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Moral Injury and Consequences of Maternity Care Advocacy for Nurses with Melissa Anne Dubois

We are hosting a FREE training on Trauma and the Perinatal Journey on Dec 2 at 9am EST live on Zoom. The training will be recorded so he hope you will still sign up even if the time does not work for you: https://resilient-birth.mykajabi.com/pl/2148550678

Keywords: obstetric violence, labor and delivery nurse, healthcare, moral injury, patient advocacy, maternity care, trauma-informed care, healthcare hierarchy, nursing ethics, healthcare ethics, obstetric care, mistreatment, nursing advocacy.

In this episode of the Resilient Birth podcast, Justine and Sarah welcome Melissa Anne Dubois, an experienced perinatal nurse and childbirth educator. The conversation explores the themes of leadership in nursing, the importance of advocacy for patients, and the challenges faced by nurses in a hierarchical healthcare system. Melissa shares her insights on obstetric violence, moral injury, and the emotional toll of advocating for patient-centered care in a system that causes significant challenges for nurses who want to speak up on behalf of the patients and provide trauma-informed care. The discussion highlights the importance of supporting labor and delivery nurses in their roles as advocates for birthing people. In this conversation, Melissa Anne discusses the ethical responsibilities of healthcare providers and the importance of acknowledging obstetric violence and mistreatment in maternity care. She emphasizes the importance of being a leader among nurses and advocating for patients wants and desires, evidence based care, and trauma-informed care, while also acknowledging the very real professional consequences of doing so.

Takeaways

  • There is significant injustice in maternity care.
  • Advocating for patients can lead to professional consequences.
  • Nurses often feel powerless in the hierarchical system of obstetrics.
  • Moral injury affects nurses in maternity care as a result of obstetric violence.
  • Guilt and shame occur when nurses experience moral injury.
  • The term 'obstetric violence' has to be named for the problem to be understood.
  • The narrative of 'a few bad apples' hinders systemic change.
  • Acknowledging mistreatment is crucial for patient care.
  • Advocacy can lead to personal and professional consequences.

 Chapters

00:00 Introduction to Resilient Birth Podcast

08:49 Understanding Obstetric Violence

18:19 Moral Injury in Nursing

26:15 The Ethics of Healthcare Practice

32:32 Acknowledging Mistreatment in Healthcare

37:49 Navigating the Tension in Nursing Advocacy

46:50 Connecting to Community in Nursing

On the Resilient Birth podcast, Justine and Sarah explore the impact of trauma across the perinatal period, from trying-to-conceive to pregnancy, from childbirth to postpartum and parenting. Through an inspirational quote that drives our weekly conversations about trauma and healing, Justine and Sarah explore topics such as birth trauma, parenting as a survivor, and finding healing with vulnerability and compassion that support birthing people and birth professionals.

Each week, listeners leave with takeaways to utilize in their lives and/or clients. Justine and Sarah hold the stories they share with honor and respect with the hope to impart knowledge, increase understanding, and bear witness to this challenging topic.

Sarah is a licensed mental health counselor, educator, and mom of three. She walks with a story of trauma from before and as a result of her perinatal experience.

Justine supports survivors of trauma through perinatal coaching and childbirth education. As well as being a mother of three, she holds a Ph.D. on representations of consent and sexual violence.

Melissa Anne is an experienced perinatal nurse living in Central Massachusetts with her husband and three children. She graduated summa cum laude from the University of Massachusetts Amherst School of Nursing in 2006 and has worked in a variety of perinatal settings since 2007 including: in-patient labor and delivery, high-risk obstetrics, outpatient OB-GYN, homebirth, and postpartum home health. Melissa Anne became a childbirth educator in 2011 and a lactation counselor in 2014. She currently teaches childbirth classes for babiesincommon.com while she pursues her PhD in nursing. Her research interests include obstetric violence and moral injury in perinatal nurses and she plans to work as a nurse researcher and professor after defending her dissertation.

A useful article of Moral Injury in Maternity Care Providers: Kendall-Tackett K and Beck CT (2022) Secondary Traumatic Stress and Moral Injury in Maternity Care Providers: A Narrative and Exploratory Review. Front. Glob. Womens Health 3:835811. doi: 10.3389/fgwh.2022.835811

Here are some of the resources Melissa Mentions during the episode

Mandy Irby: https://mandyirby.com/

Birth Monopoly: https://birthmonopoly.com/

Evidence Based Birth: https://evidencebasedbirth.com/