Tag: trauma

Categories
fertility Loss Mental Health Trauma Trauma Uncategorised vulnerabiliity

Light in the Darkness: Interview with Layla Micheals, an Infant Loss Parent

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Light in the Darkness: Interview with Layla Micheals, an Infant Loss Parent 

At Doula School, one of our leading continuing education courses is our Infant and Pregnancy Loss Support certification program, which is such an important skill in our birth worker toolkit. Our gradates go on to support families who have experienced infant and pregnancy loss. It’s important to destigmatize speaking about infant and pregnancy loss because 25% of people experience loss at some point in their fertility journeys. We never want anyone suffering in silence.

Jessica Palmquist, our very own senior instructor and program coordinator for the infant and pregnancy loss programs experienced a unique journey to parenthood made possible through In Vitro Fertilization (IVF), which ultimately ignited her burning passion for fertility awareness and birthwork. Through her IVF journey after losing multiple embryos, she understands the importance of talking about loss and fertility struggles. With October being Pregnancy and Infant Loss Awareness month, Jessica Palmquist interviewed her best friend Layla Michaels, founder of Big Hearts Little Stars and she shares about the loss of her son Ryker and how she found light during her darkest time. 

Jessica and Layla’s friendship began in the early 2000’s when they worked together at a Lululemon pop up store in Moncton, New Brunswick. Nearly decades later, after both women went through Assisted Reproductive Technologies they joyfully were pregnant together, both expecting baby boys who would one day grow up together and be best of friends. Jessica delivered in October 2019 and Layla’s estimated due date was Easter 2020. Layla’s water broke unexpectedly at 25 weeks gestation and she was hospitalized. Layla was in constant contact updating Jessica daily. Two weeks later, Layla delivered her son Ryker who lived a life too short and he died in her loving arms. When Jessica received the news of Ryker’s passing she held her newborn son Hudson tighter than she ever had and sobbed uncontrollably. Her heart had broken that day along with her best friend’s. Layla and her partner Adam had big plans for their son and had already built a life for him. Jessica and Layla had dreams of what their boys’ future would look like. This is another side of loss that often goes unspoken – the loss of the future and the loss of a family’s hopes and dreams. Loss is more than the loss of a life, it is the loss of a life and so much more. Jessica regularly asks about Ryker and Layla gingerly shares pictures from Ryker’s short stay in the hospital and the mementos in their home. Whenever Jessica and her family have the opportunity they honour Ryker on his birthday, holidays, and whenever she writes a letter to the family he is included. Jessica has been Layla’s biggest cheerleader as she has been trying to conceive after her loss. After four long years, Layla is pregnant and Jessica is excited to meet Ryker’s baby sister. 

Get to know Layla, as she shares her loss story:

Would you like to share your story of infant loss?

We became pregnant with our son, Ryker, after two years of infertility and seeking out the help of a fertility doctor. The pregnancy was perfect, I wasn’t sick, and had that pregnancy glow and blissful ignorance thinking nothing would go wrong.  Until it did.

At 25 weeks my water suddenly broke and I was hospitalized. Then at 27 weeks our son Ryker was born via emergency C-section. He was 2lbs 7oz and a fighter! It was touch and go in those first few days, but then he turned a corner and we thought everything would be ok. Then overnight, he developed a brain bleed that wasn’t something that could be treated or survived. We spent the remainder of that day with him, surrounded by our families, as we said goodbye so soon after we had just said hello. It was heartbreaking. But also during that time we created beautiful memories with him and said everything we needed to say. He died in my arms after about an hour and half from being taken off life support.

What was your experience with our healthcare system? 

There is a big gap in experience across the country when your baby dies. But one universal area that I found is that there is not much direction or support for what to expect when you leave the hospital without your child. Your milk still comes in, you are still in active postpartum recovery, but it all feels very foreign and different when the baby you grew is no longer with you. The only check-up is the standard 6 week check-up, which felt years away.  You are trying to heal and trying to process immense grief at the same time and it is truly too much to handle.

What did you find the most helpful in your journey? 

I found the pro-activeness of friends and family to be what was needed. You often hear people say “if you need anything, let me know” or “call me” but when you are in the depths of grief, there is an inability to understand what you need, or have the courage or mental capacity to ask for the help. People would show up at our door with food, or to check on us, or the messages that came in reading “you don’t have to respond, but we are thinking of you and how you’re doing”.  Those messages made me feel open to talking and I would respond every time. Asking me about Ryker and using his name helped as well. My advice to people: “do not ignore what has happened, it may be uncomfortable for you, but it is far worse for the family who has lost their child and are surrounded by people who do not acknowledge the space they are living in”.

You’ve been supporting the pregnancy and infant loss community for many years now. What was your motivation to start Big Hearts Little Stars, an organization that supports families who have experienced the loss of a child?

My motivation for Big Hearts Little Stars was to fill the gap that exists when parents experienced the loss of a pregnancy or child. It initially began with donating books on Ryker’s first birthday, 10 books of stories written by Mothers to Mothers, and 10 of Fathers to Fathers.

It organically grew from there into what we now refer to as our Comfort Boxes. We supply both our local hospitals with large and small comfort boxes that include items to assist families through the grief process after their child dies. Items include a teddy bear, baby blanket, memorial candle, books for parents and young siblings, a booklet of resources (local and other) and some other meaningful items.

We also offer a private support group on Facebook so that grieving parents have a safe space to speak and ask questions with others who have been on a similar path.

What services does Big Hearts Little Stars offer? 

Directly we only have our support group, but we do have connections to a lot of community resources and access to contacts across the province. We will do whatever we can to assist families who reach out.

