Debriefing at the Bedside #066

In this episode, we are going to be diving into the topic of debriefing: what debriefing is, how it can benefit folks in the immediate postpartum period as they start to reflect on their birth story, on their journey on the feelings that they have as they reflect on what happened during their birth, whether those were, you know, overwhelmingly positive or negative experiences.

Together with Emily and Mandy we have created a resource for Debriefing at the Bedside, that we are really eager to share with you all. This is a free resource. We want to get in the hands of as many folks who interact with people in that immediate postpartum period, whether that is at the hospital bedsides, whether that is at home in those first few weeks, we want to provide this tool so that you all can feel more confident as you look to assist folks in reflection in thinking about their experience, as we break down some of the barriers that stop folks from feeling like it is okay to talk about what happened.

We are so hopeful that you all will walk away from this with more awareness about how important debriefing can be for everyone for every birth.  That you will be able to put this into action in your practices as you look to create a space that is more welcoming for folks to speak to their lived experiences, and that prepares us to support them along the way.

Episode highlights include:
~Defining debriefing vs reflection vs processing
~Navigating conflicting feelings about your birth story
~Debriefing as a tool for fostering connection with caregivers
~Normalizing the need to debrief
~The privilege of pausing to contemplate your experience
~Why birthworkers need to seek out their own debriefing support

Here is a preview of the Debriefing resource & here you can request the full free fillable pdf.

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, a birth nurse, educator and advocate who has been searching since 2010 for 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 of 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 podcast, we are going to be diving into the topic of debriefing. And what debriefing is how it can benefit folks in the immediate postpartum period as they start to reflect on their birth story, on their journey on the feelings that they have. As you know, they reflect on what happened during their birth, whether those were, you know, overwhelmingly positive or negative experiences. And we have created a resource for debriefing at the bedside, that we are really eager to share with you all. This is a free resource. We want to get in the hands of as many folks who interact with people in that immediate postpartum period, whether that is at the hospital bedsides, whether that is at home in those first few weeks, we want to provide this tool so that you all can feel more confident as you look to assist folks in reflection in thinking about their experience, as we break down some of the barriers that stop folks from feeling like it is okay to talk about what happened. We are so hopeful that you all will walk away from this with more awareness about how important debriefing can be for everyone for every birth. And that you will be able to put this into action in your practices as you look to create a space that is more welcoming for folks to speak to their lived experiences. And that prepares us to support them along the way. Onto the show. 

Oh, well. Welcome back to the podcast, Emily & Mandy. I am so excited to have you joining us. For our longtime listeners, you've heard both Mandy and Emily on the podcast before but we're coming in with a new topic around debriefing today. And so I'm excited to get to hear from all of us about why we think this is so important and why this is a big change that we need to be making at the bedside. So share a little bit about yourselves with our audience, just to remind them what your what your role in perinatal care is.

Emily, PMH-C  2:46  
Sure Mandy do want me to go first? 

Mandy, RNC-OB  2:48  
Yeah. Perfect. 

Emily, PMH-C  2:50  
So thank you so much for putting this together today. My name is Emily Souder, and I am a licensed therapist certified in perinatal mental health. And I do have a private practice and I'm also an intuitive Reiki practitioner. I do trainings with both professionals and therapists around both birth story reflection and birth story processing. Fantastic.

Mandy, RNC-OB  3:11  
Awesome, awesome any have two books. Hi, Emily. Hi, Maggie. Thanks for having us. Maggie. My name is Mandy Irby. I am the founder and owner of the birth nurse. And I teach trauma informed nurse care and parent education around childbirth in an effort to change the culture to be more trauma informed and safe for all.

