Happy Hour with Bundle Birth Nurses

#95 Being Trauma-Informed: The Soft Skills that Change Birth Experiences

• Bundle Birth, A Nursing Corporation • Season 7 • Episode 95

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In this episode of Happy Hour with Bundle Birth Nurses, Sarah Lavonne talks with licensed therapist Krysta Dancy, MA, MFT, CBD to explore what trauma-informed care really looks like in labor and delivery. Together, they unpack how nervous system regulation, presence, and connection shape the labor and delivery experience for both patients and nurses. This conversation goes beyond checklists and protocols to address burnout, compassion fatigue, and why trauma-informed care is as much a way of being as it is a set of skills.  Thanks for listening and subscribing to the podcast!

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Sarah Lavonne: Hi, I'm Sarah Lavonne, and I'm so glad you're here. Here at Bundle Birth, we believe that your life has the potential to make a deep, meaningful impact on the world around you. You, as a nurse, have the ability to add value to every person and patient you touch.
We want to inspire you with the resources, education, and stories to support you to live your absolute best life, both in and outside of work, but don't expect perfection over here, we're just here to have some conversations about anything birth, work, and life, trying to add some happy to your hour as we all grow together. By nurses for nurses, this is Happy Hour with Bundle Birth Nurses. If you don't know Krysta, you are in for a treat. Krysta and I go way back. We have known each other now for, Lord, how long? Four or five years, six?
Krysta Dancy: Yes, maybe six.
Sarah: 2020, it's coming up on six years. I had attended one of her trauma-informed classes online early days of Bundle Birth and was obsessed and like, "We have to work with her. We have to get her work in the hands of nurses." Then me and Justine, were building out our Bundle Birth nurses mentorship program, year of our lives. In the midst of that, we coerced her to join us in mentorship. We drove up, not knowing her at all, and drove up to Northern California, where she was living at the time, and met her, set up all of our film equipment.
Krysta: Yes, in an Airbnb.
Sarah: Yes, in this random Airbnb that we found. We just met her, and we recorded three classes, almost, because we did trauma level two later.
Krysta: Yes.
Sarah: I talked you into doing a grounding techniques class at the same time.
Krysta: You did, it was so fun.
Sarah: Then we filmed Healing Trauma and the Birth Professional, and then trauma level one, which is preventing trauma level one. If you've been through our mentorship program, you know Krysta very, very well. If you've been to our MOVE learning retreat in 2023, you know Krysta very, very well, and if you are coming to MOVE in 2026, you will know her again or newly in person, because she will be joining us on the main stage for our upcoming MOVE learning retreat. Krysta, please introduce yourself. Tell us your professional background, what you love about your job, what you care about. Give them the insider scoop.
Krysta: Yes, the whole thing. Thank you for that intro, and I feel so lucky that you pulled me into all of those fun projects. I'm still really proud of the work that we did together. I think the videos are great. MOVE was definitely a highlight, so yay, lucky me. Thanks for having me again. I'm excited to talk about it.
My day job is that I am a licensed therapist. My specialty is this strange niche of the intersection of trauma and birth, so all things related. The giving care to trauma survivors, giving trauma-informed care, preventing trauma, and all things nervous system [unintelligible 00:03:06], like how to regulate, how to be present, how to ground, how to show up in birth spaces. Not just doing the skills, the nursing side, which is your stuff, not just doing the physiologic and the nursing and the good skills, but also showing up in a way that even how we show up helps our clients and patients to have their best outcomes and have the best experience possible and have trauma-informed care, all of that stuff.
Sarah: Your practice has shaped me as a nurse and as an educator, and in everything that we do, we talk-- I'm like, "We're talking nerdy, nervous system, vagus nerve, neuroscience, brain psychology." If you've done any of our Bundle Birth stuff, you're like, "Oh yes, they talk a lot about that," and that has been heavily influenced through Krysta's work and how she has trained me, and how we've partnered and all of that.
I want to get to all of that, but before I do, I want to ask you, because I know we've had you on the podcast before. We can link your previous episodes, as we were anticipating MOVE last time. I think back in the day when I first took your classes, and when we first started partnering to put together the classes for Bundle Birth nurses, trauma-informed care, was really sexy. It was just barely coming out. It was like, "Ooh, I'm going to be trauma-informed. What does that mean? I'm going to advocate, and I'm going to," blah, blah, blah, blah. The word that I use constantly is downregulate my nervous system. Help downregulate your nervous system.
I think it feels a little more old news now that we're later in life and years later, and almost to the point where I feel like it's become a buzzword and almost overused to the point where we get desensitized to what that actually means. Could you give us your definition of trauma-informed care, and then maybe paint a picture of what that looks like at the bedside for nurses?
Krysta: Yes, absolutely, because I totally agree. I think a lot of things, it starts out that it's great that awareness is raising, but at some point people catch on, and they go, "Oh, that's a buzzword, let me add that to what I'm offering." It starts to become-- after enough time, you start to be like, "What does it even mean anymore? What does that even mean?" My disclaimer is, there's a lot of people saying what they think it means, there's a lot of experts saying what they think it means, and it's not totally decided what it means, but I'm going to tell you what I think it is.