I have also gone to coffee with a few people, as sometimes it is helpful to have an in-person heart to heart when dealing with such an emotional and difficult time.

How did you find light in your dark time? 

When you lose a child, there is no hope for their future. You can’t hope they’ll get better or magically return home. The reality is, they are no longer here and nothing changes that. The hope or light I found was in sharing our story and the story of Ryker’s life. In sharing our story, I have been told that it allowed other people to find the courage and strength to speak about a loss they had suffered and had never talked about. In being open and honest about the experience it has allowed other people to feel less alone in theirs. That is the hope that I hold onto, the hope that if we are able to help one person feel less alone in their loss, that we can all carry the memories of our children who walk ahead.

What advice can you offer parents who have experienced infant and pregnancy loss?

Take your time, and give your grief the time it needs. This can mean many things. There is no rush to feel better, and no linear way that you will move through your grief. There is no moving on, but you will learn to put one foot in front of the other, and as you do you will always bring their memory with you. The grief will stay with you forever, but it will not always feel as raw as it does in the beginning. You will grow around it, and it will grow around you. I would encourage you to share your thoughts and feelings if it feels right to you, but if not, that is also ok as well. No two people navigate this the same way (including you and your partner).

Are there any resources or recommendations that you would share with parents who have experienced an infant or pregnancy loss?

There are a number or very good organizations within Canada, the US, and abroad that offer support.  Here are just a few:

Pregnancy and Infant Loss Support Centre (Calgary) www.pilsc.org

PAIL Network Sunnybrook (Toronto) www.pailnetwork.sunnybrook.ca

Return to Zero (RTZ) Hope – US based www.rtzhope.org

Saying Goodbye – UK Based www.sayinggoodbye.org

There are also many groups that are geared towards specific issues that may have effected the loss of a pregnancy or child.  Stillbirth, Preterm Premature Rupture of Membranes, Termination for Medical Reasons, and each of these (and more) have their own support sites as well.

What about the parents who want to try again after the death of their baby. What challenges might they face when trying again? Do you have any suggestions that might support them on their journey? 

I don’t think there is ever a right time to try again, if that is something that you wish to do. I strongly believe in therapy as it will help you navigate the decision and also the emotions that will come up during the trying process, whether that includes fertility treatments or you are able to conceive naturally. Once pregnant again, there will be obvious and not so obvious things that may trigger you along the way, based on your history with a previous loss.  

There is a really good app and website for Pregnancy after loss (pregnancyafterlosssupport.org) that I have personally found helpful while navigating this pregnancy. In addition, there is a great book called Pregnancy After Loss by Zoe Clarke Cotes that has day by day reading and journaling which helps families navigate their pregnancy after loss.

Is there anything else you’d like to share?

Take care of yourself during this difficult time. Set boundaries where needed, and know that your feelings are valid and you are not alone. When you are ready there is a whole community out there that will help you navigate the days, months and years ahead, and honour you and your baby.

 

About the Author

Layla Michaels (she/her), is a passionate advocate for fertility and infant loss awareness. She is the founder of Big Hearts Little Stars, a nonprofit based in Moncton NB, serving families who have experienced the death of a child through pregnancy to infant loss. Her nonprofit was founded in 2021 after the death of her first son, Ryker in the NICU in 2020. The mission of Big Hearts Little Stars is to bridge the gap felt by parents in caring for their grief after loss, and knowing they are not alone. Families are provided a comfort box from their local hospital with items and resources to assist them in navigating their grief, as well as an online support group. Layla has also volunteered with Fertility Matters on their East Coast Miracles committee, who worked to raise awareness, conversation and political pressure surrounding fertility benefits and access in the Atlantic Provinces. Her personal fertility journey has taken her through multiple procedures in Canada, overseas, and then finally having to seek treatment out of province. It is Layla’s hope that access to fertility care becomes more accessible for all persons wishing to grow their families, alongside compassionate care for families experiencing loss as well. 

Connect with Layla:

IG @laylabun   IG @bigheartslittlestars   Tictok @mamagotguts

Interviewer- Jessica Palmquist (she/her), Doula School’s fertility & loss support program coordinator and senior instructor works with a diverse population and believes education, reproductive health, and wellness services should be accessible and customizable. In addition to Jessica’s training as a certified Fertility, Birth, & Postpartum Doula & Infant and Pregnancy Loss Support Specialist, she is a certified yoga teacher and has worked in the public and post secondary section sector for nearly 20 years. Her own unique journey to parenthood made possible through IVF paired with a passion for teaching, learning, and helping others led Jessica to birth work.

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Categories
Health Care Labour Doula pregnancy Trauma

Empowering NICU Parents as a Doula: Strategies for Support

[vc_row][vc_column][vc_column_text css=”.vc_custom_1696077782676{margin-bottom: 0px !important;}”]September is NICU (Neonatal Intensive Care Unit)  Awareness Month. ​This special month is dedicated to acknowledging the challenges families face and providing them with the support and resources they need.

As a doula you will encounter times where families are navigating a baby in the NICU for various reasons. This is an overwhelming and difficult time for all of those involved. It is a traumatic separation of parents and baby. A time where navigating expectations of what parenting was supposed to be and what it is, is up against the fear of will my baby be ok. 

Often times as doulas we feel scared and unprepared in supporting families as they navigate their way through this journey. Here are a few ways you can show up for families in the NICU. 

Listen

Just as you might support someone going through any kind of trauma by listening as they speak, simply lending an open, non-judgmental ear can be of huge help to NICU parents. Focusing on listening ensures that you honor the experience they’re having, instead of clouding it with your insights, birth story, or advice.