Maggie, RNC-OB  3:34  
Yes, yeah. Which is why you are two phenomenal people to partner with to create this debriefing resource. And so just sharing a little bit about what for folks haven't had a chance to look at it yet, what we realize is that there's really just this whole in terms of how we support people in the immediate postpartum period, after they've just experienced their birth, no matter how it went. And, you know, we had heard through some of our nurse colleagues who've gone through the trauma informed birth nurse program, that they were really looking for a resource, a kind of a rubric for how to start having these conversations with their patients in an immediate postpartum period. And, you know, when we started talking about this together Mandy, I through TIBN you know, we realize like, okay, there's like, you know, we want with this other perspective, too. We want to make sure this isn't just us as nurses at the bedside that we are involving someone else. And that's why we asked Emily to come in, I have loved Emily's books around how they kind of foster reflection and thinking through how we are how we're approaching our own birth stories and how we help other folks and support them as they process their so we were delighted to have Emily join us in this and so I think maybe the first question kind of did touch on is and Emily, maybe if you want to start with this one, if you want to just kind of tell us a little bit about like what debriefing is and isn't I think there's some other terms we kind of used somewhat interchangeably times, maybe inappropriately interchangeably. So if you want to kind of share what debriefing means to you. 

Emily, PMH-C  4:57  
Sure. So I can I think in the best way to kind of back into that is to sort of talk about what some of the other terms are as well. And sort of, you know, like I said back into that, and I, you know, the way that I define these terms is, of course, not like the only way to do it, there are other ways to do it as well. And you might hear other terms, but it really made sense to differentiate them in this way, in our conversations.

So you know, my trainings when I talk about reflection, that is a, you know, more in depth process with any birth professional, who has the availability and the time to be able to like, listen, for as long as as needed and to provide reflection and validation for as long as needed. And emotional support processing is the term that I really use with therapists when we're really going to even another level, to be able to bring in the therapeutic modalities that we're trained in to be able to offer healing. And of course, all of these things can be healing in their own right, I want to just say that, that to offer healing and address some things in a different perspective. Debriefing is from you know, our conversation was really this, it's the first line of response to being able, it's an opportunity for somebody to say, I hear you, I'm listening, to be able to offer that early reflection and validation and listening ear, like just the space, which we don't often have, you know, when there's that quick turnaround, we don't even offer have that often have that that space and so debriefing being that very first line, space holding supportive, trauma informed and to warm to be able to let you express, perhaps the very early inklings of how your birth story affected you, which could be a whole range of ways.

Maggie, RNC-OB  6:44  
Yeah. Yeah. Mandy, do you want to touch me, because I know I've heard you speak about it before about kind of debriefing and what sometimes our clients who have had a birth before that didn't maybe go the way that they planned, and then they're coming back into that if you want to touch on kind of what you've heard from parents on that on the other side of it.

Mandy, RNC-OB  7:01  
Yeah, and I'm not a therapist, I am a nurse, and I do some I dabble in the processing within the nursing scope. And that's why I really was drawn to this resource request, we've wanted to make this for a while and continue on it because like Emily said, it's helpful for the parent. And it can also be really helpful for the person that is doing the debrief, often the nurse in this situation, but it is geared toward parents, like you said, holding space for the parents. So parents, what we know from studies and even recent research is that parents can interpret their birth and feel that their birth is traumatic or pieces of it or traumatic when they feel alone abandoned unheard. They've lost autonomy, even it not in life, or death, or perceived life or death situations or serious injury situations. And what folks have said afterward when processing with me and just kind of essentially debriefing. And like game planning is what we do afterward, they come to me because they feel like they weren't heard. And they feel almost a second like layer of abandonment, when no one in that space that was with them acknowledges what happened. And it's like, they didn't think that it was wild. And they just they talk later and and parents say maybe this is normal, maybe this is how it is. But this is so far from what I expected and feels so far from what I want to feel after my birth, that I need some perspective on what is normal, like, is this normal? Because no one acknowledged the events that happened that I perceived is really scary. I lost my voice. I lost choice. I felt a dis impairment. I maybe like left my body. And no one gave me the details of what happened when I kind of disengaged and then came back No one. No one really validated my story at that time, is what I hear is this huge missing piece.

