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Reframing Trauma

A different approach to birth trauma education is sorely needed. It should be centered around understanding how to organize our systems of care to optimize the possibility of safety and connections for families and the people caring for them.

Trauma awareness and education has exploded in recent years. We now have a deeper understanding of the impact of adverse childhood experiences on our long term physical health and most recently we have all endured the collective trauma of a global pandemic.

The increased ‘buzz’ around trauma has found its way into the birth world as ‘trauma informed care’ and ‘respectful maternity care’ and professionals and institutions are rightly paying attention. But what, if anything, is actually changing?

Obstetric violence continues to be deeply embedded in our medical systems that perpetuate harm in the name of ‘safety’. In spite of increased spending on health care, we continue to fail to keep birthing families safe, with our shocking maternal mortality rates that disproportionately impact communities of color. While we have learned and know much about what public health practices are best equipped to improve this dire reality, a different approach to trauma education is sorely needed.

A different approach to birth trauma education is sorely needed

When we focus our understanding of trauma by centering the trauma itself, something crucial is missed. Of course we need to define and name what constitutes trauma. (Gabor Mate, Peter Levine and Bessel Van der Kolk all teach us that trauma lives in the human response to the experience of disconnection.)

But what this fails to do is name the larger framework and cultural conversation needed which is the central importance of the experience of human connection and safety in the first place.

What prevents trauma is exactly the same as what heals it:

the felt experience of connection and safety.

We know the central role of the nervous system is regulating our bodies ability to feel safe and in connection with others, as well as protect ourselves when unsafe. As Deb Dana shares in this video, Polyvagal Theory reminds us that we are 'wired to connect' and seek safety in human relationship.

We also know that supporting physiologic birth first requires the possibility of feeling safe in our bodies and connected to those around us. Thus, understanding physiologic birth through the polyvagal lens of our wiring towards human connection is at the heart of truly becoming trauma informed.

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