*Trigger Warning*
Some may find this blog post triggering as it covers subjects that some may find distressing. Please be kind to yourself, step away if needed and make sure you have good self care in place.
I would like to begin by noting that the trauma statistics I used for this blog post were based on binary gendering systems and did not take into account race, religion or ethnic background and are generalised over the UK population. I wanted to acknowledge and make clear that for the marginalised members of society, we know that their perinatal outcomes are likely to be far worse due to bias and discrimination.
We know from 5x more and the women's maternity experience report that institutional racism is rife and a dangerous reality for black, brown and Asian people. We also know from the national centre for transgender equality that "transgender and gender non-conforming people bear the brunt of social and economic marginalization due to discrimination based on their gender identity or expression".
Trauma Informed care is beneficial and important for everyone involved in perinatal care.
So, let us just begin with thinking about 3 types of trauma that we would all think of as being highly relevant in the birth space and when supporting people through the perinatal period:
20% of women have experienced some type of sexual assault since the age of16. 3.1% of women (510,000) aged 16 to 59 have experienced a sexual assault in the last year. That is, 1 in every 35 women has been raped or assaulted in the last year. Likely at least 1 person you know and 7 in 35 since the age of 16.
The Crime Survey for England and Wales (CSEW) estimated that 5.0% of adults (6.9% women and 3.0% men) aged 16 years and over experienced domestic abuse in the year ending March 2022. Likely over 2 people that you know.
Research shows that about 4-5% of women who give birth develop post-traumatic stress disorder (PTSD), with symptoms such as flashbacks, nightmares and extreme anxiety that makes daily life immensely challenging. Up to 45% of people report experienceing birth trauma. Likely over 15 people that you know.
If we assume that each person that has survived one of the types of trauma above is walking through a pregnancy right now, then around 25 out of 35 people are living with these types of trauma. There are MANY other types of trauma. So it makes sense really to use trauma informed care for EVERYONE, as the majority of people in life are survivors of trauma of one form or another.
What Does Trauma Informed Mean?
Trauma Informed Care nurtures a culture of compassion and kindness for all and seeks to avoid re-traumatising people. It offers an environment in which we endeavour to understand and pay attention to the signs and symptoms of trauma and the variety of ways this may present. For a doula, it is important to recognise that the people and families we support AND the healthcare practitioners (HCPs) we are working with need compassion and kindness. HCPs are highly likely to be survivors of significant levels of trauma.
What is Trauma?
What is traumatic is personal. Similar experiences can affect people differently. Trauma can include events where you may feel:
Frightened
Under threat
Humiliated
Rejected
Powerless
Abandoned
Trapped
Invalidated
Ashamed
Unsafe
Unsupported
Ways Trauma Can Happen:
One-off OR ongoing events
Being directly harmed
Fearing for your life or someone else's
Witnessing harm to someone else
Vicarious trauma from hearing about events that have happened to someone else
Living in a traumatic atmosphere
Fearing that you or someone else is going to be hurt or frightened
Being affected by trauma in a family or community
Possible Immediate Reactions to Trauma
Possible Delayed Reactions to Trauma
What does this mean for our brains?
We are innately programmed to be kind and work as a team to best survive as a species. We have reward mechanisms in our physiology - when we help people, we feel good.
We are also programmed to protect ourselves from danger and have a strong survival instinct - These can sometimes be at odds with one another
When we suffer trauma, our higher brain function shuts down and our fight, flight, freeze responses kick in.
Trauma alters the way our brain works, increasing cortisol, making us more susceptible to further trauma and more wary of danger.
When our higher brain function is bypassed, the way we communicate is much more basic.
This all has a direct impact on how our clients and HCPs function in the workplace and interact with everyone around them.
What about Midwives?
In an article published in Midwifery 2019, the survey of RCM members clearly showed that the UK's midwifery workforce is experiencing significant levels of emotional distress. 83% (n = 1464) of participants scored moderate and above for personal burnout and 67% (n = 1167) recorded moderate and above for work-related burnout. Over one third of participants scored in the moderate/severe/extreme range for stress (36.7%), anxiety (38%) and depression (33%). Personal and work-related burnout scores, and stress, anxiety and depression scores were well above results from other countries
The impact of trauma on society
Trauma has a huge impact on every individual, their family and friends and also on society, not only in the cost of ongoing care but also on how it affects family and work life. If everyone in a perinatal settings worked in a trauma informed way, it would drastically cut the currently shocking statistic of 45% of people suffering trauma during their birth experience.
How do I learn more about becoming trauma informed?
You can join Bitesize Birth this Wednesday February 1st live to learn more about trauma, trauma informed care and how to communicate safely and effectively in a trauma informed way. If you cannot join live, you can sign up to recieve a link to the recording here or scan the QR code below. Each lecture costs just £10. I hope you will join me and help to make a positive impact on the currently absolutely shocking trauma statistics in our perinatal services!
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