S3 E18 TRANSCRIPT Birthing & Medical Trauma

[00:00:00] Jennifer: Welcome to Trauma Rewired, the podcast that teaches you about your nervous system, how trauma lives in the body, and what you can do to heal. My name is Jennifer Wallace. I am a Neuro Somatic Psychedelic Preparation and Integration Guide.

[00:00:15] Elisabeth: I’m Elisabeth Kristof, founder of Brain-Based Wellness and the Neuro Somatic Intelligence Coaching Certification. If you’re a coach, a therapist, or a practitioner you may know that you don’t want to go back and revisit trauma over and over and over again in the name of healing. You see that going there doesn’t always actually help your clients move past it.

[00:00:33] And maybe you feel what it does to your own nervous system. You experience the burnout, that it creates too much stress for too long, and you know that it’s just not as simple as saying it’s in the past, let it go because the body is holding it. And so the past continues to shape the present in reactions in outputs that we experience and in responses.

[00:00:53] Trauma resolution is more than talking about the past and deeper than cognitively deciding to move forward. Trauma lives in the now, in the body and the nervous system, and affects the present moment until we find a way to rehabilitate the system. If you wanna learn more about how to do that, get some practical, actionable tools and a framework, we are now enrolling in the next cohort of Neuro Somatic Intelligence Certification. You can go to neurosomaticintelligence.com to learn more. The link is in the show notes.

[00:01:20] Elisabeth: Hi everybody, today we are diving into a topic that I find incredibly fascinating, which is the birth process, how trauma can show up in the birth process; why trauma informed care is so important as part of that process and how that impacts our nervous system and our relationships.

[00:01:42] Really the architecture for the brain is constructed through an ongoing process that begins before birth and continues into adulthood. It establishes either a fragile foundation for health, for learning, and for behavior that follows. That is coming from a study from Harvard University’s Center for Child Development. Today we are joined by Mandy Irby, who is the Founder of Birth Nurse. And she’s also a Neuro Somatic Intelligence Certified Practitioner who is weaving nervous system work into trauma informed care in the birthplace. So we’re really excited to talk about this with you today. 

[00:02:20] Mandy: Thank you so much and thank you for having me. So we’re told about childbirth is so scary. We’re told pregnancy is awful. Childbirth is awful. What we see in the media- screaming, terror,pain, sweat, tears, violence. And while I did not see that, did not see childbirth as just that, there were definitely parts of the job that were really scary, but not for the same reasons. 

So I’ve spent my career trying to figure out how to make it less scary to be in and around childbirth because if you ask folks, birth workers or folks in childbirth, we will say, often you’ll hear, ‘we love the work, we hate the job’. And we can never imagine ourselves doing anything differently. Like, being with Birth is so specific and so magical. Yet so challenging and so terrible at the same time. 

So, it felt like a lot of system functions were getting in the way of childbirth inside of the hospital. We were trying to make changes, but they weren’t sticking. I was often encouraged to push past my stress. Even though I was a straight A student, a good worker, good nurse, good at my job, the job was very unpredictable. So I knew that I needed to make a change and I knew that I couldn’t do the work forever, but I never really had an idea of how I was going to make that happen until I had a baby. 

And I have the cliche story of ‘had a baby changed my life”. As the patient giving birth, where I worked with my colleagues, it gave me a whole new perspective, as you can imagine. But I thought I knew what to expect in that perspective. 

[00:04:14] Elisabeth: So you started in this profession and do you feel like having the experience was living it in a different embodied way when you became pregnant and even though you had been working in this field, you started to experience your own trauma, your own past as you were going through that. And no one had ever prepared you for that in any of your nursing experience and practice?

[00:04:38] Mandy: Yes, I was expecting it to hurt. I was expecting it to be work, but I wasn’t expecting it to be so lonely and so personal. I thought as the nurse that I was witnessing someone’s experience when I was with them. And then realized that it was a lot of internal work that I had no idea was going on. So many thoughts, so many insecurities, so many fears that my patients were going through that I didn’t know about. I experienced all of that myself and felt super alone. Why is no one seeing me? Why is no one able to help me? It felt really different going through that experience. I thought I knew how it was going to feel. And a lot of my past stuff that I thought was already resolved came up in my childbirth. I needed help figuring that out. I had kind of flashbacks and I had these memories and I had these thoughts that didn’t really relate to having a baby. So I got help with that. Realized that there were a lot of experiences in my past that came up during my birth experience. And my colleagues didn’t know how to support me. So my journey began then trying to teach childbirth education. And everything that I was learning about sexual assault, childhood abuse survivors, which actually related back to nurses and our community at large.

