square bulletUnsolicited Feedback: A Birthing Experience

From , Instructional Designer for Trauma Informed Care, Trauma Informed Oregon

Many birthing people may be used to the unsolicited advice that can sometimes come along with a growing baby bump. While preparing for the arrival of my first child, I actually welcomed the bits of insights people felt compelled to share. Not because their worldview aligned with my parenting ideals, but because I found it interesting sociologically. Why some people would caution me about one thing, or why others would share stories about another, was fascinating to me.

As my due date got closer, I had to decide where I would birth. Having been forcefully hospitalized during a mental health crisis in my 20s, I have since been afraid and distrusting in most medical settings. Even after eight years and an abundance of helpful therapeutic services, I still had fears and anxiety surfacing. When considering a hospital setting, I began to mentally play out a handful of imaginary situations, all of which involved my choices not being honored or my voice being diminished. I even had a haunting nightmare which involved the birthing room locking, forced medication that immobilized me, and my doula trying to break me out! I consciously knew my anxieties were rooted in my previous traumatic experience, but my soul was still scared and I was having trouble convincing myself it would be safe.

I did not want my daughter’s entrance into this world to be another experience in my life that I viewed as traumatic. I knew I needed to build trust with the place and people I would be relying on while navigating this new and intense experience, but how? COVID-19 changed many of the protocols in birthing places and they were no longer allowing in-person tours of the hospital. Instead, we were offered a time in which we could join a live presentation online. Shortly into the slide deck, to both my and my husband’s surprise, I started crying. The enormity of emotions connected to both my past and my future simultaneously spilled out of me.

At the end of the presentation, they made time for Q&A. After waiting until others had finished, I nervously asked if there was any way to tour in person. I explained briefly that I had a trauma history in hospital settings and an in-person tour might offer more predictability in what I could expect from the facilities than what was offered in the online orientation. The presenter was kind and did not have an answer for me at the moment, but wrote down my email and promised to get back to me after asking around.

Thankfully, the presenter advocated for me and specially arranged a time in which I could tour the birthing unit. When we arrived, my body was slightly shaking. This physical response was familiar to me, especially in the earlier days of my recovery. I told myself this was just a perceived threat and it made sense that I was having a stress response. My husband squeezed my hand gently, silently assuring me. The nurse who gave us a tour was warm and receptive to all of our questions and did her best to assure me, too.

care pack for hospital staff to communicate past medical trauma

After the tour and many additional hours of deliberation, my husband and I agreed on me birthing in a hospital. Having had a trauma response while simply touring, I knew I would still have residual reactions during my labor and I wanted to be as prepared as possible ahead of time. Equipped with my basic knowledge of neuroscience, and my familiarity with myself in an activated state, I decided I needed something more than just a birthing plan to feel ready.

Out of the fight, flight, freeze, or fawn trauma responses, I tend toward freezing and fawning most often. I sincerely believe if I am friendly and kind, it is more likely that others will show reciprocity. Although I had never birthed before, I imagined my fawning skills wouldn’t be as accessible while experiencing the intense pain of laboring. Fawning provides me with such a sense of security in scary situations that I wanted to find a way to still do so. I thought, who doesn’t love goodie bags!? So, I assembled enough goodies bags to hopefully have covered any staff who were working during the time of my labor.

In each bag, there was an assortment of items that I imagined would have been appreciated if I was working a long and potentially stressful shift; granola bars, bone broth, chapped sticks, almonds, chocolates, and candies. I also added a short paragraph with ways they could reciprocate care.

The note read:

“Hello, I’m Danielle. This is my first-time birthing and I would like to make it as positive as possible. I have a trauma history with misdiagnosis and forced treatment, so I can be very anxious in hospital settings. You can help by knowing I may be extra sensitive to facial expressions and tones of voice. I trust your expertise and would also love a bit more spaciousness and explanation around interventions, with extra time to make decisions. I appreciate you and thank you for being part of our new beginning!”

I am thrilled to report my care team was phenomenal! They provided me with all the time I needed to make decisions, they were sensitive to my needs, and communicated clearly throughout the entire process. I imagine they would have been this way regardless of me providing goodies bags and an instructional paragraph, but ultimately, those gestures were in greater service to my own safeguarding and nervous system regulation.

That isn’t to say my labor and delivery wasn’t without intensity. In fact, I labored for multiple days, and had an infection and internal lacerations causing excessive bleeding that could have been life-threatening. I was very grateful to have been in the hospital, as other birthing situations would not have been equipped to handle the amount of blood I lost. Even so, because of the trauma-informed care I received, I honestly can say my birthing experience was not traumatic! There are not sufficiently adequate words to describe how big of a deal that is to me.

baby feet print on baby blankets

None of the feedback I offered the hospital staff was solicited, but it was all warmly welcomed. As a result, I feel like I have finally turned a corner with some of my institutional trauma. I dream of a day in which it is just standard practice to solicit feedback from folks in all settings so it becomes normalized that we can, and should, ask for what we need in situations that may scare us.