Why Don’t Survivors Tell Us What They’ve Been Through?
Because the world taught them not to
Survivors come into our hospitals with invisible scars — from past sexual violence, medical harm, systemic racism, family trauma. And most of them don’t say a word.
Not because they don’t want support, but because they’ve been burned before.
Maybe they disclosed once and were dismissed. Maybe they said “no” to something and were overruled. Maybe just the sound of gloves snapping or the sterile smells makes their whole body tense.
The truth is, most survivors don’t need to be re-traumatized again to remember what it feels like to not be safe.
And when we don’t make space for that unspoken history, we risk becoming part of it.
Because trauma hides itself
Other times, disclosure isn’t even an option, because the trauma is buried.
A defining feature of trauma is that the brain tucks it away.
Survivors may not consciously remember what happened.
Or they’ve been in therapy, done the work, and believe it’s in the past. (ask me how I know)
But birth is raw, embodied, and deeply vulnerable.
Even when a traumatic memory feels resolved, birth can stir up sensations and emotions that bring it all rushing back.
That’s why we can’t rely on survivors to “just tell us.”
We have to build systems that are safe, whether or not someone discloses.
Because trauma-informed care isn’t reactive — it’s preventative and protective.
Cultural and Systemic Barriers
For many, the risk is even greater. Patients who are Black, Brown, LGBTQ+, disabled, undocumented, or don’t speak the dominant language are navigating systems that were never built with their safety in mind.
They carry the weight of medical racism, ableism, and other forms of discrimination.
These communities have experienced harm inside healthcare long before they ever reached a labor room – and they may have even fewer safe spaces to share their story.
So instead, they may protect themselves the only way they can: by saying nothing.
And the system stays silent, too.
When Trauma Goes Unnamed, It Doesn’t Disappear
When trauma isn’t recognized, it’s often misinterpreted.
A firm “no” is labeled as “noncompliant.”
A panic response during a cervical check is brushed off as overreacting.
A freeze in the middle of an emergency? Seen as uncooperative or slow.
But what if we stopped asking what’s wrong with her and started asking what happened to her?
Because here’s the truth: when trauma isn’t recognized, we don’t just miss an opportunity for connection — we risk causing harm.
We can inadvertently retraumatize people who are already carrying more than we know.
We reinforce patterns of silence, fear, and powerlessness.
And the people most affected — Black birthing people, survivors of violence, people with disabilities, those who’ve been systemically ignored — end up with worse outcomes and deeper wounds.
Trauma that goes unnamed doesn’t just live in one birth story. It ripples.
Through families. Through bodies. Through generations.
And nurses are absolutely in a position to interrupt that ripple.
The Cost of Undisclosed Trauma in Childbirth
Trauma that isn’t recognized is often misinterpreted.
A firm “no” is labeled as “noncompliant.”
A panic response during a cervical check is brushed off as dramatic.
A freeze in the middle of an emergency? Seen as uncooperative.
But what if we stopped asking what’s wrong with her and started asking what happened to her?
Because here’s the truth: when trauma isn’t recognized, we don’t just miss an opportunity for connection — we risk causing harm.
We re-traumatize people who are already carrying more than we know.
We reinforce patterns of silence, fear, and powerlessness.
And the people most affected — Black birthing people, survivors of violence, people with disabilities, those who’ve been systemically ignored — end up with worse outcomes and deeper wounds.
Trauma that goes unnamed doesn’t just live in one birth story. It ripples.
Through families. Through bodies. Birth-related trauma ripples through generations.
And nurses? We’re in a position to interrupt that ripple.
Trauma-Informed Care Isn’t About Waiting for Disclosure
Most of the time, you won’t get a warning label.
No one’s going to pull you aside and say, “Hey – I have a complex trauma history. Please explain all routine testing and ask before touching.”
That’s why trauma-informed care isn’t something we turn on when we think it’s needed. It’s how we practice all the time as the new nursing standard of care.
It means:
- We ask before we act — every time.
- We explain care like it’s a forever memory — because it is.
- We stop when someone says no.
- We recognize that safety isn’t just physical — it’s psychological, too.
It doesn’t mean we can avoid every hard moment.
But it does mean we don’t add harm to an already vulnerable experience.
It means we protect the dignity and agency of the person giving birth, even in the chaos, and navigate their unique journey with them as it unfolds.
And it’s not fluffy or extra. It’s clinical. It’s ethical. Trauma-Informed care is essential.
Nurses Can Lead the Shift
This is the part that gets me fired up.
Nurses — especially L&D nurses — are already the center of the birth experience. We’re at the bedside. The witness. The guide.
And we have a choice:
We can keep practicing in a system that unintentionally perpetuates trauma…
Or we can be the ones who change it.
That shift starts with consent. With presence. With knowing what it means to hold space for people whose trauma stories will never show up in their chart.
It starts with leadership — not just at the top, but right here at the bedside in patient education and ongoing informed consent discussions.
And it’s already happening.
Every time a nurse slows down to ask, “How are you doing with all of this?”
Every time we create space for a patient to say “no” and have honored it.
Every time we take the time to explain a procedure, even when we’re short-staffed and running on the iced caffeine flavor of the month…
That’s trauma-informed leadership. That’s culture change.
And I believe we’re the ones who will lead it.
When Nurses Carry Trauma, Too
Here’s the truth most of us don’t get to say out loud: Nurses carry trauma, too.
Most of us walk into the L&D room with our own histories of sexual violence, reproductive trauma, medical harm, or grief.
Most of us are recovering from moral injury, short staffing, institutional betrayal and toxic workplaces that leave us physically and emotionally wrecked.
And all of that? It comes with us.
Trauma doesn’t clock out. It doesn’t stay in the break room while we go back into patient care.
That’s why trauma-informed care isn’t just about patients — it’s about clinicians, too.
Because when we’re dysregulated, unsupported, or carrying invisible weight, we don’t have the same capacity to hold space for others. We also lose full capacity for our incredibly powerful and life-saving critical thinking skills, creativity, and collaborative strategies.
Think: maximizing peanut ball positions for maximum pelvic space and soft tissue relaxation. IYKYK
This isn’t about blaming nurses — it’s about building systems that recognize our humanity and dignity, too.
Trauma-Informed healthcare systems that care for the people giving care are how hospitals support survivors in childbirth at a systems level.
That’s the version of trauma-informed care that changes everything!
We Don’t Need a Disclosure to Interrupt the Cycle
Trauma-informed care isn’t about checking boxes or activating an algorithm.
It’s not about waiting for a red flag in someone’s chart.
It’s about practicing like every patient has a history we can’t see (because we all do).
It’s about slowing down long enough to see the human in front of us.
And it’s about building a maternity care system where nobody has to earn safe, respectful care – they just get it.
What Trauma-Informed Care Looks Like in Practice
- “You don’t have to prove your trauma for us to treat you with gentleness.”
- “We explain before we touch. We ask before we act.”
- “We give you real choices, not forced decisions disguised as care.”
- “We trust and respect your no.”
Trauma-informed care in labor and delivery is not just about reducing harm – it’s about restoring power.
And that starts with us.
And don’t forget that you deserve this compassionate care, too. You deserve to feel safe in your body, in your practice, and in your workplace.
Your trauma matters, and your healing matters.
Nurses can lead the way in care practice changes and in our own restorative practices, because trauma-informed care starts with us.