[00:06:10] Jennifer: This season on Trauma Rewired we’re really exploring the idea of the collective nervous system and the idea that there is this social synapse that happens in the space between people and that we are always connected by nonverbal cues. That we’re always reading the facial expressions and reading the energy and reading the physiological clues that the other person is giving off without us really having to… like stuff that we can feel and see in people. And so do you think there’s a disconnection in that social synapse where the nurses, the doctors are almost acting as a separate entity from the patient, which is almost like this conscious dissociation almost in a way?

[00:06:58] Mandy: Umm not almost, that’s absolutely how it is. Absolutely. And it’s made like that. That’s intentional. And nurses talk about it a lot, where we disconnect from our patients because that’s too much to identify with our patients, that’s too much to put on when we’re at work. We have to disconnect from their experience in order to do our job, continue to come back to work. 

I was told push past the stress. It’s a stressful job. You’ll just have to kind of push past that even during the job. It was never acknowledged. What we were experiencing as nurses was never acknowledged. We deal with life and death every single day. And we’re told, you know, disconnect from our patients. Don’t experience that with them. We are having our own babies right alongside our patients. And we’re absolutely experiencing their experiences with them. But we’re told, don’t put yourself in their position. Don’t think like what if that was you? You would make those decisions. You can’t think like that.That would be too much. That would be too hard. Don’t do that.

[00:08:12] Jennifer: So then the nervous system who’s experiencing the active birth is feeling that from y’all. And then in a way you’re actively cutting off that communication between the birther and the rest of the team in a way. So it’s like it’s this weird duality of ‘we’re here with you and also I am NOT at all here with you.’

[00:08:38] Mandy: Right. Exactly. There’s no support if we were to feel that. What would be the next step? What if I felt so deeply and thought about my own kids? What if I thought about my previous pregnancies? What if I thought about my previous mother’s pregnancies while I’m in a space with you, while you’re grieving yours? What would be the next step for me? That’s not safe because who’s going to hold me? Who’s going to support me? I don’t know how to do that. So we’re experts at disconnecting from ourselves and from our patients.

[00:09:16] Jennifer: I think most first responders and people in those situations, right? It’s just not doctors and nurses, it’s law enforcement, first responders, like all of that. There is that learned and taught disconnection from it. And yet at the same time, like that idea, like I was saying that duality of being connected. I want to hear  what drew you into NSI in relation to your profession?

[00:09:43] Mandy: I have been interested in trauma and how it plays out in the birth space since having my own baby. And someone told me that was a re-traumatization that I experienced. And I had not heard that before. 

[00:09:56] So I knew trauma was an important piece. There was a piece missing when I was learning about trauma and trying to teach nurses and wanting to bring nurses into this understanding of previous experiences affecting current experiences and traumatic responses. But a huge fear and a gap was- I can’t replace this really intense information with new practice if they stop listening. If it’s too much to hear that they could be contributing to harm, or the things that they’ve done in the past, the things that they’ve learned, could be harmful, I was afraid that I would lose nurses then. I was afraid that that would kind of cause what happened to me, which was kind of an identity crisis. I thought I was a nurse, I thought I was helping, and turns out I wasn’t always doing that. 

[00:10:55] When I was pinpointing pattern after pattern, that nurse behavior was also a trauma response to protect themselves and keep themselves safe in perceived threat in their environment, that was the ticket. That’s when I knew I needed some more information and education so that I can really lead this discussion and lead this training to help grow their capacity to change their practice.

[00:11:22] Elisabeth: I think that’s such a beautiful insight that you had- to know that people would have to work with their nervous system to have the capacity to face difficult insights into their identity, their profession, their life, and to have these really difficult conversations without going into complete overwhelm. If we’re going to create change in the system, we’ve also got to be helping people work with their nervous system to create the resilience and the capacity to bring that change into being for themselves and for their patients. 