Consider starting with, “Do you feel like talking?” before asking any questions about their status or that of the baby. They may really want to share with you how much weight the baby gained that day or how they’re doing on certain good days, or they may really want to vent on some terrible days. But they also may not want to talk.  Asking if they’re open to talking before diving into a conversation is a way to respect their boundaries.

Support them in establishing communication with their baby’s care team: 

NICU parents often feel insecure about how to provide care for their baby who is in such a fragile condition.  It is important for them to know they are just as needed in the NICU as the medical team. 

  • Remind them they are their baby’s best advocate
  • Help them formulate the questions they want to ask
  • Remind them they can provide care to their newborn, changing diapers, taking temperatures, etc. The nurses will support them. 
  • Encourage them to keep a daily journal of their babies progress. keeping track of  baby’s individual body systems, like breathing, digestion, heart, brain, eyes, and any special conditions the baby has.  Keep track of milestones and ask the nurse what the baby’s current goals are.  Sometimes the goals will change daily, and sometimes they will stay the same for weeks.

Offer Practical Support 

As a doula this is our wheelhouse. Just as we would in the home, offering clear and concise suggestions about the type of support you can offer will help overwhelmed parents get what they need. 

  • Work with their support system to arrange food delivery for in hospital support and those at home. Gift cards for restaurants in and around the hospital, premade easy to heat up meals and snacks or even e-transfers will be greatly appreciated. 
  • Offer to do a load of laundry and bring it to the hospital ( or arrange for a family member to do so) 
  • Offer to be a communication liaison between the family and their extended family and friends, or help them find their person
  • Remember that the birther is also dealing with recovery, help them with practical recovery strategies like pain management, pumping, etc. 

Remember that the fear does not end when baby comes home 

 There is a lot of excitement when baby comes home however this doesn’t mean that the fear and concerns have ended. Often parents have not fully processed the trauma of being in the NICU and coming home creates a space for all of that to surface. 

Find the parents counselling and peer support resources. Expect some hypervigilance when it comes to caring for baby. Patience and listening will continue to be important. 

What strategies and tools do you use to support families in the NICU? 

 

Sondra Marcon (she/her). Education and Administration Coordinator
Sondra’s background in family therapy and mental health work drives her to create environment for her clients and students that is both supportive and challenging of bias and assumptions. Teaching and development of curriculum drives her to continue to grow. Sondra’s drive to become a doula came when she saw the impact of early childhood experiences and parenting has on the wellness of both the infant and their parents.[/vc_column_text][/vc_column][/vc_row]

Categories
Anti-Oppression Canada Equity indigenous doula understanding bias

National Day for Truth and Reconciliation

[vc_row][vc_column][vc_column_text css=”.vc_custom_1694354019009{margin-bottom: 0px !important;}”]September 30th marks National Day for Truth and Reconciliation in Canada, also known as Orange Shirt Day. The day is a national day of remembrance and reflection on the historic and current violence and oppression toward Indigenous Peoples. As a vocational school, we encourage our non-Indigenous students to participate in workshops, lectures, sharing circles, vigils, and more on September 30th.

The “every child matters” slogan dawned on orange shirts resonates deeply with us as doulas and care workers. As doulas we work intimately with families, infants, and children. The tragedies of the residential school systems and 60’s scoop, as well as the current oppression and violence toward Indigenous families in the forms of child apprehension, incarceration, birth alerts, and more are horrific and unacceptable, and impacts the families and communities we belong to and work with.

As doulas and allies, it is crucial to educate ourselves about the actions, policies, and systems that disproportionately impact Indigenous families, especially those that directly impact the work we do in terms of advocacy, intergenerational care, and reproductive justice. It is our duty to critically reflect on our identities, experiences, and our relationship to wider systems.

We understand that National Day for Truth and Reconciliation can bring up difficult emotions and be potentially triggering for our Indigenous students. We will be hosting a Indigenous-only peer support sweetgrass circle on October 1 from 1-3 EST on Zoom to debrief together. Contact kayt@doulatraining.ca to register. You can also check in 0n our progress here at Doula Canada by reviewing our NTRD Progress Report, which includes our goals between now and 2028.

Don’t know where to get started? Here are some ideas:

  • Follow Indigenous creators on Tiktok, Instagram, and other platforms
  • Take the University of Alberta’s free Indigenous Canada Course
  • https://www.ualberta.ca/admissions-programs/online-courses/indigenous-canada/index.html
  • Search up Kairos Blanket Exercises near you
  • Read up on the 94 Calls to Action by the Truth and Reconciliation Commission of Canada
  • Register for Doula Canada’s Doulas for Reconcili-ACTION Orange Shirt Day workshop
  • “Who Am I: Locating Oneself in Settler-Colonialism, A Conversation on Oppression Privilege, and Allyship” on September 30th from 1-3 PM EST on Zoom. $30, with all proceeds going to Aunties on the Road
  • Apply for our Truth and Reconciliation Action Plan Committee to contribute to our TRAP Five Year Plan
  • Assist in knowledge mobilization. Tag @doulacanada with the hashtag #doulasforreconciliaction on social media to share what you learned on September 30th that you think would benefit your fellow allies.

We understand that not everyone will have the same time, resources, finances, etc. to participate in some of the activities for the day. If you’re reflecting internally, please consider the following prompts (designed for non-Indigenous students).

  • What preconceived biases have been instilled in me about Indigenous Peoples? Where did I learn them from?
  • Whose land do I reside on? What is the story of the land here? (If applicable) How have I benefited from white/settler privilege?
  • Does the word “settler” make me uncomfortable? Why or why not?

Wishing you all a meaningful and educational National Day for Truth and Reconciliation.

