Introduction: The Adverse Childhood Experiences Study (1998) launched the importance of trauma and trauma informed care in our health and educational systems.  We suddenly had a measure of how early experiences in childhood could correlate with adult disease. Further studies have explored specific programs to help improve the conditions leading to adverse experiences, especially in education and community based programs. To date, there has not been an effort to improve birth outcomes on a wide scale using a trauma informed approach. Integrating a trauma sensitive approach to perinatal care lays the foundation for health and connection at a pivotal time human development and can truly help us get the best possible start in life. 

Rebecca Thompson Hitt, author of Consciously Parenting, Creating Connection, and Nurturing Connection, Executive Director of the Consciously Parenting Project, .

The Impact of Transgenerational influences and Race on Perinatal Outcomes

for Black Women living in the United States

Maryl Smith, CPM, midwife of 35 years

More than half of those who have been traumatized will not disclose at intake.  The reality is your new client has not yet decided if you are trustworthy.  Further barriers to disclosure may include their belief about what the trauma means about themselves, their current safety status, stoic minimization or even limited trauma recall.  Your ability to create safe opportunities for disclosure and to read between the behavioral lines can make all the difference in whether your care  is designed to heal or if it will re-traumatize.  You will learn how to create safe opportunities that encourage disclosure and explore how to offer trauma-informed care even when there is no disclosure.

The Impacts of Past Trauma on Experience and Outcomes During the Preconception,

Prenatal  and Early Parenting Periods: The Critical Importance of Trauma Informed Care 

This presentation will provide recent knowledge and research that will deepen participants’ understanding of the crucial importance of providing trauma informed care and education to parents-to-be who hold the imprints of traumatic experiences that occurred over the course of their lives, from their own conception to the present. The positive impacts of providing trauma sensitive care to mothers-to-be and their developing prenates are supported by recent research that demonstrates how maternal psychophysiological states during pregnancy impact the health, development and behavior of offspring over their life span. Recognition of the varied ways traumatic stress is exhibited in trauma survivors allows practitioners to  adapt the care they provide whether or not they are aware of these individuals’ past experiences. Recent guidelines for trauma sensitive practice created by trauma therapists can increase practitioners’ recognition of defense system activation in their clients/patients and themselves and educate them in ways they can support the reduction of defense system activation in the present moment. Incorporating trauma sensitive practice into preconception, prenatal and early postnatal care will benefit parents-to-be and their developing babies.  

April 1, 2019:  Integrating Trauma Informed Practice into Midwifery and Creating Resilience

Trauma Informed Care from the Baby's Perspective: 

​A New Model of Care to Help Families Thrive

Ann Diamond Weinstein, PhD author of Prenatal Development and Parent’s Lived Experiences,

Gender & Conception, Pregnancy, Birth and Postpartum

One out of every five women has a history of childhood maltreatment. Many survivors of such maltreatment go on to become mothers. Many survivors are quite resilient to the trauma and adversity they have experienced, but some women develop mental health challenges like depression and posttraumatic stress.  Several studies have outlined the effects of these challenges on the lives of ‘survivor moms’ and their children, and demonstrate that there are a number of possible serious adverse outcomes that include risk for intergenerational transmission of abuse and psychiatric vulnerability. Increasing our understanding of the lived experiences of survivor moms can help us to design systems of care and interventions that are sensitive and responsive to their identified needs and desires for care. In this session we will explore excerpts of narrative accounts of the lived experiences of survivor moms as reported in the literature historically and presently, and stories of caring for survivors as experienced by the presenter.  

According to a recent poll, 50% of 18-34 year olds believe gender is a spectrum. As collectively we move towards expressions of greater fluidity and expansiveness of gender, it is essential for perinatal practitioners to understand how to work with trans, non-binary and gender non-conforming clients. As practitioners, our work begins with thinking about and exploring our own experiences of gender, and then from there, deepening into ways of working with our clients. Together we will discuss: gender inclusive language; why and basic how to conception: there are many ways to make a family; pregnancy and gender identity/expression; dynamics of birth; postpartum: bonding and attachment, breast/chestfeeding, family gender culture.

March 18, 2019:  Perinatal Trauma Informed Practices for Women who have Experienced Trauma

Let's Stop Re-traumatizing the Traumatized!

