What is Trauma-Informed?

When a mother calls the arrival of her baby "birth rape" we know something drastic needs to change. Trauma informed care is based on a set of principles that guides the professional's understanding, communication, interactions, and care for the client. Trauma-informed care 

  • Acknowledges that trauma is pervasive and may result from developmental, complex, historical, intergenerational, or single-incident events.
  • Realises that trauma has a significant impact on the individual's physical, social, emotional, relational, sexual, and spiritual health. Trauma-informed care moves past intrinsic biases to support at-risk clients in building wellness.
  • Recognises the signs and symptoms of trauma in a client, their community, and their supporters. Trauma survivors can develop strategies for survival that may seem mal-adaptive in the non-traumatised individual. Trauma-informed care builds on these strategies to increase resilience and wellbeing. 
  • Respects the culture, history, dignity, vulnerability, and coping strategies of the client.
  • Responds with affective empathy and compassionate communication and practices.
  • Works to ensure the client is not re-traumatised by offering client-centred care where the client participates in decision-making and determines what is safe for them in a supportive collaboration with their care provider.

Both individual providers and systems can become trauma-informed. Trauma-informed systems, such as clinics, practices, and hospitals, implement those strategies that ensure their staff are all working from the same compassionate client-centred perspective where the elements of trauma-informed care are the standard across the organisation. Not only do clients benefit, but everyone in the organisation benefits from improved clinical accuracy, reduced burnout, increased client satisfaction, and increased wellness in the client and the clinician.

The principles of trauma-informed care are comprised of the following tenents:

  • Safety, this is the guiding principle for both clients and clinicians. Staff must be safe from client, hierarchical, and lateral abuse. Clients define for themselves what is "safe" depending on their prior experiences and thier history with medical services. Marginalised and disenfranchised persons must be safe to seek medical services without threat of child apprehension, victim blaming, threats to their dignity, sexual safety, or autonomy of their personhood.
  • Trustworthiness and transparency, means that any bait-and-switch must be promptly addressed at the highest levels of any organisation. What is promised to clients is what is delivered and isn't dependent on who is on call that day. An inability to deliver services must be clearly communicated at the outset so that clients have the opportunity to source other means of support.
  • Peer support and mutual self-help, acknowledges the power in peer support for both clients and clinicians. 
  • Collaboration and mutuality, the client and the clinical form a relationship that is built on mutual respect and collaboration where the client is at the centre of their own care. Power dynamics are addressed so that clients are safe to explore options without threat of retaliation or reprisals.
  • Empowerment, voice, and choice, recognises and validates the client's strengths and inherent knowledge. They are encouraged to build upon existing strengths and explore new skills to become empowered in their own healthcare.
  • Cultural, historical, and gender issues, are recognised and honoured. Healing strategies consistent with the client's history are employed and respect for the client's gender, historical and cultural issues are integrated into all interactions. 
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While many clinicians and systems assume they are trauma-informed, they lack the evidence-based education, training, and skills to effectively interact with at-risk clientele in a way that builds trust, confidence, and resilience-based healing.

A mother who has received disrespectful treatment during the perinatal experience, in particular, facility-based abuse, is much less likely to access medical services for herself or her child. She is also much less likely to seek regulated care for a subsequent pregnancy or birth (UNPA, 2004). In fact, the rise of "unassisted" births can be traced to a response to disrespectful care, loss of autonomy, and obstetric violence (Holten, 2016). Unfortunately, the response of many within the medical industry is to "punish" the mother when she does seek medical services for making choices they didn't agree with, further driving her away from medical support for herself and her family (Vedam, 2017).

Trauma-informed care providers have the opportunity to meet these clients with understanding and compassion. As they build a trusting relationship with the client, where the client's prior trauma and coping strategies are recognised and accepted, they have the opportunity to participate in halting the epigenetic expression of trauma and changing the course of a generation or two.

Perinatal professionals can become certified in trauma-informed care through the world's first evidence-based certification course. This course is offered through Childbirth International and is accredited with distinction by the American Nurses Credentialing Center and equips physicians, nurses, midwives, doulas, childbirth educators, administrators, and anyone that works with birthing families with the skills to halt this global pandemic in its tracks and facilitate healing that will be felt for generations.

You can review the references for the above information here.

Becoming a Trauma-Informed Professional

A certified trauma-informed professional has the unique evidence-based skills to interact with traumatised and at-risk clients in a way that builds trust, changes epigenetics, heals the past, and invests in the future. This isn't for the faint-of-heart. This is for those courageous professionals who are willing to go deep, address inherent biases, challenges current paradigms, and boldly take a stand on behalf of the wounded and the marginalised.