Miigwetch,

Kayt Ward, EDI Co-Lead, BSW[/vc_column_text][/vc_column][/vc_row]

Categories
About Us Anti-Oppression Anti-racism work birth Business collaboration community connection decolonization Equity indigenous doula intersectionality Labour Doula LGBTQ2S+ Postpartum Doula research Trauma understanding bias

Doula Canada Presents: Anti-O Bingo

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Aaniin Doulas!

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This month we are introducing a new EDI initiative, and we want our students and alumni to play! Introducing…. Anti-O Bingo!
You’ve given your input, and we’re listening. Through our Truth and Reconciliation Action Plan, and our EDI surveys, we have identified anti-oppression and cultural training as one of the many areas Doula Canada doulas are interested in pursuing.

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How to play:
1. Click HERE to download your free Anti-O Bingo Card
2. Attend an event from each category
3. At each event, ask your facilitator for your custom .jpeg stamp. Paste it into a doc! (Remember to save it!). If you are attending a livestream (Just Birth, Fireside Chat, etc), please submit a paragraph on what you learned to kayt@doulatraining.ca
4. When you have all 8 stamps, please submit your doc to kayt@doulatraining.ca for your Anti-Oppression in Doula Care 101 Certificate and a ballot to win an $100 Etsy Gift Card.

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You have until December 31, 2023. Good Luck!

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Chi Miigwetch! Nia:wen!
Kayt Ward and Keira Grant, EDI Leads

[/vc_column_text][vc_empty_space][/vc_column][/vc_row][vc_row][vc_column][vc_single_image image=”494571″ img_size=”full”][/vc_column][/vc_row][vc_row][vc_column][mk_button corner_style=”rounded” size=”large” url=”https://stefanie-techops.wisdmlabs.net/wp-content/uploads/2023/04/edi-bingo.pdf” align=”center”]Get Your Anti-O Bingo Card here![/mk_button][/vc_column][/vc_row]

Categories
Anti-racism work birth Health Care intersectionality Labour Doula LGBTQ2S+ Postpartum Doula Trauma Uncategorised understanding bias vulnerabiliity

Advocacy at Doula Canada

[vc_row][vc_column][vc_column_text css=”.vc_custom_1669384798061{margin-bottom: 0px !important;}”]Doulas support birthers, babies, and family members during an intimate and emotionally charged experience that often involves many medical twists and turns along the way. For many doula clients, pregnancy and childbirth are among the most complicated experiences with our healthcare system they will have ever had to navigate. We know that birthers need to feel in control of what happens to their bodies and to be making informed choices about their care to create a positive experience and avoid trauma. 

Doulas can change a person’s healthcare experience for the better by supporting their bodily autonomy and informed decision-making. Additionally, we are well placed to notice systemic issues that impact our clients again and again, and to use our knowledge to encourage and support changes.

Learning to engage in this type of advocacy within the scope of the doula’s role, so that our efforts are helpful, is an important aspect of our learning and professional development. To support our students and alumni, Doula Canada has developed an advocacy framework that defines advocacy in the context of doula practice and describes approaches to individual advocacy that are aligned with respect for client autonomy. 

Our framework identifies three categories of advocacy that doulas engage in: systemic advocacy, self-advocacy promotion, and individual advocacy. 

Systemic advocacy is any effort to change, remove, or add a policy or process that affects the lives of birthers, families, babies, or doulas. Examples include lobbying your elected federal representative to change the birth evacuation policy or amplifying social media campaigns that raise awareness regarding perinatal mental illness.

While we don’t usually think of it as such, our work with clients to support them to know the evidence regarding their perinatal circumstances, and ask the right questions of their healthcare providers is a form of advocacy. We encourage them to use their voice and make their conversations more effective because they are armed with information.

Sometimes, especially in the birth room, it might be necessary to advocate for the client in more direct ways. It is important that this individual advocacy does not manifest as speaking for or over the client, or in a manner that could worsen their care or medical situation.

A 2020 paper by S.S. Yam based on interviews with doulas identified three types of tactics that doulas use to advocate for their clients during labour and delivery. She calls these “soft-advocacy” techniques because they differ from what we usually think of as advocacy. Staff and instructors at Doula Canada agreed they used these strategies and had lots of guidance to offer on exactly how to use them. Their guidance was used to develop the advocacy framework. 

The three tactics identified by Yam are 1) creating deliberative space, 2) cultural and knowledge brokering, and 3) physical touch and spatial maneuvers. 

Creating deliberative space refers to strategies that give the client more time to ask questions and make decisions. One example of how doulas do this is by noticing that care that deviates from their preferences is about to happen and bringing it to the client’s attention, prompting them to ask about the intervention that is about to happen.

Cultural and knowledge brokering refer to the tactics doulas use to make sure the client understands medical jargon or cultural norms. This could involve paying close attention to the information provided by the medical team, observing how well this is understood by the client, and repeating the information in language that the client uses and understands.

Physical touch and spatial maneuvering refers to the ways we use our bodies and physical contact with the client to advocate for their needs. Examples include using our bodies to conceal the client from view, modeling consent by asking permission each time we touch the client, and using our presence to back up the client during interactions. 

The complete framework is linked below. It offers more detail on the three types of advocacy and the soft-advocacy strategies. It illustrates these concepts using case studies based on staff and instructor experiences. 

In 2023, Doula Canada will continue its work to support advocacy among its members by developing an advocacy toolkit from the framework and launching an advocacy working group for students and alumni. [/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][mk_button corner_style=”rounded” size=”large” url=”https://stefanie-techops.wisdmlabs.net/wp-content/uploads/2022/11/advocacy-framework-paper.pdf” align=”center”]Click here to view the full Advocacy Framework document[/mk_button][/vc_column][/vc_row]

Menopause Doula I ONLINE I April 3 course ACCESS date

Applicants recognize that this course material will not become available April 3rd, 2022.