Maggie, RNC-OB  9:20  
Yeah. Yeah, I know throughout the season, as we're talking about change. We've had a couple of guests come on to share about their work with birth trauma, because it is one of those things that like we we've had to keep touching on through this podcast because I don't think we can have genuine conversations about what is going on in the field of perinatal care. And what we need to change it for not really addressing this huge elephant in the room. That is our rising horrifying birth trauma rates, you know, 45% of people right now feel like their birth is traumatic like that is a lot of people and so I think there is this huge I know for us, as you've said we've talked about this  we want to see, we want to see something that folks can bring to the bedside. You know, we kind of envision this being done by really anyone who is in that immediate postpartum period. So for those of us who work in hospitals, oftentimes it's going to be you know, a nurse, whether that is the labor birth nurse who's able to, you know, go to postpartum and debrief with a client of theirs a patient of their so they took care of during the birth, that can be really powerful for both of them to connect, we also see something absolutely that anyone else involved in the team, you know, it could be a doula, I think each person each birth team might find different ways to do this each, especially in hospital systems. There are some times, you know, different red tape around who does what roles, but certainly this will be done by the unit Case Manager or social worker, the physician, the provider, the midwife, they could be doing this as well, like, this is not something that we want to see segmented to a role, we want this to really be something that serves the birthing person. And so whoever is able to be a part of that conversation, I think, is really powerful. And, you know, like Mandy was saying, we've heard so much from, from parents about that lack of connection, and the dismissiveness, and, you know, when we're talking about how you know, of those folks who experienced birth trauma, about two thirds of them feel like the biggest piece of it was not feeling seen or heard or respected by their clinician. And so we'd see this as one tool we can take, even if we weren't involved in the birth itself, this is one way we can make sure that they do have someone involved in their care team, who is coming in to say, Hi, I am here, I do hear you. Let's talk about what happened. And so I think those that those like rising statistics is certainly some of what motivated me. I don't know if you all want to share kind of where else this is fit within your within your journey. And why why now was the time for us to be like, Okay, we really need to get a resource out there. And we're certainly not the only people, you know, doing this. I think there has we've seen a couple other folks who are creating more talk around debriefing, because I think it is something that is it's really showing up as like a big need for folks.

Emily, PMH-C  11:53  
Oh, yeah, absolutely. And I think it's something it's been something right. And I think that we're all sort of feeling that more and responding to that, whether because we're, we have the energy to do that finally, after the, you know, not that the pandemic is over, right, but that we're maybe ahh part of us was getting used to it or craving, connection and healing in a different way. But really being able to have the energy to dedicate to like, Okay, we really need to be able to focus on healing here, too, right? Even though we've been in survival for so long. And some of us absolutely still feel that way today, but really being able to just uplift others and offer healing in very important times, which, like you said, is right after, you know, when people might not feel heard by their providers. And the thing is to, you know, people might not have a very safe family ear, at home or friend ear, a lot of times, people are encouraged to gloss over all the bits that might not have gone as they planned or might be sitting with them in a way that feels uncomfortable and say like, oh, but it turned out fine. And, you know, oh, but everyone's healthy. And, you know, that's really, really invalidating and embracing. I think that we're moving more and more as a people into this both and existence of like, yeah, that can be true, right? Everybody's healthy. Or maybe that wasn't the outcome. But either way, but that and there's still this stuff that needs to be unpacked. And that can be okay, that doesn't mean that you're a bad parent. Or that you know, there are things about your birth story that could fall on both sides being some things were disempowering. And perhaps some things were empowering as well, that can be really confusing to sort out on your own, right after the experience, and sometimes that sort of work and reflection doesn't come until later. But to just have somebody's day, like, however, you're feeling right now, feelings can be messy after birth, feeling and that's normal. That's normal. You know, that's completely expected. But there's not a lot of that I don't think I got a lot of that validation after, you know, either of my children were born. It's sort of like, Oh, why do you feel anxious? Why in the world? Do you feel anxious? When you got the feedback that you wanted? Why do you feel traumatized? And all you know, it was a very both and right.