[00:11:55] Then I want to touch back just a second on what you guys were talking about with the chosen dissociation and the detachment. I think one of the things about that is looking at it from a Neuro Somatic perspective and through the lens that we’ve been examining everything through this season. 

Our nervous systems are in constant communication. We are still taking all of that in, whether or not we choose to detach from the situation. It is its own response and it’s creating a reaction in the other person’s nervous system and it’s still creating a reaction in ours. Dissociation still has an impact on our nervous system, even if we think we’re doing it to protect ourselves.

[00:12:39] So the reality, the tough reality of that is you are experiencing the stress and the emotions and everything that is happening there. Whether or not we try to live in this framework of like ‘I’m not going to’, but at the level of our nervous system we are. So I think it’s really, really insightful on your part to know, I’ve got to find a way to help people work with their nervous system because they’re already stressed out and overwhelmed as nurses to have the capacity to start to see and acknowledge some of these things.

[00:13:15] Mandy: I was experimenting and identifying with nervous system communication before I had language for it. It was a really cool and unique place to do that within the birth space. Because it’s kind of like I didn’t have to ask anybody for a sort of  medical trial. I just went to work and then folks would come in with vulnerable experiences and they would be wide open in this vulnerable life transition, this identity shift. And I knew that we were responding to each other. I knew from my birth and I knew this from teaching childbirth education, that there are connections that are nonverbal that live in an unconscious level that affects childbirth. I knew that about childbirth. I knew nervous system interactions within childbirth. I knew I had a nervous system. So I played with co-regulation without knowing what I was doing without knowing co-regulation. But it worked. 

Folks would believe my nervous system. I was sensing that it could be safe to connect human to human. I was sensing that it could be a superpower to know birth and to trust birth and to know humans and to trust their innate ability to get through and to be with them in that because they weren’t coming back. Patients weren’t, either online or in person, coming back and asking me, ‘Oh, my birth was so terrible. I wish everyone solved all these problems.’ No, they were saying simple things like ‘I felt out of control and everything was happening around me and I didn’t know what it was and I felt alone.’

[00:15:01] Jennifer: It must be pretty wild, unless you’ve ever had a baby. I mean, even if you’ve been around childbirth, like you were saying, you don’t really know until you’re in it, until you’re doing it. 

I want to talk about, I really love when Elisabeth was just talking about the nervous system is always recording what’s happening and what’s going on. It’s still feeling the room. It’s still feeling all the sensations and the emotions in the room. We’re sort of laying out this very layered experience in birth trauma and pregnancy trauma. And then adding in the element of the other nervous systems, the professional nervous systems in the room, but the nervous system is recording. And I think in the recording, it’s also triggering your own traumas. So I want to hear about the triggering of your own traumas in your nervous system from the experience of either your own birth or also being in the room with a birth.

[00:15:57] Mandy: Yeah, it’s layered and gross and kind of like ever present when I think about it. The professionals have been in hospital birth often. So we’re going by now, this is just some of my personal experience, but I would be going by experiences that I’ve seen within a system that is based and founded on systems of oppression. And within the history of birth itself in the US it was kind of taken out of the community and put into the hospital for capitalism- money, power, right? So obstetricians were just developing their practice as obstetricians. And they were injecting a need for themselves and for their profession onto birth within the community. 

So there’s a generational history of harm within the story of birth in the U.S. that as the professional is now representing. Which I think is subconscious, but it is there. It is part of the paternalistic approach to childbirth within hospitals and needs to be actively dismantled if we don’t want to continue to practice in those ways.

[00:17:32] Elisabeth: Yeah, I was really excited for this conversation. I was really excited when you came into NSI and when we first connected and to know the good work that you’re doing of trying to bring trauma-informed care into the birth place. I had just finished reading, for the first time, The Myth of Normal by Gabor Mate. He spends quite a bit of time talking about how the system, very much like you said, is set up in ways that are not conducive to connection. You talk a lot about people feeling lonely in their birth experience, at a time where there is a lot of social support and co-regulation and connection to “herd”. And that a lot of the power has been taken away from women to make their own choices and to feel in control of their experience. And how all of this is a very stressful situation. 