This is an online course with 10 modules of content, 4 live meetings, 6 core assignments, module quizzes, a final exam, and a minimum of 20 practicum hours. Students have 24 months to complete all course requirements for completion.

Live meetings are scheduled for 7:30pm EST on:
April 21
April 28
May 5
May 12
*June 2 – optional business discussion and Q & A session

Students are asked to attend 50%.  All meetings are recorded for playback

Labour Doula I Virtual I November 6/7

[vc_row][vc_column][vc_column_text css=”.vc_custom_1624840038024{margin-bottom: 0px !important;}”]Join our experienced Doula Canada instructors for two days of virtual learning!

Our client-centered and trauma informed Labour Doula certification program is live and online.

This workshop will go over the materials covered in our typical two-day “in-person” workshop and creates the opportunity for DTC members to sit and hold space with our experienced team of instructors.

The workshop will be held via Zoom from 10am to 5pm.  Login details will be sent one week prior to the Virtual Workshop date.

Regular certification rates apply and members can request to join a physical in-person workshop when we are next in their area (no additional cost applies).  Members may also choose to take part in the 1 day Advanced Comfort Measures as an alternative to their in-class workshop attendance (as required by some doula associations).

*Those who register for the Dual Stream (Labour Doula, Postpartum Doula) will take part in 2 separate virtual trainings.

*Those who register for the Triple Stream (Labour Doula, Postpartum Doula, and Educator OR Fertility Doula) will take part in 3 separate virtual trainings. *Please specify whether you wish to take Educator OR Fertility in the comments section of your registration.

Those who are already registered with DTC can email info@doulatraining.ca to be added to this session (fee included in original registration).

$150 fee applies if a student misses a workshop that they registered for and wish to be added to a date at a later time.  All students must participate in an online or in-person (min. 2 days) to qualify as a component towards certification under DTC.[/vc_column_text][/vc_column][/vc_row]

Categories
birth fear gratitude Labour Doula shame Trauma vulnerabiliity

Working Through Shame – an important doula lesson

[vc_row][vc_column][vc_single_image image=”73471″ img_size=”full” alignment=”center”][/vc_column][/vc_row][vc_row][vc_column][vc_column_text css=”.vc_custom_1551307504674{margin-bottom: 0px !important;}”]Guest Blogger Jillian Hand from Hand to Heart Doula Services in St.John’s NL shares with us the importance of working through shame in doula work. [/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text css=”.vc_custom_1551308858438{margin-bottom: 0px !important;}”]When I first read Daring Greatly by Brene Brown it rocked my world. What a HUGE game changer. So, imagine my excitement when it was added to the Doula Canada required reading list. If you haven’t already had the pleasure of reading Brene Brown’s work, here’s a quick bio – Brene Brown is a researcher with a Masters and PhD in Social Work. She lives in Houston and teaches as a research professor at the University of Houston Graduate College in Social Work. She has spent over a decade studying vulnerability, courage, worthiness, and shame.

Pretty heavy topics, right? How do these pertain to doula work, you ask? Well, think about it. What is more vulnerable than being in the position of giving birth? How often do we hear our clients express sentiments like “I feel like a failure”; “I’m just not strong enough”; “I felt invisible and worthless” – these are all statements involving shame.

So, let’s dig a bit deeper into shame. Brown defines shame as “the intensely painful feeling or experience of believing that we are flawed and therefore unworthy of love and belonging” (pg 69). She goes on to explain that shame is the fear of disconnection – “it’s the fear that something we’ve done or failed to do, an ideal that we’ve not lived up to, or a goal that we’ve not accomplished makes us unworthy of connection” (pg 68). We all experience shame. It is a universal emotion and unless you lack the capacity for empathy (sociopath anyone?), you have experienced it. Brown also distinguishes between guilt and shame. The difference is best understood with the following example – Guilt = I did something bad; shame = I AM bad. See the difference?

Let’s use an example we can relate to. As a doula, I’m sure we have all experienced moments of shame. If you haven’t yet, you will. Trust me. You wouldn’t be human if you didn’t. My first bout of shame as a doula was with my third client. We had discussed her wishes prior to the birth and I knew she wanted to avoid an episiotomy if at all possible. I supported her to the best of my abilities throughout her labor and when it came time to push. Then, this happened – As she was lying supine, pushing with all her might, I watched the OB pull out a pair of scissors. In my head, I knew I should say something because it was obvious at this point that he didn’t plan to. But I froze – maybe out of fear of confrontation or perhaps I was just too intimidated at that point to question the decisions of a doctor. I’m still not sure why I didn’t speak up for her. But I didn’t; and he cut her without a word.

I had so much guilt for such a long time. I did something bad. I didn’t speak up for her. I didn’t protect her in the way I was meant to. I didn’t give her the chance to say no. I watched him violate her informed consent and did nothing. The guilt was overwhelming… But the shame.. well, the shame was excruciating.  Because you see, I didn’t only think I DID something bad, I also thought I WAS bad. What a horrible doula I was! I felt unfit and unworthy of supporting women during this precious, vulnerable time. Not only did I harbor guilt about my lack of action, but I internalized it and made it about who I was as a person, as a doula. Now THAT is shame.

I didn’t talk about that experience for a long time. I never admitted that I saw those scissors. I found it hard to look my client in the eye while she explained after the fact how painful her recovery was. I avoided the second postpartum visit because I couldn’t face the shame I was experiencing… and of course, that just reinforced my shame, deepening it until I felt like I was drowning.  That’s what shame does – it spirals and makes us pull away, disconnect, avoid. The more it silences us, the larger it looms. I almost gave up being a doula after that.