Mandy, RNC-OB  14:20  
Yeah, for sure. For sure. I always think back to modeling behavior for my kids, because it's just coming up constantly as a parent, and I know that the folks that we work with are parents now, and we're modeling for them what, you know, we might want or need from parents and around parents and changing parenting, and that's my space right now personally, and also modeling behavior for nurses and professionals that we want to see. So like Emily said, it made me think it's not that maybe we have the capacity it's that we want. We have this need Do we have the shared, need to fucking debrief all that's going on? And we all collectively are like, Okay, I've sat with my body for a while we've had some quiet, this is some real shit. Is anyone gonna say anything? That's right professionals are like, I don't want I know my body is feeling this like, can we acknowledge I'm not, I don't want to layer on that debriefing with a new parent is a debrief for professional, they are separate. And we're very specific about that in this download and in this beginning debrief. But I know that Maggie mentioned, it's perceived as dismissive by parents when no one acknowledges the experience. When no one holds space for the story, a real container, a real validating container for the story, it is perceived as dismissive. But on the other end, nurses and healthcare professionals in perinatal spaces want so desperately to have the words and almost like the permission, the skills, the training, that it doesn't take a lot, but they want, they haven't gotten that, to be able to offer for their patients. They're in an abusive system, they're in an abusive relationship with you know, each other and their facility. And they're taught all of the other things they're taught like, well, let's do some toxic positivity. Well, you know, I'm not to blame. So let's like, lighten the mood a little bit, because we're all scared of you suing me and suing in you know, there's these fears that are real. And so the professionals really want to be able to do this. And I think also, they really want to be able to have this.

Maggie, RNC-OB  16:40  
Yeah, I liked that parable. Like, there was that piece do that, like this is for every birth? You know, it's not just I think, so often, we talked about the ones that are not going well, because obviously, yes, there is there's power and there is at times what feels a stronger need to make sure that those are those feelings are validated and normalized and, and talk through. But this is also like a, you know, you talk in nursing about like the stages you go through as a parent as you like, take what just happened in the birth and you process that part of the story, you try to like make that make sense within you before you can really address it with like your partner or other family members or the baby. And so, you know, times I read like us talking through, you know, yeah, sometimes like the person you're talking to, will seem almost like they're not really paying that much attention to the baby, they're still talking about what happened to them. And that there's that important thing that they do, you know, again, nursing students that like, hey, so that means like, don't think that they're being self centered, or anything, this is literally something they need to do this isn't they need to process before they can actually move on to being whole and being ready to like, Okay, now I'm the parent, I'm taking care of you, baby. But we learn that, but I don't feel like we do that as a society. 

Mandy, RNC-OB  17:47  
No, literally. There is no pause.

Maggie, RNC-OB  17:52  
 like we so often don't give people, that's ways that I've heard it even with like the push to, and again, you know, caveats for everything. I believe fully in skin to skin and getting immediate skin to skin and the golden hour. However, I've heard folks say that to like, you know, when right away, they've just finally had this baby come out of their body. And immediately, it's on their chest. And they're supposed to be like connecting with it. And for some people that feels very much like that's exactly what I want to do the baby's right here. And for other people, they would prefer if the baby was just like right there. But like, they just have like a moment to breathe before the baby is like, there. And they're supposed to have all their attention on the baby. And so he they're just other that's like, oh, we can do a whole podcast on that. But like how we support the golden hour. But to derail too much. But I feel like it's that piece of how we like layer these pieces on top that like you birthing person just went through a major transformative life experience. And you get time you deserve time and space to process it, whether it was the best thing you could have ever imagined. And it met every expectation and you were just so glowing. And you want to tell everyone about how that felt and how powerful you are and how it went this way and whatever, or you want to be like that was nothing I imagined everything went wrong. And I need to talk about the fact that I am screwed up. I really want to get pregnant. I really want to have this baby. And now it's here and I'm not so connected. That was the worst experience for her life. Wherever you fall on that 

Emily, PMH-C  19:11  
literally everything you mentioned is exactly why I wrote Birth Story brave to be like that's everything you just said if I could have like, encapsulated that. And that that is all that's

Maggie, RNC-OB  19:23  
I will write the next foreword for the book. Thank you.

Emily, PMH-C  19:26  
I need all of that. And that is exactly it. And the PA like mandates that we don't pause and to be fair, sorry. I signed comes in. He says you're being too loud because I'm passionate.

Maggie, RNC-OB  19:38  
Oh, we appreciate your passion.

Emily, PMH-C  19:40  
And I want to pause here and just say you know, unfortunately, we're in a society where pause can be a privilege. Oh, yeah. You know, and that's a whole other that could be its own podcast episode. Right pause can be a privilege, but maybe we can start making helping. So that but it doesn't have to be in the same way. Of course there will always be varying degrees. But starting with debriefing helps to perhaps offer that on a larger scale. 