Then that infant is coming out of a stressed body into a stressful situation. That it’s really one of the first layers that our nervous system can be really impacted during development as well as a traumatic experience for the mother. You’ve mentioned that there are many layers of trauma that can be present in the birth experience. And so I’d love for you to just touch on those a little bit.

[00:18:55] Mandy: Sure, so I do want to go back to the professional’s layers of trauma, but I think it would be easier. Yes, because these layers of trauma, created and present, I feel like they keep coming up and I definitely want to hear what you all think about this. 

So I have three main themes: one, birth can be inherently traumatic. Birth can be inherently overwhelming to the system. It doesn’t necessarily have to, it doesn’t mean that every birth memory stays a traumatic experience within the body, but it can be overwhelming and a lot to process and a need for process after the experience, right? It can feel threatening. It can feel scary for our body to go through emotions that we don’t have control over. We go through stages where our awareness changes which can be threatening and there’s no warning. There’s no, like your body doesn’t shut down into a mode where you really can’t drive and make conscious thoughtful decisions, you just kind of get there. 

Number two is re-traumatization. So the body can experience associations that feel similar to a previous traumatic experience, which activates that trauma response. It is on an unconscious level. We’re not thinking necessarily that this touch or this experience that’s coming from within ourselves could activate something that happened in the past when we were previously had loss of agency over our body, inability to stop a process, inability to seek safety, power differentials, not feeling seen or heard. They do not have to mimic, ‘Oh, this is like that time when I thought I felt like I was having a baby 15 years ago.’ They can be totally seemingly unrelated, except our body takes that pattern and is like same, same. We’re not safe suddenly, or just any inability to take effective action. 

Then the third is the people in the birth space can contribute to actual or perceived harm or threat, which can activate a nervous system reaction. This, I think, walks us into the next part of that question that you had, Jennifer, of the activations that are showing up from the professionals. They may show up dysregulated, not be able to see a whole human. Or they’re acting on their biases or their own safety seeking drive. The birther’s perspective reads that someone is unsafe based on their past experiences. The people in the space aren’t protecting the birthers control safety, security, or they break trust, which can impact how they perceive safety in that space and then abandonment. The professionals are going through their own situations. They may be in denial that they’re experiencing this with you, disconnected like we talked about, disassociated.

[00:21:39] There’s a lot of social factors and hierarchy within obstetric, perinatal health care that have a lot of play into how someone responds, or they’re afraid of someone else’s reaction. Or there’s drivers like policy and leadership that are totally disconnected from what bedside care is and what patient centered care is. So nurses and the professionals in the space have to answer to a lot of other red tape. 

So that perceived abandonment can come from the folks that are truly not able to center and see the human in front of them or hold space for them, even though they’re physically a ton of people in the room. No one is centering the birther, which can create that felt sense of distrust or unsafety. And look like and feel like later in the processing physical or emotional neglect or mistreatment. Or in addition, actual physical or emotional mistreatment would be coercion, physical mistreatment- doing things without consent, manipulation, things like that. Those are also very common.

[00:22:49] Jennifer: To speak to the very last thing that you said, I think wraps back to the oppressive system that is the control of women’s bodies. The making money of it and the disconnecting. It’s giving the power away to somebody else instead of the woman having the power in her body. And the knowing that she can trust what’s happening for her in her body, the actual birthing canal. That really could bring up some repressed trauma for a lady because it’s the pelvic floor. Like you said, we live in a, the community at large has sexual trauma, or some sort of, I would imagine that the birthing experience could be an emotional flashback in the body at the same time as the experience. That’s got to add to the layer of fear and the emotional component to the woman giving birth.

[00:23:51] I’m glad you spoke to some of the emotional stuff as well. We often say, even though in this season, we are talking about the collective nervous system, we also talk about N = 1. Each person in front of us is a new experience, it’s a different nervous system than the other one. But in a place like a hospital, you are not treated like N =1. You’re just treated like ‘the herd’. So the abandonment and the neglect that could get triggered for a person in a birthing situation, I would imagine could get really high. I can see now really. Thank you for all of what you just said because I can really start seeing the layers starting to add on.