I didn’t quit though. I came to learn that I was actually a very good doula. I just wasn’t perfect. I learned to cut myself some slack when it comes to mistakes. I found empathy in my heart for that newbie doula who still hadn’t found her voice to speak up against obstetric violence, and who lacked the confidence to take a stand. She did the best she could in that moment. I truly believe that now.

As doulas, we will experience shame. We will also witness the shame of others – our clients, their partners, family members, our doula colleagues. Unfortunately, Brown’s research confirms that there really is no way of avoiding shame. Shame resistance is impossible. “As long as we care about connection, the fear of disconnection will always be a powerful force in our lives, and the pain caused by shame will always be real” (pg 74). What Brown did discover however is that we have the ability to build shame resilience. “Shame resilience is a strategy for protecting connection – out connection with ourselves and out connections with the people we care about” (pg 76). It’s about moving from shame to empathy, which is the real antidote for shame. It’s the “(pg 74).[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column border_color=”#441f93″ blend_mode=”soft-light” css=”.vc_custom_1551308244095{background-color: #300032 !important;}”][mk_blockquote font_family=”none”]It’s the “ability to practice authenticity when we experience shame, to move through the experience without sacrificing out values, and to come out on the other side of the shame experience with more courage, compassion, and connection than we had going into it” (pg 74).[/mk_blockquote][/vc_column][/vc_row][vc_row][vc_column][vc_column_text css=”.vc_custom_1551308385042{margin-bottom: 0px !important;}”]So, how do we build our shame resilience? Brown identifies four elements, and the steps don’t always have to happen in order. They are:

Recognizing Shame and Understanding Its Triggers.

I love the description “Shame is biology and biography”. To build shame resistance, we must first be able to detect shame in our bodies. That’s the biology. Do we flush? Feel nauseous? Get headaches? What is our physical reaction? I know mine inside and out. First, I feel queasy and I get clammy. Then, my mind starts to race, and my breath quickens and a headache starts, right behind my eyes. I flush and can feel the grip of anxiety.

The biography piece refers to our ability to figure out what messages and expectations triggered it. What’s the story we are telling ourselves? Let’s take my shame story for example. The expectations I set for myself were that, as a doula, it was my sole responsibility to protect my client against unwanted interventions in any situation.

 Practicing Critical Awareness.

This is where reality checking comes into play. How realistic or attainable are the messages and expectations driving your shame? Was it realistic for me to set the expectation that I alone was responsible for the actions of my client’s healthcare team? Was it attainable for me to assume that I had the power to stop unwanted intervention? I know now that I am only one person.

Reaching out.

Are you sharing your story? Empathy requires connection and if we aren’t reaching out, we aren’t connecting. WHO we choose to share our story with is vital. Are we choosing someone who has earned the right to witness our vulnerability? Are they going to hold space for us in a non-judgmental way? If not, we might want to choose someone else because those that judge us and do not have the ability to provide us with compassion and empathy will only feed our shame.

When I first shared my story, it was with another doula who I trusted wholeheartedly. She listened and validated me, and was able to tell me about her own experience with shame. I didn’t feel alone anymore, and it made me realize that we all have moments of humanness where we make mistakes.

Speaking Shame.

Finally, are you identifying shame as SHAME? Are you saying the word, out loud? It’s important that we talk about shame and ask for what we need when we feel shame. By naming it, it loses its power.

Now, when I feel shame coming on, I look it in the face. I say to myself “This is shame”. I know exactly what I need to do to work through it. I call that same friend you gets me and I say “I need help, I’m in a shame spiral”. She knows exactly what that means. We talk it out. I usually cry. I tell her I need to hear that I’m still a good doula. I need her to believe that I did the best I could. She always believes me. Always.

Working through shame takes work, and self-compassion, and most of all, empathy. Remember, you need to go I.N.T.O it.

Identify it.

Name it.

Talk about it.

Own it.

I promise you, you will make it to the other side.

Brown, brene. (2012). Daring Greatly: How the Courage to be Vulnerable Transforms the Way we Live, Love, and Parent. New York: Avery Publishing.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text css=”.vc_custom_1551307936785{margin-bottom: 0px !important;}”]

Jillian is a certified birth and postpartum doula through both Doula Training Canada and DONA International . She is one of the original founders of the Doula Collective of Newfoundland and Labrador.She is also a Certified Birthing From Within® mentor and doula and  a Birthing From Within® Birth Story Listener. This training, along with a master’s degree in social work, has provided her with the necessary skills to facilitate the processing of difficult birth experiences in a way that leads to growth and wholeness. Finally, She is a birth doula trainer through Doula Training Canada, as well as the mother of two beautiful and creative children. 

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Labour Doula

Birth Trauma Part 2 – When Trauma Takes Root

Birth trauma and Doula support

 

 ​As doulas, we are given the opportunity to provide support and hopefully enhance the birth experience of our clients. As I’ve outlined in my previous blog post, The Seeds of Birth Trauma, doulas can have some influence on how we prepare our clients to minimize some of their risk in experiencing birth trauma.  Unfortunately though, even with this preparation, the unexpected can happen, and our clients come through the experience feeling traumatized. Also, it is not uncommon for people to hire doulas only after they have already experienced a traumatic birth, and we are then put in the position of supporting them through processing that previous birth before moving on to their next one.

So, as a doula, how can we best support our clients after they have already experienced a traumatic birth?