Mandy, RNC-OB  20:13  
Yeah, yeah, the opportunity. And it's not going to be safe for everyone to do that, at the same time with the same people with the people that they were with. Maybe they were absolutely the next stranger in there. Like, you got five minutes, I need to tell you my birth story with this huge, whatever that looks like. We're not able to just be like, Okay, this is your container you've got here time and here we are. We're supposed to do this. Because said, Yeah, pausing is a privilege. And when I'm thinking of like, all of our nervous systems are activated. It's a privilege to be able to do that, to know how to do that to turn things down to professionally and personally.

Emily, PMH-C  20:55  
Like you said, Yeah, to feel safe doing that or to have the to have the support from any means to be able to So yeah, that's a whole other really good conversation. I'

Maggie, RNC-OB  21:05  
think we'll all you have you back for "pause is a privilege" next season. But yeah, I feel like this also is a conversation he had with Kayla Bittens around postpartum general and talking about postpartum mental health. And I love how she explained about like, kind of how we how we d stigmatize and normalize conversations through access, you know, so like, something becomes normal becomes rote if it's just right there. Oh, yeah, of course, everyone has access to a debrief. So you're not having one, because of something that happened to you that like you especially need to do when you're having lunch, it's everyone got to debrief, everyone got to have a few minutes to, to share their birth story. And to talk through these kind of, you know, we've through this resource, we've created this handout, you know, we have a couple standard questions there for everyone. They are intentionally open ended and broad, so that they address, hopefully, at least start to open the conversation for whatever the experience was, you know, and I think in this, you know, in this perfect world, we vision that everyone, it would just become normal to like, of course, you're gonna go and talk about your birth story. You just had a baby, you just gave birth.

Emily, PMH-C  22:08  
Like, right, and that's like, something they're talking about. They're, like screaming for postpartum depression and anxiety. Right? Yeah. 

Maggie, RNC-OB  22:14  
Like, how can we make? And just like any of those other screenings that we do automatically? This is just yeah, of course, you're getting a debriefing? Let's talk through it. And we really want to see it be a standard for everyone and not something that becomes I worry what you know, with any tool like this, they can get warped. So like, oh, you know, like, we gotta go through debrief so and so because x thing happened that we all know would be, you know, traumatic, and how that can kind of add to the isolation of feeling and that feeling that you're being like,

Unknown Speaker  22:43  
I don't know. Yeah, abandoned or other

Maggie, RNC-OB  22:47  
being othered by that feeling of like,

Emily, PMH-C  22:48  
you don't want to pathologize it

Maggie, RNC-OB  22:50  
have that everywhere. I, you know, yeah. So we really want to see this is something that like, you know, folks, hopefully, you know, we have this, like we've created, surely, we think is a really great free resource for you to bring to your unit and like, make it a if you're, you know, Nurse out there, make it your quality improvement project, bring this on and have everyone doing it, you know, for you know, doulas birth workers, anyone else, like have something that you put in your bag, and you bring it to every, you know, everywhere to meet, we can get into timing a little bit, too. And I know, Emily had like some great thoughts about that, if you want to share kind of where you see this falling within that postpartum period. This is not so that's happening in that golden hour. Where is this falling between, like, you know, birth happens? And then that six week follow up with your provider? Where are we seeing something happening within that pool? 

Emily, PMH-C  23:32  
And that's going to vary? Okay, that's a tricky one. Because it's also depends on which provider right? Obviously, this isn't something like, right, like, when you're talking about Golden Hour, like, this isn't something that you're gonna spring right on somebody? Right? In that moment, you know, people need time to process. And with that said, there's a whole range of time that people need to process, we're all different in how we sort through our emotions about an experience in how safe it feels to be honest with ourselves about those feelings and everything, I'd see it having a place in different places. Okay. So like, it's almost like an invitation, right? So if we, if there's an invitation within, you know, the following the following day, or there can be an invitation that early I'm, the birthing person might not choose to accept it, you know, but there's the invitation, there's the resources, there's the opening, and there's the normalization, and depending on how often you know, or what type of contacts they have with the provider, you know, that's, that's very variable, right. So I can see there also being that invitation at the sixth week, but you know, there might be opportunities in between, depending on what type of provider relationship this is. But I think that multiple invitations might be needed, not in a way that's pressuring we need to meet people where they are right, but an opening and again, that normalization and saying like, hey, you know, I know we talked about this, and you know, you weren't feeling quite ready to reflect on it or you didn't have any thoughts? Has that changed at all? For you? Would you like to take some space to do that right now. And, you know, ultimately, this isn't anything that's going to be forced, because as much as we might want to be the person to be that place, maybe they prefer doing that reflection on their own. But again, we're offering resources and normalizing, and those two things can be really helpful in and of themselves, you know, you get the wheels turning.