[00:24:29] Mandy: I left the bedside in January 2020 and felt like one more thing was gonna put me over the edge. I was not discharging the stress well. There were cycles of abuse going on, cycles of not safe relationships going on, and a lot of different varying levels. And I left the bedside in order to do education work and more meaningful work.

[00:24:55] Jennifer: If you are a coach, a therapist, or a practitioner, and you’re looking to find a new way to bring the body and nervous system into your work, but you’re not looking to spend years learning a somatic process that really isn’t your passion. If you’re looking for a practical, actionable framework to bring into your coaching model that brings a Neuro Somatic component to everything that you’re already doing, then Neuro Somatic Intelligence Certification is for you. We’re enrolling now and the link is in the show notes.

[00:25:22] Elisabeth: So you mentioned January 2020 is when you left and started this business of trying to help the birth nurses themselves find ways to cultivate more resilience and become more trauma informed and to have an educational platform for nurses. I think that that’s so important because we talk a lot in here too about- it starts with us first. So when people come to me and ask what can I do for my kids to help them be more regulated or to help their nervous system? I always say, the first best thing to do is to start with yourself to become a safer container, a safer place for them to do emotional processing and to co regulate with.

[00:26:06] So I feel like to bring about a lot of change into this big machine, this big process that is the birthing process here in the United States. Helping the nurses themselves to have better skills for regulation so that they can go into those experiences- one, to be able to have the conversations like you were talking about, but also then to go into the experiences able to connect, able to be Present, able to discharge the stress and not be burned out and to be a safer nervous system for people going through the experience to be in contact with is, is so critical. How have you started to weave some of the Neuro Somatic tools into the work that you’re doing for yourself and with nurses?

[00:26:50] Mandy: Sure, we start slow. So, I’m starting slow. And as you always say, minimum effective dose in all the ways. So, starting with the neurology of trauma, fostering a nervous system self care practice, within the framework of my programs, because it’s all related. But, you’re right, I went into NSI certification wanting for others. Every time I tried to move faster than I could, I was met with- what if you just did the work for yourself? What would happen? What if you just did the exercises? What would happen? Could that be your minimum effective dose? And I’m surprised that I don’t have an urgency to push so fast and like hurry hurry hurry and get this into the hands of everyone. I felt like I would want to do that and that’s usually my mode, but I need to. 

[00::27:44] I am clear and transparent when I’m in a room of nurses. I’m transparent that I am working to regulate my nervous system and worked ahead of time and will afterward in order to show up and be Present with them. And I want them to feel that. Because what we’re great at in healthcare is just telling people to trust us. ‘Oh, you can trust me. I’m a nurse.’ And then they see the stats of how many people die in childbirth in the US. and they’re like this doesn’t math.  

[00:28:20] I literally can’t just trust you and we can’t take that out of their experience. We can’t disconnect the numbers and the reality of what’s going on in birth in the U.S. from who we represent, from our scrubs, from our status. So I do the same with nurses. I try to really just tell them this is what I do to be Present for you and I hope that you’re Present in this space so this is what we can do. We work on a few simple drills together. This is what we can do because: one, I want them to feel safe in the room. And there’s no other way that I know how to do that except prove it to them. So, getting their nervous system regulated is another best way to do that. And I want them to make change.

[00:28:59] I want them to implement what they’re learning. The selfish, I want this to work. The information that they have, I want them to be able to put into practice and have the capacity for. And post COVID, no one has the capacity to learn new things. Let alone buck a system that has been doing the same things since the beginning of obstetrics in hospitals. And nurses know that, it’s not safe for them. While we do prioritize patient safety above all, we are responding at the level of our nervous system as well as we can, like you always say.

[00:29:38] And we’re responding to seek safety within ourselves. So biases, we’re working within and around biases. We have physical memories of experiences that we’ve had, seen, or heard about within the birth space that are going to look like our patient’s experiences. So we are kind of compensating for that all the time. My goal was for nurses to increase their capacity just to learn more information. And because I think that they have a unique and profound impact on birth outcomes and birth culture, and I can’t give them more information without them having a place to put it, and having the capacity to use it and change. 

