Ep. 19 - Clinicians & Preventable Birth Trauma | OB Insider Dr. Tracey Vogel [Mother May I Series]

During pregnancy and birth, trauma can happen. Dr. Tracey Vogel, an OB anesthesiologist from Pittsburgh, Pennsylvania talks to us about the stories of such traumas–especially those related to anesthesia and surgery–that she will be featuring in her upcoming book, and how the medical community can help prevent further birth trauma.

“There is a big gap between how providers think they are doing, and how patients think those providers are doing.”

There are many problems with how maternal care providers deal with their clients. First, they aren’t asking the right questions. The focus is almost exclusively on the physical; there is little to no addressing of the emotional or mental wellbeing of the patient. If they do ask the right questions, however, they aren’t considering that not all mothers want to tell you about their feelings, especially if they see you as responsible for their terrible experience. Care providers carry on thinking they are doing a good job. Meanwhile, women are traumatized.

“Women end up with PTSD after what should be a positive event.”

Conversations about trauma and wellbeing should happen before anyone ever gets to the operating room. Be clear beforehand about views, wishes, and expectations, and talk about contingency plans. Instead of telling the patient how things will be done, there needs to be a shift to inquiry. In order to do that, the medical establishment needs to learn new skills – how to listen and how to plan collaboratively. Being open to feedback isn’t enough; there is a need for proactively seeking feedback, really listening, and being willing to dig a little deeper. So many people are so unaware that they have trauma, or that childbirth, under care, can be retriggering of that trauma.

“One size fits no one.”

All of the protocols that we are adopting aren’t for everyone. Birthing needs to be a tailored experience. It’s hard to go through all of this training and find out we need to start again with new skills, but we do.

Advice to other clinicians:
– Get some education and learn listening skills.
– Beware of the phrase “at least.”
– Be careful with your words, even “congratulations.” Let patients put their own words to their experience.