Unknown Speaker  25:23  
Yeah, and we're modeling for anyone that's in the room with them. We're modeling, that we're listening, we're modeling that we're asking, and we're asking twice, we're asking again and again, in an neutral way, and like, hey, so here's the thing, I'm here, and then 24 hours might go by, and they're like, I just had this flood of memories, I really want to get something clear, I'm so glad you asked. And, as a nurse, I might not even be providing care for them at that time, that might be a phone call from my unit down to their room, or they're on the same unit, but in the postpartum space. And that's a connection that you're just offering multiple times and modeling for the folks that they're going home with. Because that's probably when they're going to need it and when we're not going to see them.

Maggie, RNC-OB  26:13  
Yeah, no, that's I think one of the things too, we had, you know, created the resources, the piece of paper, the handout that theoretically would go with each person. So because I think that's something we also wanted to be open to folks for, for now, for later, whether it's a they said yes or no, you know, is there a way to say like, oh, that's totally fine. I understand this, maybe not you want to talk about? Would it be okay, if I gave you a handout to look at if you know, if you get home later and and you want to kind of think through some of these and have some some guiding questions to, you know, journal and reflect on, you know, again, there is an option, there is an opening, you know, and how do we and we have, you know, resources on there for folks, if they realize, like, oh, I want I want more support, I, you know, I'd maybe I need to talk to someone else in a professional capacity about some of this, you know, we have resources on there. So folks know, where are safe and trusted, you know, sources to turn for to get, you know, some support as they navigate this once they are not maybe seeing, you know, clinician of birth worker as frequently.

Emily, PMH-C  27:05  
Yeah, and I think one of the I don't want to jump ahead in the conversation. Now, but one of the things that's part of this, too, is also more debriefing support for birth workers, too, right. I mean, that's something that is mentioned on the handout, in passing and a lot of that focuses on the birthing people themselves, but but being able to have that resource to which is so important, because, you know, birth professionals have plenty to unpack often themselves, and not the space to do it, and not the pause, or support.

Unknown Speaker  27:35  
So you're talking about each professional having their own outlet separate. Yeah, yeah. Finding their own flow for professional help group discussion, right? Not just debriefing with their clients.

Emily, PMH-C  27:51  
exactly correct. Like their own a healthy funnel, because what we really don't want to do, especially if we're present for the birth, or in general, if put our own interpretations, our own feelings, bring them into the room with us and make them be belong to the person that we're with, you know, it's so so contributes to health and wellness, for us to take our stuff and find the appropriate place to, to have that whether there's sort of like a debriefing group, in a hospital setting, whether there's a group in a community setting, or like a trusted partner, or it could look like so many different things, right, or another type of healer, but still having that old, separate special space to do that.

Unknown Speaker  28:36  
Yeah, for sure that that's so true. Because beginning this and like, talking to someone or listening to someone about their birth, each individual is gonna have their own feelings about it. And yeah, it's new and difficult to go in and not be like, yeah, so I know that that shoulder dystocia was really scary for you. And like, what's a shoulder dystocia? Yeah, right. So everyone's gonna have a different perspective, and totally separating the professional totally separating their own stuff. And idea and understanding can be like, I think, the most crucial part of actually holding a space because otherwise you're not holding a space. You're like, throwing in these little tidbits of these little sprinkled ideas. And no matter who the birth worker is, no matter who the pseudo or pro professional is, that tidbit that sprinkle comes with weight, has a weight on it, as someone who knows more about birth has seen a lot of births. It comes with this, whatever we put on it as a society as someone who knows more, which we're trying to switch and flip is like the birthing person is the center and the expert on their own body. But that's just not how it is right now. And so if we say something might be upsetting now they're like, holy shit, okay, well, I gotta go start getting upset about that. Figure out what that is. And I've got my own stuff that I've come with from previous experiences or fears or triumphs or whatever they're bringing in. That's their own unique that we really just have to practice being curious about. Yeah,

Maggie, RNC-OB  30:24  
I think that like that curious word. I know Emily, like you use that all the time. I won't. I won't steal your thunder let you let you talk. You're curious chat. 

