What Does Crisis Intervention Have to Do with Birth Work?
Doula work is interpersonal work. At BADT, this means that we center relationships, communication, and accessibility– both at the individual and collective levels. Furthermore, we are committed to honoring the complexities of being human, which means acknowledging that humans experience times of unwellness, crisis, and disability.
If we fail to address this and work towards whole-person support, we are contributing to ableism. In this blog, we will address some of the key ideas Stefanie Kaufman-Mthimkhulu from Project LETS shares in our live Crisis Response for Birth Workers course.
“This workshop was a great way for me to integrate what I've learned about abolition so far with the things I've learned in my full-spectrum doula training. We spent time learning about the context of the issue of carcerality in birthing spaces as it relates to mental illness, altered states, and other neurodiversities and differences. Stephanie and Nadia both provided such valuable information!" -Crisis Response for Birth Workers participant
Defining Safety
Birth Workers hold space for clients to name what they’re experiencing- their joys, fears, anticipations, hopes, wishes, needs, and so on. As we walk alongside clients who are navigating reproductive experiences (from abortion, to birth, to postpartum, to considering parenthood), we invite them to consider what safety means for them.
While dominant culture and the dictionary may have a narrow definition of safety, we know that real safety exists in the context of culturally respectful, mutually responsible, trusting relationships. This means: no judgments, assumptions, or agendas. It means meeting our clients where they are and staying open to learning their unique and complex relationship to safety. Additionally, this means acknowledging that one’s definition of safety is not static; it may be context-dependent or changing over time.
As birth workers, it is imperative that we invite clients to consider the things that make them feel safe, as well as check in with experiences that make them feel unsafe. This is not done through one singular conversation; rather, it comes through the process of building trust and rapport together.
This also means that if or when a client shares that they are feeling unsafe, rather than jumping to problem-solving (a typical fear-based response), it is beneficial to slow things down and ask questions from a place of curiosity. Open-ended questions, when asked with care and in the context of a trusting relationship, can invite your client to self-reflect and get in touch with what they want and need. Each person is the expert of their own bodymind, and as birth workers, we need to hold this at the centre of our work.
Safety Planning
Whether our client’s have disclosed a history of trauma, crisis, mental illness, or disability, it is important to invite clients to consider crisis and safety planning. Reproductive experiences can be significant moments of transition and heightened emotion, and folks may experience emotional or mental states that are unfamiliar to them.
Offering crisis and safety planning might mean simply planting the seeds and sharing resources, but this also might mean walking through the planning process with your client. You and your client will determine this together.
Questions to consider in crisis and safety planning include:
Are there any guidelines or limits? (ex: don’t reach out to my parents)
What does a crisis look like for you? (There may be different stages/states to describe.)
What do you need during a crisis? What helps you? What should others suggest/offer?
What is the timeline for taking action?
What is the worst case scenario and what do you want in that case?
We believe in normalizing the fact that people can and do experience states of unwellness or crisis. Addressing crisis planning is a powerful way to hold space for others to consider their needs.
Deescalation Techniques
If or when a client is experiencing a crisis, de-escalation should come from a place of empathy and patience. If we decide to engage in this process with our client, we need to be willing to collaborate with them, not just tell them what to do.
These are some of the basic the principles of de-escalation we practice:
Focus on helping them access physical and emotional safety. Remember: everyone’s definition of safety is different, and it may be dynamic or changing.
Ask them what they need from you to be able to trust your help. Again, rapport and relationship are key!
Work with them to help them get what they need. Refrain from telling them what they should be doing.
Keep their voice and choice centred in your interactions. Continue to check in with them by asking things like: “Can you tell me what you need?” or “What usually helps you when you feel like this?” or “Here are some resources we can connect with, what feels best for you?"
Consider power dynamics around historical oppression. This includes the consideration of identities such as race, ethnicity, gender, economic access, and/or past experiences of trauma. (Lead teacher, JB’s blog on social location is a helpful starting point for acknowledging power dynamics.)
Note: Just as we are not always the best fit as a doula for every client, we may not be the best fit for the crisis. Consider whether there is someone else that may be able to better respond based on shared identity and experiences.
Join Us in Learning and Unlearning
BADT is committed to harm reduction and will continue offering Crisis Response for Birth Workers twice annually. We will dive deeper into the conversations above and expand on other facets of crisis response including harm reduction, frameworks for approaching crises, the politicization of suicide/suicidal ideation, de-escalation do’s and don’ts, and more.
It is our hope that this work reaches as many birth workers and consequently birthing people as possible. Learn more and sign up here!
"This workshop was encouraging and enlightening. Many highlights i could share and overall the honest transparency and autonomy of the presenters was affirming and encouraging in every way. The institution of white supremacy was created to dehumanize and to create every system to do just that. Crisis Response workshop showed another path of navigation and whole approaches to exit and dismantle the fuckery going on. Innate in our human existence we are born with empathy but the institutions want to destroy that in the womb. They have set up that shame is innate and empathy is learned which is backwards. This class was clearly affirming to stand in the true innate empathy and let them keep their shame, their dehumanized ways! Empathy is our birthright and crisis response starts from there. This class was amazing and appreciated by all who attended! ‘The master’s tools will never dismantle the masters house!’" -Crisis Response for Birth Workers participant