard time navigating how to how do we connect both worlds? That we get low and it happens? It's just rare that we get these beautiful, Low risk, low intervention, beautiful environment type births, you hospitals, and like, that's what we want to see more of, or just trauma informed care for complicated parts like mine. Absolutely. Oh, yeah.

Maggie, RNC-OB  33:35  
We've talked about how like, Absolutely, there should be choice in birth setting, in delivery method in the ways that we want to bring our babies into the world. We are all encouraged to have a multitude different things. I probably want a different name for my birth than you did that doesn't make either of us right or wrong. And I think we have sometimes when we try to kind of push back the pendulum swings, right? You know, we kind of push from this like over medicalization of birth read the hospital to like everyone should just have a Hummer. Yes. And if everyone just had a little bit, but there's several, there's several falls in that reasoning. One, not everyone wants that. Not everyone's a good candidate. And there is this piece where we may say, as a labor and birth nurse, in a hospital, we can issue responsibility for our care for the way that we provide care. Yes, I'm informed care. In the hospital, we can say like, oh, well, if they want X, they should have had a home birth. Why are they here telling me that their birth plan is X, Y and Z? Why do they even bother coming in? Yeah, well, they came in because this is where they wanted to have their baby. And because they expected us to be care providers, because for any number of reasons, they so they were comfortable with. They like their physician. They wanted the option of having you know other higher levels of medical care and support for the baby there. For any number of reasons for insurance coverage. Let's not even pretend that homebirth is my own birth center. They're financially accessible. Everyone like all of these things that we can get really bogged down in. But the reality is that it is reductive and irresponsible to pretend that people who want trauma informed care just need to look elsewhere. Hard line, and I'm sure many people who are listening to this podcast probably are nodding aggressively that but this comes up all of the time. And, and I've engaged in conversation with people over a decade. This is not like this is not a new belief. It's also not going anywhere. Okay. So we have to actively break down that idea that, you know, people who want to have these expectations of birth, like they need to look elsewhere, we need to alter the care that we offer in hospitals, so that it needs feel where they're at. This is not about some small subset of the population who wants this special thing. So they should go elsewhere for that? No, this is what birthing people loudly, regularly, repeatedly are saying they need trauma informed care, every person deserves that every person deserves to have patient centered care, person centered care, that acknowledges their individual wants and needs that again, are different. Yes, we can't pretend that because it's also I also want to pretend that everyone who has the homebirth, or Western birth or low intervention birth has a non traumatic birth. Yes, that is not. That's not an equal sign there. No. And it's also often normalized, like, yes, no, we had a home birth, well, absolutely. You can have a traumatic birth at home and have that divorce Center, you can have everything checked off on like what you thought birth was supposed to look like on your birth plan, and still have trauma for that. And that is not a personal responsibility to find about those expectations and everything. And so, being aware of that, how these things like, play back and forth, and there will each of us have, in breaking down these expectations about what a good birth looks like, what expectations are, and how we cope with it afterwards. You know, I think one of things I love about your, your page, and maybe kind of a final thought to share with us here is how do we as as birth care workers, as supporters who loved ones? How do we show up for the people in our lives who have birth trauma that isn't magically going away on the timeline that we anticipated? Yeah, I

Kayleigh, Therapist  37:14  
think there's a lot of things a lot of it has to come down to being willing to listen and sit in those really uncomfortable feelings with that person. Because often when we deploy toxic positivity, everything happens for a reason, at least you're both alive. It all has to do with our discomfort, and sitting with them in those difficult, challenging emotions. And so telling the person I'm sorry that this happened, I'm so sorry that this was your birthing experience. It's unfair, and it's not what you deserved. And I'm here, if you ever want to talk about it, I'm scared. I'm willing to listen. Because some people you know, they're not ready to talk about it, or some people, all they want to do is talk about it. And being able to give them that option in that choice to be there with them. But really, don't ever use the term at least. And really just being cognizant of the toxic positivity, because it is rampant in the postpartum space. Yes. Okay.

Maggie, RNC-OB  38:19  
And can you end us with like, what are your top three? Do not say this to someone who has had to try? And yeah, I'm sure it's hard to get into this a couple. But you know, what are those types? Like, do not ever say this? Because chances are, we've all said things that were not ideal. Again, this is not a way to like feel guilty about that. But as we move forward, what are those phrases you would love to like? Never hear again in that, like, post birth, traumatic birth space.

Kayleigh, Therapist  38:43  
 I'll give to like general ones and then one specific to workers. Well, that sounds terrible. But all that matters is healthy mom and hold the baby. Big thumbs down? Yes. Yeah. And we've all said it. I've said it. 

Maggie, RNC-OB  39:00  
Oh, yeah, this is it rolls right off the tongue. It feels like that's a good thing to say to try to like reorient in the present. It is not.