Providing Perinatal Safety The JJ WayⓇ

For each date: 
First Presentation: 
4 pm PDT, 7 pm EDT  Second Presentation, 5:30 PDT 8:30 pm EDT​​ 

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Perinatal Trauma Informed Practices for Women who have Experienced Trauma:

How Listening to Women Can Help Us Create Effective Interventions for Those in Need 

Jennie Birkholz, Principal of Breakwater Light, LLC, Trauma informed educator,

Health Clarke, CNM, Midwife and midwifery professor at Frontier University

The Trauma Informed Care movement in health is now widespread, ranging from pediatrics to adult care and organizational development to school curriculum.  This presentation will take the trauma informed care model into the prenatal period, and introduce competencies for practitioners and practices for parents to support the baby’s experience.  Five basic areas regarding the prenatal and perinatal period will be presented: preparation using nine positive aspects of relating to babies in utero; reparation of previous difficulty in the family, conception or birth, differentiating and communicating with baby; support for parenting to understand the baby’s story and heal their overwhelming experiences; promotion of peaceful communication, pacing, tempo and connection for the whole family; and establishment of layers of support for mother, partner, birthing and postpartum team.  Trauma informed care during the prenatal period that incorporates the baby’s experience is the missing piece in the healthcare puzzle.  This presentation lays the groundwork to complete the picture.

March 25, 2019:  Trauma and Attachment and Trauma Informed Practices from the Baby's Perspective

Mickey Sperlich, author of Survivor Moms: Women's Stories of Birthing, Mothering and Healing after Sexual Abuse

From Trauma to Resilience: Navigating Cultural Change

Elsa Asher, MA, practitioner and specialist in LGBTQ perspectives

A key aspect of trauma-informed service provision is to create environments where recipients of services do not experience further traumatization or re-traumatization.  Re-traumatization may occur in situations that reflect previous experiences of powerlessness and loss of control. Trauma-informed programs are also guided by the four ‘R’s.  In this one hour presentation, Jennie Joseph will illustrate how The JJ Way® IS a trauma informed practice for midwifery, showing direct maternity practices for how it REALIZES the widespread impact of trauma and understands potential paths for recovery, RECOGNIZES the signs and symptoms of trauma in clients, families, staff, and others involved with the system, RESPONDS by fully integrating knowledge about trauma into policies and procedures, and practices, and seeks to actively RESIST RE-TRAUMATIZATION  

March 4, 2019:  Introduction to Trauma Informed Care and Trauma Sensitive Perinatal Intake

March 11, 2019:  Perinatal Trauma Informed Practices for Marginalized Populations, especially Women of Color and LGBTQ Families

Despite the strong consensus that racism is the underlying factor responsible for race-related maternal-child health disparities in the United States, there exists a lack of awareness about the negative impacts of transgenerational and epigenetic influences on perinatal health outcomes. This is especially true to Blacks living in America. Lessons learned from Dr. Christine Monk and others demonstrate that trauma during the perinatal period can result in alternations in gene expression and behaviors at least four generations. forward. The implications for screening and delivery of perinatal care to improve race related perinatal disparities are significant. Providers who care for Blacks must obtain a transgenerational history to gain insight into the inherent health risks to the mother and unborn child. This presentation will present a detailed discussion about transgenerational trauma resulting from racism and its  association with perinatal trauma among Blacks living in the US. In addition, participants will learn how the experience of transgenerational trauma for Blacks may vary depending on whether their recent family origins are from Africa, the Caribbean or the USA. In addition, recommendations for screening, and building resiliency using ritual and healing traditions are explored

Becoming trauma-informed cannot be achieved through the energy of compliance; it takes a traumainformed approach to initiate and successfully navigate trauma-informed change on the interpersonal and systems levels. This presentation explores the importance of assessing and fostering change readiness, building stakeholder resilience, and embodiment of trauma-informed principles. While simultaneously integrating the motivational interviewing approach and lessons from implementation science, Nkem Ndefo brings her personal cross-sector experience developing guidelines, training professionals and community members, and facilitating organizational trauma-informed change. Participants will gain a functional framework with practical implementation resources and skills to begin their own trauma-informed journey. •

Our Perinatal Trauma Informed Practice Panel

The Art of Trauma Sensitive Intake in the Midwivery Model of Care