[00:30:21] So, that’s the priority and why I don’t work with parents as much, and why I don’t teach childbirth education right now is because it’s impossible. It was impossible for my brain to prioritize both. Even though that’s what we’re trying to do. Instead take the angle of- what if we prioritize nurses, allow them to practice a felt sense of safety, what would happen? So that’s the level that we’re at, the foundation.

[00:30:45] Jennifer: That is so beautiful. It’s a really beautiful offering and service really to the greater good. And I feel, like you said, prioritizing both of course, the energy being put into the nurses and making sure that they’re supported is going to support the other nervous systems in the room on top of their own. And I would imagine you’ve seen some pretty traumatic moments and been with maybe with the potentiality of women losing their lives. Or the babies losing their lives. There’s just no way, I don’t think as dissociated as you think you might be. Like we were talking about earlier, you can’t separate that from your nervous system. At some point, you’re gonna feel that experience in your body, probably reflect on it later, live the experience all over again, have the thought loops around it. There’s a lot of energy that probably gets used in your own nervous system after you walk out of an experience like that- any birthing experience. 

[00:31:43] Mandy: Yeah, for sure. Nurses are so fucked up. They’re not getting the psych care that they need, because they can’t put their pain on somebody else. We’re bottom of the basement, not even really ready to even let go of that. I hear a lot of nurses say, I’ could never tell someone what I’ve seen.’ And so talk therapy when we’re like, yeah, get a therapist and work it out. I mean, if you have years and years and years and you’re not afraid to hurt somebody with your stories, because we then have to grapple with how do we know ourselves and love ourselves and have compassion for ourselves when we have been used by the healthcare system to perpetuate violence. 

And when we learn about obstetric violence and we learn about coercion. That’s what I was so afraid of- is I’m teaching nurses that they’re part of a bigger problem and all we can see as nurses are barriers to changing the problem. Because we’re part of cycles of abuse, and we’re part of the systemic oppression, and we’re part of all of this. There’s gotta be a way where we can understand our locus of control, and have some, take some responsibility for it, have some accountability for that without losing ourselves in the process, having self compassion about that. I talked to Elisabeth before the program, and I was like, I have to be assured that I can safely incorporate this with nurses because they are still being hurt and witnessing violence all the time.

[00:33:27] Elisabeth: Yeah, I’m so honored to know you and to be a part of your bringing this work into this world. We’ve talked on here in several episodes, and we talk about it in the course too, that these nervous system tools are not here to help us regulate around maintaining a system that is oppressive and unjust and harmful to especially certain portions of the population. I don’t ever want to advocate for people regulating to be able to sustain a fucked up system. 

But what we do want is to be able to help the people who are in the trenches and who are being affected by the harm that this system does to be able to have agency and an understanding of their own nervous system and to give them the tools for regulation and for resilience so that they don’t have to incur the consequences of living in that stress day in day out. So that they don’t get sick. So that they aren’t having to take all of this stress and all of this harm that society is like, ‘here, you take it.’ and continue with this. Then they suffer the health consequences. If we can give them the tools then hopefully we can mitigate some of that damage. Then all have the resilience to change the system to deconstruct it. Dismantle it.

[00:35:01] Mandy: Yeah, absolutely. Absolutely. I’m seeing it in ways that I’m not teaching about yet, but I know you all see it and hear about it all the time. What if I just work on myself? Because while I’m not teaching nurses how to heal somebody’s trauma. We’re not treating trauma, we’re not doing that. I think there’s some confusion in health care spaces, mental health is far ahead of medical health care and even The police force is well ahead of medical health care. So there’s still some misunderstanding. Are we working with people who just have trauma? Do we need disclosure? There’s still a lot of that. 

