Why SAFER Birth exists
Trauma-informed maternity care
A note before you read: this piece discusses the impact of sexual trauma on maternity care. It does not contain graphic detail. If you find this difficult, please look after yourself and step away if you need to.
There is a moment I saw again and again over fourteen years of supporting women during pregnancy, birth and postpartum.
A woman I had prepared with for weeks, calm, organised, ready, would reach a point in labour and simply go somewhere else. The labour was progressing. The baby was fine. Nothing we could see explained it. But she had gone quiet, or frozen, or begun to panic in a way that did not match anything that was actually happening in the room. She was unreachable.
For a long time I thought I was failing her. I thought that if I taught better, explained the physiology more clearly, gave her stronger tools to cope, it would not happen again. So I did. I taught more. And it kept happening.
It took me years, and a great deal of study, to understand what I was actually seeing. These were not women who were unprepared. They were women whose bodies were remembering something. For many survivors of sexual trauma, aspects of birth, being touched, being examined, exposure of the body, pain, the feeling of being unable to say no, can reach back and reopen an old experience of powerlessness. What looked like distress from nowhere was a trauma response. And ordinary antenatal preparation, however good, was never going to reach it, because it was never designed to.
So I went looking for the missing piece. Training with Michel Odent. Pre and perinatal psychology with APPPAH. A Masters in Psychology. Search for trauma-informed maternity care. And the one that changed everything, the When Survivors Give Birth practitioner training with Penny Simkin and Phyllis Klaus, the leading international programme on supporting survivors through birth. I trained with Penny Simkin in 2015, and again in 2018.
I remember sitting in those rooms and feeling things quietly fall into place. As the teaching unfolded, faces came back to me. Women I had cared for years earlier, whose reactions I had not understood at the time. Women who had responded strongly to what should have been routine care, and left me confused about why. Piece by piece, like a puzzle that finally makes sense, I understood what I had been seeing all along. From that point, how I cared for women and how I supported them changed forever.
And it did change. I stopped seeing these moments as something going wrong and started seeing them for what they were. I remember women who would go somewhere else in front of me, or who would plead with me. I remember a woman calling out for help as she was pushing, in a way that had nothing to do with the birth in front of us, and everything to do with something behind it. Before, I might have been confused, or rushed to reassure her about the labour, asking her to keep calm and relax. This time I did not panic and I did not lose my footing. I reinstated safety, over and over. I stayed beside her. I remembered which words could pull her back into something frightening, and I did not use them. I chose what I said, how I touched, and what I explained with her history in mind, even when I did not know the details of it.
In the years since, many women have come to me, often referred by other birth workers who knew this was the support their client needed. Across my career I have supported thousands of women through pregnancy and birth, written hundreds of birth plans, and sat with many of them afterwards to make sense of what happened.
The more I learned, the clearer one thing became. This knowledge was the most important thing I carried into any birth room, and almost no one around me had been given it. Not because they did not care. The midwives, doctors and teams I worked with cared deeply. They had simply never been taught this.
So I began to shape what I knew into something others could use. Not a theory, but a practice. That became the S.A.F.E.R. model: See the Survivor, Ask and Affirm Consent, Foster Safety, Empower Control, Respond Don't React. Five simple movements that change what a woman experiences in a room, whether or not anyone knows her history.
SAFER Birth exists to close the gap I lived with for years. On one side, survivors who deserve to be prepared for birth, and supported through it, by someone who understands. On the other, maternity teams who want to do right by them and were never given the knowledge to. So the work has two arms. I support women directly, through birth preparation, survivor-informed birth planning, and debriefs afterwards. And I train the professionals around them, so that awareness becomes everyday practice rather than one more idea that fades once the training day is over.
I always wished that everyone a woman met already understood. That from her GP to her consultant to her midwife to her health visitor, she would be met by people who were on the same page, so that she never had to arrive somewhere new and explain herself all over again to someone who did not know what she needed.
That wish is what this is. Care shaped by years in the birth room, so that a frightened woman is met by people who already understand her, and she only has to say it once.
Why this is different
This is not another training you tick off and forget. SAFER Birth was built by someone who has been in the room, for the people who will be. Awareness is where most training stops. This is where it starts to change what happens for the woman in front of you.
SAFER Birth offers information and support. It is not therapy or clinical advice.
Wherever you are coming from, whether you are preparing for your own birth or you care for women who are, take a look around. You can find out about support or learn about the training.
If you have been affected by anything here, support is available. Rape Crisis England and Wales, The Survivors Trust, and Sexual Assault Referral Centres (SARCs) offer specialist help for anyone affected by sexual violence, whether recently or in the past. The Birth Trauma Association and Birthrights offer support and information around birth. In a crisis, contact your GP, call Samaritans on 116 123, or call 999 in an emergency.
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