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How can I support pregnant survivors accessing services?

Tuesday, July 01, 2014

Pregnant WomanSince releasing the TA Guidance, Birth Doulas and Shelter Advocates: Creating Partnerships and Building Capacity [21 p], and hosting a webinar on Trauma-Informed Birth Support for Survivors of Abuse [1 hr 24 min], the NRCDV has received several TA questions about how advocates can support pregnant survivors accessing domestic violence related services. One of the NRCDV staff moonlights as a birth doula, or childbirth/labor companion, and she offers the following advice:

Knowing what I know now as a birth worker, I realize that I truly had no idea how to support pregnant survivors in shelter. At the time, I thought knowing a survivor’s general plan of what she wanted staff to do if she went into labor while in shelter was enough. Typically the plan consisted of her care provider’s phone number, instructions to call a taxi or the ambulance to transport her to the hospital, and her emergency contact to let someone who cared about her know that she was on her way to have the baby—that was it. Nothing significant or meaningful, just get her to the hospital to have the baby and hold her bed until she comes back.

Now, since growing my career to include becoming a birth doula, I know that there are many ways advocates can help improve birth related outcomes for pregnant survivors accessing services. The expectation is not that all advocates become birth workers, but the goal should be to become better informed about where and how to guide pregnant survivors to the healthcare resources they need to feel respected, heard, and treated with dignity as they bring new life into this world. All birth is about transition and this can be a very powerful time for pregnant survivors to experience a positive, healing transition into motherhood.

First, caring advocates can engage women in meaningful conversations about their experience with birth—it’s definitely not like what’s depicted on movies and TV. During these conversations advocates should listen openly, withhold judgment, and help direct survivors to credible, useful information to explore their labor and delivery options. This can be an important time to help survivors find their voice and maintain control over their own bodies, birth, and baby. The following books can help survivors and advocates learn about labor, childbirth, breastfeeding, and newborn care.

  • The Birth Partner: A Complete Guide to Childbirth for Dads, Doulas, and All Other Labor Companions by Penny Simkin
  • Pregnancy, Childbirth, and the Newborn by Penny Simkin, Janet Whalley, and Ann Keppler
  • Gentle Birth Choices by Barbara Harper and Suzanne Arms
  • Cut, Stapled, & Mended by Roanna Rosewood


Second, we can promote and expose survivors to positive birth stories. Envisioning a happy, calm, peaceful birth is important to help women mentally and emotionally prepare for birth. During pregnancy, many will want to talk with pregnant women about their own experience and offer unsolicited advice—usually about a terrible or devastating thing that happened to them in labor. Not only does this instill fear of birth and heighten any anxiety that a pregnant woman may have, but it also may not even be relevant to their situation. Encourage pregnant survivors to read stories of amazing births—those that left women feeling empowered and satisfied with the process, their birthing team, and the decisions that were made. A few great resources are below.

Third, make time to help survivors draft a birth plan (see examples below). Talking with survivors about their detailed birth plan doesn’t mean that advocates act as medical or healthcare professionals; rather they can help women think through their choices, learn about possible interventions, identify questions or areas where they need more information, and practice how they will talk with their provider about their needs and desires. Many women will revisit their birth plan a few times before making final decisions and feeling confident in those decisions. Share the links below with pregnant survivors so they can choose a style that works best for them and begin working on their plan as soon as possible to have time for all their questions to be addressed by their provider.

Last, we know that many survivors may also experience sexual violence, either within the context of domestic violence or from a prior experience apart from the relationship that bought them in for services. Penny Simkin is a pioneer in creating support tools for birthing survivors of sexual violence—watch this short video [6 min] of her speaking on this issue. More resources are listed below that can assist survivors in thinking about ways in which their experience with abuse, rape, molestation, or other forms of sexual violence may create anxiety when laboring, and how to plan to calm those fears.

We’d like to hear from you! What are your experiences supporting pregnant survivors in shelter, on the crisis line, in support group, or other services? Are there resources that you’ve accessed in your community to help pregnant survivors?