And I see nurses as in this prime spot to meet individuals where they are- whether they’re bringing their trauma, whether they experience trauma, whether their nervous system is activated, they’re in a vulnerable space no matter what that pattern is that shows up. That we meet them with radical acceptance, compassion, trust, and support. And then new pathways can be formed in their life. They’re in this identity transition into parenthood or into the next phase of their life as a person who’s given birth. They can change their reality in that way. They will have witnessed it, seen it, and experienced it in such a transformative time. They can choose a different response at that time and decide to kind of buck their own system.bIt doesn’t have to be like that. I can scream and yell and be safe or whatever it looks like for them. And exist in safety and experience that safety. Then teach the next generation to seek that safety and experience that safety. And what feeling seen can feel like even during that scary sensation or that big experience. 

[00:36:57] I’m seeing it for myself show up in parenting. I’m seeing it show up in relationships that I’m in. I’m able to have an elevated perspective and be more Present in ways that are important to me- that don’t have anything to do with my job. Just because I have a nervous system and it’s everywhere. It’s always with me. So I’m grateful for that, and I feel like I can also grow the capacity to do the work and talk about this with nurses and be with them during their processing of, ‘Oh my gosh, I have to accept myself and soothe the parts of me that weren’t seeing patients for their whole selves and were participating in the harm’. And I can have the capacity to continue to do that and parent and be a whole person and navigate.

[00:37:55] Elisabeth: I find it really fascinating. I think I knew this, but it’s a little bit upsetting to hear that the medical profession, the medical system, is behind even the police force on understanding the role of trauma in people’s behavior and in their work with other people. And really even being able to start to distinguish between being trauma-informed does not mean we’re working with people on their trauma. It just means understanding everything through the lens of how trauma affects the nervous system and being aware of it so that I can provide the best care possible with people. I just think that was an interesting thing.

[00:38:32] Jennifer: I just don’t think you can have understanding in an oppressive system. The system is set up in such a way so that it doesn’t have to understand you. I mean, we’re talking about the ownership of women’s bodies once again. I can’t even imagine how other demographics are experiencing childbirth. What’s it like for a black woman in a lower socioeconomic situation to go in and have birth? I can’t even imagine how dangerous that is and how fucking scary it is, honestly. To hear about the violence that’s perpetuated in childbirth is really sad. It’s really sad. I hope the whole fucking system bucks, honestly.

[00:39:11] Mandy: Yeah, and also, we hold nurses accountable. We hold nurses accountable for the number one biggest employee within the healthcare system. My goal is that every nurse hears this. We have 350,000 perinatal nurses on the list to learn trauma informed care within this space. This is completely layered, nuanced, gender violence, obstetric violence, hierarchy, all of that. Once we know, we can’t unknow. We have to hold ourselves accountable also, that we are in a position of power, and our positionality is unique and ready to help dismantle and decolonize the way that we’re doing health care. And yes, it is for profit. And yes, it is a business. But we help support that business for being productive and being successful. It’s not going to look like we have a coup on health care. It’s going to be disjointed, and it’s not going to be linear, and it’s messy as it already is. 

[00:40:10] But you’re right, it is an inherently traumatic experience to be pregnant in a black body- just for that. So we’re not even at that point preventing. How are we even preventing birth trauma and something like that when it’s actually life or death and it’s actually so much scarier and so much worse than that. They’re working on surviving. So we as nurses have to learn this information and put it into practice so that we can stay at the bedside and continue to do the work if that’s what we choose to do, but see it for what it is and take responsibility for our positionality in that. And that’s also the push toward, ‘okay, let’s regulate our nervous systems. Let’s do this because it can’t be worse than what we’ve already been doing.’

[00:39:59] Elisabeth: I feel like we could have this conversation for hours. There’s so much more that I wanted to get into and talk about today, so we may have to do a part two to keep going down this path because there are many types of trauma that I want to explore in this space. I just hope if you are a nurse and a practitioner, please get a hold of Many at the Birth Nurse. 

[00:41:24] Jennifer: Thank you so much, Mandy. It was so nice to be here with you today and thank you for speaking so vulnerably and honestly about the changes, about what’s really happening. I think that is really brave.

[00:41:37] Mandy Thank you. Thank you for being open. It’s kind of a heavy conversation. But, yes, it’s important. Thank you for having me. 

[00:41:44] Elisabeth: Thank you. So important.

[00:41:45] Jennifer: Bye, ladies. 

S3 E18

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