Before I continue, I want to address the topic of obstetrical violence that is still prevalent in western birth culture. Throughout this post, you will see that I reference a client’s expectations, shame, and self-beliefs which I believe can often be the origin of the trauma taking root. That being said, I in no way mean to minimize the seriousness and devastation that comes from obstetrically violent acts which happen all too often to birthing persons in our culture. Part of our role as doulas is to uphold the importance of informed consent and supporting our clients’ autonomy. For more information on obstetrical violence and what we can do about it, go to www.birthmonopoly.com.

In my work both as a doula and therapist, there are a number of things I have learned about birth trauma. First, the people that supported the traumatized person through the experience, whether that be a doula, or partner, or family member, may not be the most appropriate person to help her process the trauma. As a doula who attended her birth, YOU are part of her trauma story, even if you did not contribute to the trauma. In speaking about her experience, she will likely edit her version to avoid hurt feelings, or blame, or guilt whether this is conscious or not. It is also possible that she could associate you with the traumatic experience and speaking to you specifically about it may not be helpful for her. As her doula, it is important to have this self-awareness, not to take it personal, and offer to refer her to someone who is outside the story circle that has the experience and skill to assist her in healing.
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Second, I’ve learned that telling a traumatizing birth story over and over again is rarely helpful in healing. Retelling the trauma in detail over and over in the same way engrains the story in our psyche and solidifies the negative self-beliefs we have taken from it. It can often lead to us feeling ‘stuck’ and unable to move forward. A process developed by Pam England, creator and author of Birthing From Within, called Birth Story Medicine has been invaluable to me in assisting women find new ways of telling their stories.

​As a doula, if you have a client who has had a previous traumatic birth, encouraging her to tell her story in a different way and shifting focus can lead to a new perspective. For example, instead of retelling their story as they always have from start to finish, I ask clients to choose a moment from their birth that was difficult for them and retell THAT moment, as a snapshot,  preferably in the present tense as if it is happening right now. I focus on how they are feeling in that moment, what emotions are they experiencing, and most importantly, what do they believe about themselves because this has happened to them. In other words, what self-belief are they holding on to – “Because this happened to me, I am ______________”. Some women will identify feeling weak, unworthy, powerless, stupid, irresponsible, not a good mother, etc. When they are able to identify that belief, it often has a visceral reaction and triggers an emotional response such as tearfulness, panic, anger.

Once that self-belief is identified, using some solution-focused questions to find exceptions to that self-belief can lead to a shift in perspective. For example, asking questions like “what’s one thing you did well/that surprised you/that you thought you couldn’t do but did anyway?” can help them see that there is something MORE true about themselves that’s more positive, more realistic. Focusing on what they want to begin believing about themselves when they think of this moment is a good start. For more information on solution-focused questions and dialogue, I would recommend the book Brief Coaching for Lasting Solutions by Insoo Kim Berg and Peter Szabo.
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Often times, that self-belief has an element of shame for the traumatized person. Brene Brown, social worker and shame researcher, defines shame as the intensely painful feeling or experience of believing we are flawed and therefore unworthy of acceptance and belonging (pg 5). It is also valuable to distinguish between guilt and shame as they both have a very different impact on how we view ourselves. Brown states that “guilt and shame are both emotions of self-evaluation; however that is where the similarities end. The majority of shame researchers agree that the difference between shame and guilt is best understand as the differences between “I am bad” (shame) and “I did something bad” (guilt). Shame is about who we are and guilt is about our behaviours.” (p 13). [Read more from Brene Brown in her book  I thought it was just me (But it isn’t)]

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In my experience, the self-relief that stems from birth trauma is rooted in shame. Identifying the belief and acknowledging the emotion attached to it as ‘shame’ is the first step in building our shame resilience.  Brown defines shame resilience as that ability to recognize shame when we experience it, and move through it in a constructive way that allows us to maintain our authenticity and grow from our experiences. She identifies four elements to building shame resilience which I have personally found invaluable in assisting birthing persons in working through their negative self-beliefs that stem from their birth experience.

​These elements are:

  • Recognizing shame and understanding its triggers – what does shame feel like? What happens biologically and emotionally? What topics or insecurities trigger our shame and what part of our story do they come from?
  • Practicing critical awareness – How realistic are our expectations? How is our personal experiences linked to larger social systems? How does cultural or societal expectations influence this shame experience?
  • Reaching out – Who in my life has earned the right to hear my story? Who can I trust to be gentle with my vulnerability? By sharing our story, we create change – within ourselves and others.
  • Speaking shame – When we speak shame, we learn to speak our pain. By saying “I am feeling shame”, it loses its power and can create connection and empathy, which is the medicine for healing shame.

When it comes to birth trauma, I believe that when we are able to move past the descriptive details of the experience and shift the focus to how that experience makes us feel about ourselves – this is where the healing begins.
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You can find more in-depth training in Birth Story Medicine® at https://www.sevengatesmedia.com/. I highly recommend this life-changing course.

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This series of blog posts is brought to you from our East Coast instructor Jillian Hand. Jillian shares her perspective on trauma from the lens of social worker and doula in this 3 part series we will benefit from her personal and professional experiences.

Jillian is a certified birth and postpartum doula through both Doula Training Canada and DONA International and have been involved in the local birth community since 2007. She is one of the original founders of the Doula Collective of Newfoundland and Labrador. Over the years, she has been actively involved in the doula movement both at a local, national and international level. You can find out more about her through her business page Hand to Heart in St. John’s NL. www.handtoheart.biz/

Categories
Labour Doula

The Seeds of Trauma – Part I: Supporting Birth Trauma as a Doula

 

This series of blog posts is brought to you from our East Coast instructor Jillian Hand. Jillian shares her perpesctive on trauma from the lens of social worker and doula in this 3 part series we will benefit from her personal and professional experiences.