Kayleigh, Therapist  39:07  
No, it is not. And then I would say down the sort of anything with at least and their situation. At least your you got to have a baby. At least you experienced one pregnancy. At least you didn't die at least you could do surrogacy or adoption, at least like all things, just anything, minimizing the situation and thinking that you're helping them perceive it more positively. It's not working. It's totally invalidating and diminishing their experience. Oh,

Maggie, RNC-OB  39:37  
yeah. I wonder if honestly, is there ever a place for the phrase, at least in the English language? Like is there ever even out of this context is originally we're saying that someone actually makes them feel better like that. You want to hear that? No,

Kayleigh, Therapist  39:48  
not the last one is a little tricky. But it's for birthworkers and it's not too hard to explain. It's not Like every situation, but I've gotten a lot of feedback about this, even though I don't personally feel affected by it, it's more just like a be cognizant of this, when you do have someone who has a massive complication, what I've seen happen is that that person who had that massive complication was not aware when the complex for the most part, typically, they were not in or they were not ever, so everyone else, you know, in my thought I was gonna die, like everyone in the ER was chosen to die. And so they're all likely dealing with some trauma. And my team did not do this to me to be clear, they were amazing in their feedback for me, but often what I've heard is that, that team will then come in and say, like, Oh, my God, you're a miracle. Oh, my God, you shouldn't be here. I am so grateful that you are here, you Oh, my goodness, you should be so grateful to be alive right now. And it's all coming from a really good place of like, what they saw. And the fact that we are now sitting there alive is like, cognitive dissonance time, the million for them, given what they had seen. And so the feedback that I've gotten from other patients who have experienced this is that this makes sense. When they go on to live out their healing journey, all they can think about is like, I should just be grateful, I should just be grateful. And I have to live this amazing life because I shouldn't be here. And so when they start to feel angry and sad, yeah, this happened to me, just because it's a part I think of like a near death experience is just, I didn't feel like I could feel sad or angry. for like the first probably six months, especially because like a month after my aFe another woman in really great hospital, really great providers didn't make it. And so how am I allowed to be mad and sad that this happened to me when I get to be here in Boston, my son grew up and she doesn't know survivor guilt piece of it so much survivor guilt. And so I think that's actually a really great way to sort of wrap it up. I think that sometimes providers unknowingly can contribute to the survivor's guilt by being so sort of like, Oh, my God, I can't believe you're alive. You're a miracle, sort of all of these things that then replay in that patient's mind when they're trying to heal. And again, not everyone feels that way. And if you have said this, it is totally fine. There are a few random support people that have said it to me, and I'm okay with it. It's cool. But I think just being aware of how it can affect and so saying the like, I'm so sorry, that this happened to you. I'm grateful that you're here. But I know how incredibly difficult this must feel for you. You only need a different we don't have to completely throw it out. But just making sure you're giving them space to feel off about it rather than just grateful. Yeah.

Maggie, RNC-OB  43:00  
That is it's such a powerful way to and I think, again, so much of what we've covered in this episode is how we are aware of our own stuff, how that shows up in how we're relating to hooks, how do we kind of internalize our own feelings about birth trauma? And then how do we how do we change that? How do we change the narrative so that all experiences are validated? Everyone feels like they're able to be on their journey where they are? Absolutely. So some people have a traumatic birth. And they they don't want to dive into it that much. They really just want to kind of take that and write it on off and be like, Yep, I'm here. And I'm fine. And I'm gonna tuck that away to maybe do later, but maybe not. And that can be okay, too. So not expecting everyone to be just on this, you know, linear journey in processing their birth trauma and how we how we support them through that. Absolutely. Well, thank you so much, Kate, this is such a powerful conversation. I could obviously sit here and talk about this all day. So I really appreciate you taking the time to share with us. Can you just tell our audience where they can find you how they can kind of follow your work and learn more with you?

Kayleigh, Therapist  43:59  
 Yeah, absolutely. So on both Instagram and Tiktok, where username is at the birth trauma underscore mama perfect.

Maggie, RNC-OB  44:07  
Yeah, well, and truly Kayleigh's Instagram and, and presumably, to capitalize on that platform less is just a treasure trove of of information and insights that really help to just like plant seeds. Help us to reflect and grow on, you know, our journey as birth care workers as we look to just provide better care and support and remember trauma. So thank you so much for this conversation with Kaylee.

Kayleigh, Therapist  44:27  
Yeah, thank you so much for having me and for all the work that you do in the space.

Maggie, RNC-OB  44:30  
Oh, well, I know that this can be kind of an activating conversation for many of you. So thank you for tuning in and and sharing this as we process through how we better support folks as they experience trauma in the perinatal period. Hope as you take the time to think through this and reflect on your practice that you are surrounded by support for yourself and for your own processing. We started they welcome you to join us over in your birth partners community in our Facebook group. If you want to share your thoughts and reflections, we would love to support you as well. Till next time