Mandy, RNC-OB  30:31  
She loves it. 

Maggie, RNC-OB  30:32  
But yeah, I feel like that too. Because I think I mean, that has happened to all of us outside of, you know, a work context. Like, I'm sure all of us have heard a friend or loved one recount their birth story. And you're sitting there like, red flag, red flag, red flag, like, the whole thing is activating every part of you. And then they are like, seemingly really genuinely like fine. Like, it was good. Yeah, it was like a great everything was it was and you're just like, I'm, I'm so glad you're at that's Wow, thank you for sharing your story with me. Because you're just like, oh, okay, oh, you're like, Oh, you don't actually want to talk about any of that? Fine, right? That's for all that, that's totally fine. You don't, we don't have to, you know, you're like ready to like, who and that you know, so I think it's so like, it's interesting, like, each of these things are going to pull apart. First that we've been a part of before, whether they're our own or someone else's, like all of that trauma that we carry. That secondary trauma, we cared for other stuff, too, that like feeds into that story. And I think that's something for, you know, while we envision this as a resource that anyone in the perinatal space could pick up and used. This is also something that like you do have to do your own work to be prepared. Yeah, you should offer you know, so we don't want to oversimplify the process, or make it seem as if this is just something that like, your your managers and start rolling out, hey, everyone's got to do a debrief on every client now. Like, that's not, that's not the vibe, because that's not going to translate, right? You know, this isn't ending we want people to picking on with intention, with curiosity with that ability to to kind of pause and separate and have your own supports, that it's something that feels good for all involved and ends up actually being that you know, a healing modality and not a check the block activity, so many things end up being in healthcare. 

Emily, PMH-C  32:06  
Yeah, yeah, that's really brings up the relative nature of trauma that how it is and how it lands. And sometimes it's mind boggling blowing here in the room, and you're like, wait, what, you know, these two people had this different experience, but it's how our minds work. And our systems sometimes, you know, our nervous systems and everything. Yeah.

Maggie, RNC-OB  32:25  
So yeah, and I wonder too, maybe as we kind of get ready to close out this conversation, if if we want to kind of speak just a little bit more about how this fits in if you know, if you are in a hypothetical situation, you've just done this debrief with someone and it has felt beyond what they are sharing feels like, you're not able to kind of hold a container for it, you're not feeling prepared to deal with it, or you're just realizing like they have had a lot to go on with their birth, and they need other different support, if you want to kind of maybe you kind of share how you would talk through that with, you know, with a patient with a client and kind of share next steps again, how do we like share that this is something maybe folks need further processing, or therapy or what that looks like, but again, without creating more like, the othering or making someone feel bad, or that they have shared and how they have opened up during their debrief?

Unknown Speaker  33:14  
Yeah, I think first I always have to say thank you, because I need a minute to like, decide what I'm going to say. So thank you for sharing that.

Emily, PMH-C  33:22  
Right. So you know, usually, language that's really gentle to us, as you know, it's not uncommon that people need extra space to spend on this story or extra space to stand on this experience. And sometimes people feel that way. Is that how you know you, you and sidenote, not to overshare about your own experience with your own birth? You know, because sometimes people do that to thinking that it could be helpful, and it's not, it's not always but you know, being able to say, it's totally normal to, for some people to need some extra space to process reflect on their birth story. Here's a list that we give to people who feel like that might be valuable for them to feel like that could be healing for them, and to look at them and say nothing is wrong with you. This doesn't make you broken. This is part of your story. And there's healing, like there's an opportunity for healing here.

Unknown Speaker  34:23  
And validating that they want to talk through it, they want to process it, they want to debrief it, because that will inevitably affect their connection to parenthood, that will affect their connection with their baby.