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I suppose it’s no surprise that over the past seven years, I have gravitated toward providing therapeutic support to birthing persons, their partners and birth professionals in the area of birth trauma processing and recovery. My master’s degree in social work combined with my passion for birth work has provided me with the education and skill to facilitate these therapeutic conversations toward healing. Of course, as with all experiential learning, I’ve gained a lot of insight into this topic over the years and it has influenced how I work with doula clients while wearing my doula hat.
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I have developed this three-part blog series with the intention of trying to provide some answers to three questions that are posed to me on a regular basis by other doulas. First, as a doula, what can I do to help minimize the risk of birth trauma; Second, How can I best support my client after they have had a traumatic birth experience; and third, how can I protect myself, as a birth professional, from vicarious trauma? There are no quick, easy answers, but I will do my best to share what my experience has taught me, beginning with how a doula can minimize the risk of birth trauma.
In the early days of this work, one thing I struggled to understand was how two people could have very similar birth experiences and yet, one will describe their experience as traumatic, while the other seems to have taken it all in the stride. For example, I have had the experience of working with two different birth doula clients on separate occasions. Both had the same obsterician, the same doula (me), the same induction procedures, the same complications down to the letter, and in the end they both ended up giving birth by cesarean. In debriefing with the first client, it was obvious that she was devastated. She used the following words to describe her experience – “violated”, “just a file number”, “cut open”, “robbed”, “disrespected”. I supported her in the best way I could in those early days, and as a new doula, I remember feeling that I had somehow let her down since she didn’t get the experience she hoped for.Fast forward to my second client with the similar experience. I had prepared myself for the same feelings of loss, trauma, and anger afterward that I assumed this client would also experience – but surprisingly, her attitude was completely different. She was disappointed, sure, but she felt like there was nothing more that could have been done and she was happy to have the experience behind her and move on.  These two practically identical births but vastly different reactions started me on my quest to seek out how this could be so. If the actual events themselves didn’t create the feeling of trauma, what did?

My own research, inquiries, and experience has taught me that one of the biggest influences in birth trauma is the focus, attitudes, and preparation of the birthing person/couple.

How outcome-focused are they in their vision of their birth experience? Are they rigid in their birth planning? Do they express an unwillingness or resistance to acknowledge and appreciate the ‘unknowns’ in labor and birth? Are they open or closed to learning ways of coping with a deterrence in their birth plan (for example, are they skipping the chapter on cesareans because “that won’t happen to me”)?

​ It appeared to me that the more attached a person was to the outcome of their experience, the more likely they were to feel traumatized after the fact if it didn’t go the way they hoped. I consider rigid expectations and lack of well-rounded preparation to be seeds of birth trauma. Once planted, they can take root and grow if other unexpected events are added to the mix – like the client who is adamant that she will give birth at home but ended up needing a transfer; or the client who refuses to acknowledge the possibility of a  cesarean, and yet fails to progress.

What is a doula to do?

So, as a doula, what can you do to help minimize the risk of birth trauma? First of all, it is important to emphasize that, as doulas, we are not responsible for outcomes. We cannot make promises to clients that hiring a doula will mean less interventions, a natural birth experience, a shorter labor, etc. Sure, the research suggests that we can make a difference, but in the end, our role is to provide support and encouragement, to facilitate good communication, and to assist in comfort – NOT to guarantee a client gets what they hope for. Doulas new to the profession are particularly more likely to feel the pressure to promise a certain experience and to feel responsible when they cannot deliver. Be conscious of this impulse.
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Here are some things you CAN do:

  • Facilitate discussions with your clients about the things they have control over (care provider, place of birth, classes they take, books they read) versus the things they cannot control (how long labor will be, when labor will begin, how baby will cope with labor, how their bodies will respond).
  • Take a non-outcome-focused stance in prenatals – acknowledge what their wishes are, but also emphasize the importance of planning for how to cope with those unwished-for events, should they arise. Focus on how they can feel satisfied and supported no matter what the outcome.
  • Prepare them for the possibility of a cesarean birth or the use of pain medication, even if they believe they will not need the information. I call this the “it won’t happen to me” phenomenon. It is a breeding ground for trauma.
  • Suggest they take a non-outcome focused childbirth preparation class. Birthing From Within™ is a good example of a class that focuses on preparing for all possible outcomes.
  • Explore not only their hopes but also their fears when it comes to birth. Ask solution-focused questions like “How would you cope if that were to happen?”
  • Assist in the development of a clear but flexible birth plan. Watch for unrealistic expectations and address them as they arise.
  • Avoid using clichéd affirmations like “Trust Birth” or “Trust your Body” that are outcome-focused and absolute– these can imply to the birthing person that if they just trust enough, they will get the outcome they wish for. This is often not the case, and can lead to feelings of failure and shame when their birth does not go the way they hoped.

As doulas, we have a lot of influence over our clients. They often see us as being ‘in the know’ and look to us for guidance and support. We have the opportunity to make a significant difference in how our clients perceive their birth experiences based on how we approach the preparation phase of our work together. Prepare them. Tackle the hard topics. Encourage them to keep an open mind. Otherwise, I believe we do them a disservice.

Stay tuned for parts two and three of my Birth Trauma series. .

 Jillian Hand, MSW, CD/PCD(DONA) Birthing From Within® Mentor
Jillian is a certified birth and postpartum doula through both Doula Training Canada and DONA International and has a Masters Degree in Social Work  She is one of the original founders of the Doula Collective of Newfoundland and Labrador. Over the years, Jillian has been actively involved in the doula movement both at a local, national and international level. As a Certified Birthing From Within® mentor and doula, and she facilitates childbirth preparation classes that embrace birth as a rite of passage. You can find more information about Jillian here http://www.handtoheart.biz