What Is Moral Injuries?

In this episode, Kimberly and Kathleen discuss connections between birth, trauma, and breastfeeding. As a researcher and writer on these subjects, Kathleen describes much of her research that centers around birth-related trauma, how trauma affects breastfeeding, as well as secondary trauma experienced by providers and birth workers. They discuss the importance of oxytocin as an antidote to stress, particularly during the early postpartum period. In addition, they discuss how many mothers, care providers, and birth workers experience secondary trauma within labor and delivery units and the importance of more substantial support and postpartum care for mothers.

Bio

Dr. Kendall-Tackett is a health psychologist and International Board Certified Lactation Consultant, and the Owner and Editor-in-Chief of Praeclarus Press, a small press specializing in women's health. Dr. Kendall-Tackett is Editor-in-Chief of the journal, Psychological Trauma and was Founding Editor-in-Chief of Clinical Lactation. She is Fellow of the American Psychological Association in Health and Trauma Psychology, Past President of the APA Division of Trauma Psychology, and the chair-elect of APA's Publications and Communications Board. Dr. Kendall-Tackett specializes in women's-health research including breastfeeding, depression, trauma, and health psychology, and has won many awards for her work including the 2019 President's Award for Outstanding Contributions to the Field of Trauma Psychology from the American Psychological Association. Dr. Kendall-Tackett has authored more than 470 articles or chapters and is author or editor of 40 books.

What She Shares:

--Breastfeeding after trauma

--Need for more adequate breastfeeding and postpartum care and support

--Increasing oxytocin amidst stress and trauma

--Mothers' mental health

--Secondary trauma experienced by providers and professionals

--Plans and hope for future generations in birth, postpartum, and breastfeeding support

What You'll Hear:

--Connections between trauma and breastfeeding

--Birth trauma impacts two key hormones in breastfeeding

--Important to honor mother's wishes around breastfeeding

--Seeing trauma as opportunity for extra breastfeeding support instead of limiting it

--Being careful not to put negative expectations on breastfeeding after trauma

--In 80s started identifying birth trauma as factor of postpartum depression

--Trauma and context when identifying women's mental health

--Uptick in preterm births related to anxiety, stress, and depression

--Fish oil/DHA in reducing risk of preterm birth

--Three part stress system: Hypothalamus, Pituitary, Adrenal glands

--Inflammatory response system also connected to mental health and preterm birth

--Oxytocin as a stress fighter which is why breastfeeding is beneficial for mother

--Supporting women's decisions and goals for breastfeeding

--Tending to our bodies to feel hormonal surges and differences of baby/partner touch

--Understaffed lactation consultants in hospital causing lack of support

--Study shows epidurals related to lower rates of exclusively breastfeeding

--Study of epidurals related to more depression despite other common factors

--Postpartum hemorrhage, postpartum surgery, and epidurals all linked to postpartum depression

--Needs to be competency checking in with women postpartum much earlier around breastfeeding and mental health

--Lack of adequate pelvic floor health

--Secondary trauma happens to providers when witnessing trauma

--Secondary trauma vs. professional burn-out

--Obstetricians and nurse midwives secondary trauma almost always associated with baby

--Labor and Delivery nurses note when providers do something or cause unnecessary harm to mothers and babies

--"Moral injury" occurs when forced to participate or witnessed something you knew what wrong

--"Acts of omission" (failing to stop harm) causing secondary trauma with birth practitioners

--Nurses and doulas reporting witnessing harm done they wish they stopped but couldn't

--25-35% rates of secondary trauma in providers in US compared to other countries

--Sanctuary trauma and institutional betrayal trauma to victims of trauma

--Getting used to low-level, chronic stress and effects postpartum

--Oxytocin to repair trauma

--Oxytocin builders: touching a pet, infant massage, skin to skin on chest, being warm, warm bath, wanted touch, positive social interaction, etc.

--Bigger goal of breastfeeding is connecting mother with baby

--Importance of supporting mental health of providers

--Care-providers knowing where they're vulnerable to avoid secondary trauma

--Positive ways to turn off hyper-active stress responses (omega 3s, exercise, cognitive therapy and mindfulness)

--Hope for moving forward in repairing traumas and systems and reclamation of birth and postpartum

--Early intervention as hope against spiraling from trauma and mental illness

Resources

Website: https://www.kathleenkendall-tackett.com/

Book: https://stores.praeclaruspress.com/breastfeeding-doesnt-need-to-suck-how-to-nurture-your-baby-and-your-mental-health-by-kathleen-kendall-tackett/?showHidden=true