Sarah: Great.
Krysta: Having worked in these spaces for a long time. Trauma-informed care, at its essence, is giving care understanding that you're giving care to a whole person as a whole person.
Sarah: Oh.
Krysta: There's more happening here than I did in IV. There's a whole person there, and I'm a whole person, and there's a lot of things at play in that room. The way I like to break that down and make it simple, I like to say past, present, future. Trauma-informed care understands past, present, future. Past being this person and myself come to this moment with a past. That past is going to inform how we interpret everything that's happening, what resources we do or don't have, and what we're bringing into this room right now. That's our past.
Present means, the way I'm interacting with you in this moment is either going to contribute to a positive outcome for you and trauma-informed care, or it's not. It's how I'm working with you in this moment, that's the present part. Then future is having a plan for those unavoidable traumas. What's my plan? How am I going to assess and refer? What resources am I going to give them? Where am I going to send them to give them and their new family best shot at this new life that they're creating? That's where I go with it, with trauma-informed care, is like past, present, future set in this mindset of understanding you're a whole person, I'm a whole person.
Sarah: I think that definition, for me, gives me a little bit of an aha, because I think when we think trauma-informed care, we're talking about people's traumas, and we're aware of their traumas, and we must know their traumas, and we assume they're traumatized, and all of that. Whereas this feels a lot more expansive in its definition, and even accounting for personality differences or just life experiences that contribute to the present day, which I feel like, honestly, is a lot less pressure.
Krysta: Oh, good. I'm glad that it feels like less pressure, because I think it should be. I think we put too much pressure on it and that can really squeeze the oxygen out of the situation and make it feel like it's just one more thing we have to get right. Especially my experience working with medical professionals, is that they tend to be A-plus students who really, really want to get it right. When you make a topic this pass, fail, you have to get it exactly right, everyone feels that squeeze, and I think it should be expansive. I think it should be something we settle into as learners to be curious about.
I think that good trauma-informed education, in my mind, and this leads back to the topic of the MOVE retreat and learning in general, I want the learning to feel like I learned about my patient, but I learned about me. I also learned about my loved ones. I also learned about experiences I've had. I have this light bulb, aha, moment of like, "Oh, that's what that was." I understand my colleagues differently, and that, to me, is like, "That's good learning." Learning should feel expansive. It should expand us.
Sarah: Us as people, which was the entire goal of 2023, and is always the goal for our MOVE learning retreat. It's funny you say us medical people want skills, because my next question was, are there skills of trauma-informedness, or is it more a way of being, or both?
Krysta: Yes, to both. I think it's anything in life, especially as a new learner, when we're first coming to a topic, we need concrete. We need to know step one, two, and three, what do I do? That's how I break it down, past, present, future. Let's break this down into something concrete that we can really sink our teeth into and feel like we've got somewhere to go with it. There are absolutely very concrete skills that, as you know, I can nerd out about endlessly. There's just so much there around-
Sarah: Same.
Krysta: -birth and the way that we give care, the way that we ground our nervous system, the way that we respond when our patients show us that they are struggling, the way that we give resources. There's really good concrete tools of things that we can do, and we do talk a lot about that. At the same time, as we go deeper into learning, it's like anything else, like what is nursing?
Nursing, at the beginning, you're learning a lot of skills, but as you do nursing, and as you become a nurse, and as you experience, it's also a way of showing up in the room. It's something that's a little harder to define. It's a presence. It's a way that you approach a situation. I don't have to spend very long with somebody to be able to clock the fact that they're a nurse.
Sarah: Interesting.
Krysta: It's some of my favorite people. It's a way of looking at situations. There's a problem-solver lens associated with it. There's a caregiver lens associated with it. There's a resourcefulness and a grit that's associated with it. Yes, can you make skills out of it? Yes, we can and we should, and it's important to have concrete tools that we walk away with feeling like, "I've got this in my toolkit and I know how to use it right away," because that's always a good boost.
Also, it's kind of a thing that you, I would say caught, not taught. There's a little bit of being in the space of it too. Yes, which is why when I was in person longer, things are more fun for me, because I'm not just giving you an hour of, "[unintelligible 00:10:30] here's what you do," which is good. I like those opportunities, but this is an opportunity to also be with each other as we unpack what that looks like in more nuanced ways and individual ways, and that part's really fun.
Sarah: To me, being trauma-informed, part of that skill is being therapeutically present and opening your eyes and seeing, like you said, the whole person and recognizing that they're different from you, but that takes a certain level of internal work that can't just happen when you're at the bedside. Good luck. I'm not going to therapy while I'm at the bedside. I'm not processing my own life and how I show up and my presence and all the things. No, you show up and you have to be there. Do you have tips for us for how we show up at the bedside and how that makes a difference?
Krysta: Yes. I think what you said is so smart, which is this recognition that if you don't give this any thought until you're at the bedside, it's going to be an uphill battle for you. It's not that that's not worth anything, but it's going to be a struggle.