Emily, PMH-C  34:39  
It's a story that they tell forever.

Unknown Speaker  34:40  
Is this important? And acknowledging that they already know that I was trying to find these little pieces. Ah, you're already you feel like when you know what you need? Is this what it feels like, you know, acknowledging it sounds like this is a need for you or sounds like you want to talk about this, thank you for sharing all of this with me. And identifying the pieces that they seem to be already putting in place for themselves, I think is important because of this huge transition, emotional, physical, spiritual, everything that is brand new to them, even if they're the sixth time parent, they've never been a sixth time parent. And acknowledging that, because what we say does have power. And if they think, Oh, wow, if so and so, this nurse or this doula, or this doctor said that I was doing a good job at finding that, like, that's kind of cool. If they may feel lost, or hopefully that gives them a little, I don't know, 

Emily, PMH-C  35:43  
I think it's brave work to do. 

Unknown Speaker  35:45  
Yeah, it is, you know,

Maggie, RNC-OB  35:47  
I love like planting those seeds, just a validation, and, you know, accomplishment, and just, again, having the how much all of us just need to hear stuff outside of our own head, like, yeah, the power of someone else looking you in the eye and saying you're not broken. You didn't do anything wrong. Oof. Like, that can be just so healing to have someone else genuinely, like looking and acknowledging. And I think, again, we've talked at length about just how busy you get in birthcare, because because we're too busy, because we have too much on our plates, because we don't have, you know, the best staffing or, you know, hospital systems that we need to truly show people the way they need during birth. And you know how that shows up now. So like, for those of us when you can just take those couple moments to just be slow with someone to just look them in the eye to just sit with them. Even when you're saying nothing, just be like, is it okay? Can we just sit here for a second? As you know, you reflect like, can I just hold space for you and just genuinely having someone else putting all of their like, attention and mental space and holding that space? Like that's just, it's really powerful. And I think we forget in our, in our desire to help and to do more. It also often feels like we need to be doing something right. We're so like, action driven. And I feel like you know, the whole last season, we had talked to your holding space. So no one else is like this is calling up that there's plenty of episodes where we dive deeply into all that because I think it's something I certainly have struggled with personally, about how do you really just be there for someone to knowledge it? And so I think what we're hoping is that this debriefing resources, both like here is a rubric. Here are some tools, here are some things you can do. But it's also hopefully just creating an opportunity to hold space for folks to acknowledge where they're at and to just create that pause 

Emily, PMH-C  37:30  
yeah to absolutely. Yeah, I'm so glad that you and that Maggie, you and Mandy kind of came together to start creating this because it's so valuable. Yes.

Maggie, RNC-OB  37:48  
Well, in particular, shout out to Amy, for being the inspiration to really get this going. Now, as she was asking for this and saying she wanted to see us putting something together that really spoke to folks. So is there anything else that you all want to share about this as we as we kind of close out this conversation? 

Emily, PMH-C  38:03  
Not that I can think of this has been great. You know how I love talking about this stuff?

Maggie, RNC-OB  38:10  
Yeah, so we will be sharing the resource. You all there is, you know, there's a copy of that. And there will we do plan to create kind of some more in depth conversations and role planning and a training around this because we know that it's something that is you know, folks hearts that they want to know how to really bring this into life in a deeper way than what we've been able to dive into and you know, in a quick podcast episode, but we'll share all those information in the show notes so you can get access to that. And we'll be putting up you know, stuff on social media. So you can kind of get an idea of how this how this plays out how we bring this into reality. So thank you so much. I am so appreciative of having the chance to work with you all in creating this resource and to have the chance to watch it kind of flourish together. I appreciate you both.

Emily, PMH-C  38:48  
Me too. Thanks to you both for inviting me into the space. Thank you.

Mandy, RNC-OB  38:52  
Thank you. Thanks, Maggie. Thanks, Emily.

Maggie, RNC-OB  38:56  
Well, thank you so much for joining us in this important conversation. I hope you are feeling inspired to think about how you can bring debriefing into your own practice to support folks as they begin to reflect on their experience. And as you work through this and encounter obstacles and hurdles we would love to hear from you in the your birth partners community group on Facebook, so we can work through those challenges together and create a system that works well for all of us. Till next time