Trauma-informed care

More awesome graphics at: https://stores.praeclaruspress.com/free-posters-and-graphics/

Johanna Sargeant’s BA, BEd, IBCLC Mastering Lactation Conversations: Creating Successful and Achievable Care Plans is an excellent reminder of compassionate and effective counseling. Early in her presentation, Sargeant unpacks the perception that lactation care providers (LCP) can sometimes desire breastfeeding “success” more than the clients themselves.

As LCPs, it can be easy to get wrapped up in checklists and targets and “perfect” latches, forgetting about the complexity of the human experience and how infant feeding is inextricably influenced by parents’ lived experiences. Parents must be allowed to define their own terms of success, and as LCPs, we must honor the complexity of their lives. 

April is Sexual Assault Awareness Month which is as good a time as any to focus on trauma-informed care, which should be the standard of care for all perinatal services.  

Sexual trauma is common and affects approximately 20 to 25 percent of women, according to  Kathleen Kendall-Tackett, Ph.D., IBCLC. 

Image by Nadezhda Moryak

“Abuse survivors can experience a full range of responses to breastfeeding: from really disliking it to finding it tremendously healing, “ she writes in an Uppity Science Chick publication.

All of those many years ago that I completed the Lactation Counselor Training Course (LCTC), one of the most striking bits I took away was learning about the “hands off” approach. I was perplexed that this even needed to be emphasized( though I had experienced a “handsy” LCP after the birth of my first daughter and have so many friends who share similar experiences.)

These cloth breasts are a solution to demonstration without touching people’s bodies. (It is advised to exercise care when dealing with breast models in childbirth and breastfeeding education as the symbolic dismembering of the female body can carry powerful negative messages.)

Jennie Toland’s BSN, RN, CLC article on trauma-informed care reminds us that acknowledging the existence of trauma and its effects is the first step LCPs can take to providing proper care.

“Recognizing signs such as anxiety or emotional numbing can prompt further discussion that builds trust and fosters collaboration and engagement,” Toland writes. “…It can be as simple as asking if someone would prefer the door shut for privacy, positioning ourselves so we are not standing over another person when performing assessments, or verbalizing next steps and asking for consent to move forward…. It can happen within just a few seconds as we ask, ‘What is your preference?’ to provide someone with control over their care.”

[Here’s an older piece that explains how the simple prompt “May I?…” changed the way I view healthcare.]  

Toland writes that trauma-informed care does not need to be complicated, and the approaches she suggests aren’t specific to any one kind of trauma. 

While birth and breastfeeding can be remedial and healing for trauma survivors, these experiences can also be the source of abuse and trauma. 

Dr. Gill Thomson’s work describes this phenomenon. 

Dr. Karen Scott’s work through Birthing Cultural Rigor challenges the reality of maternity care for Black Indigenous People of Color (BIPOC). Indeed,  “We cannot fix the maternal mortality problem without fixing the human rights problem at its core.

There are so many others acknowledging trauma and incorporating compassionate care. In Milwaukee, BOMB Doulas are providing wrap-around care services, thorough screenings like the Adverse Childhood Experiences (ACES) and sensitive, respectful care.

Photo by Mateusz Dach: https://www.pexels.com/photo/photo-of-baby-on-mother-s-arm-4504005/

The White Ribbon Alliance UK offers programming like Safer Beginnings which includes Free From Harm for maternity workers which works to address obstetric violence.  

There are those like Audrey Gentry-Brown, Full Spectrum Birth Sista, Certified Blactation Educator (CBE), Student Midwife, and Medicine Woman in Loudoun County, Va. working to  rewrite cultural norms within her community, introducing “Afrofuturist healing modalities” that reconnect to “ancestral magic.” 

Xavier Dagba’s words embody her work well: “As you focus on clearing your generational trauma, do not forget to claim your generational strengths. Your ancestors gave you more than just wounds.” 

Photo by Serdi Nam: https://www.pexels.com/photo/close-up-of-mother-breastfeeding-baby-19178588/

Shawn Ginwright, a Black clinician, shares a similar ethos in a piece that challenges traditional approaches to trauma-informed care by exploring the distinction between simple ‘treatment’ and true healing.

“A healing centered approach to addressing trauma requires a different question that moves beyond ‘what happened to you’ to ‘what’s right with you’ and views those exposed to trauma as agents in the creation of their own well-being rather than victims of traumatic events,” Ginwright writes. “Healing centered engagement is akin to the South African term ‘Ubuntu’ meaning that humanness is found through our interdependence, collective engagement and service to others. Additionally, healing centered engagement offers an asset driven approach aimed at the holistic restoration of young peoples’ well-being. The healing centered approach comes from the idea that people are not harmed in a vacuum, and well-being comes from participating in transforming the root causes of the harm within institutions.” Essential reading! 

Other relevant resources and articles 

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