For instance, when I talked at the beginning about trauma-informed care is understanding you're a whole person, I'm a whole person, so that means that sometimes some of the hardest patients to give care to, it's hard for a reason. There's a history there. There's something else going on that, for some reason, perhaps it's my own trauma, which we know medical professionals have their own trauma. They have their own professional trauma. They have their own trauma from their childhood, from their life experiences.
It's not that we come in the room a blank slate, we come into the room a whole person with our stuff. There are some patients that the patient's stuff and our stuff don't play well together. What they're putting out as a result of what's going on for them is also bringing up stuff for us. When you're talking about how we show up in the room, I think what you said is such a beautiful example of being aware of our own sensitivities, starting with awareness about our own areas of wounding and what for us has brought up, perhaps to overuse a word, triggers, but being aware in a curious way, in a nonjudgmental way.
When I walk into a patient's room and something's going on where there's some friction here, or there's some panic here, or there's some feeling that feels a little bit off for me, then instead of approaching it with judgment, and this is a tricky thing because so much of doing medicine is evaluation, and I'm asking for you to pause on the judgment for a moment and pause on the evaluation and go into curiosity about it. "That's interesting. That's interesting that that's how they're responding. That's interesting that's how I'm responding."
When I write the story in my mind of what's happening on the patient level and what's happening on my level, I'm going to do it with curiosity and openness instead of, what I see is so common, which is not only judging patient, which is an easy thing to do as a human, but judging self, like, "I'm bad. I'm doing it wrong. I'm shaming myself." I'm going into a spiral about it, like, "I must have done something wrong."
One of the things I talk about in my longer classes with people is one of the principles of trauma-informed care is it's never personal, ever, ever, ever personal. Once you understand the way that our previous traumas caused us to project those experiences onto current circumstances, you realize that when people give you a reaction that's a little sideways, it almost never has to do with you at all, it has to do with what the package is that they're bringing into this.
Having that awareness when I come into the room lets me know it's important that I show up in a space of regulation, if at all possible, it's important that I show up curious, it's important that I show up empathetic, it's important that I show up gentle to myself. How am I going to give trauma-informed care if I'm just beating myself up? Then within that, a lot of trauma-informed care points to, really, a couple things.
Let's see. It's going to point to, how do we regulate our nervous system so that we can get into a safer state with ourselves and one another, especially in birth? Because guess what? Nervous systems that are in fight-or-flight don't bring babies very well. Mechanically, it's an advantage to have the skills to know how to bring that into the room and how to concretely help your patient get there. That's one subset of the skills.
The other subset of the skills is understanding that the experience I'm having with this person has so much to do with how their understanding and navigating through life and the fact that the birth environment is rife with potential triggers for somebody who comes from any sort of trauma background. Once I know that, there's ways that I can communicate to really improve clarity, to improve a sense of safety in the room, to improve connection and attachment between myself and my patient.
As you can see, as I'm talking, there's a complexity here, but there's concrete skills that come out of that complexity. I would say, to your point of what should nurses do, bringing that awareness is actually almost the whole thing. Once you're aware of that and you're bringing that lens into the room, it is this aha of like, "Oh, oh." Then there's infinite options within that. When you guys talk about the-- am I going to say it right, the team underwear pin?
Sarah: Yes.
Krysta: I love that. I think that is a great example of trauma-informed care. It's cute, it's fun. It can be lighthearted. Also, at its core, it says, you're in control, you're safe here, your body is sovereign here. I'm asking what you want and honoring you as much as is reasonable, we're always honoring you, but honoring your choices in a way that is reasonable to the circumstances and making sure that what we prioritize is that you feel that you feel that autonomy and you feel that safety in this room.
Well, it's a cute pin. It's a cute idea, but underneath it is a serious trauma-informed perspective. That's why when you say, what are the tools? We could list them, but also there's infinite tools. Any way that you bring that awareness into your interaction with your patient, you're practicing trauma-informed care.
Sarah: I remember that aha, for me, actually. As a new nurse, my gosh, there's so much going on, and the charting, and the dynamics of different team members, and where's this supply, and then, "Oh my God, an emergency in a D cell," and like, "Wait, but I can't find the heart rate, and what does the cervix feel like?" It's so hard to actually think beyond the very mechanical medical stress of the job.
I remember getting more comfortable and starting to feel like, "Okay, I can pull up a chair." I remember being able to pull up a chair and just having that conversation and also having read about some of this stuff and being like, "I really want to expand my skills and I want to be better," but it was like a, "Oh, wait, there's an experience happening here that I would like to help facilitate." That's what we talk about all the time, of the importance of our job, but also the potential that it's not just skills. You are missing it. If you are showing up to chart, check a cervix, throw an IV in, make sure mom and baby are safe and out, hopefully, vaginally.
It's so much more than that, which was really the impetus for me starting Bundle Birth, to be honest, and why so much of everything that we do is so incredibly aligned. As you're saying that, I'm like, yes, I remember moving from skills to like, "Okay, what if I just slowed down and saw what was going on here, picked up the little nuances?" That, as a nurse, as we are assessors, there are so many more intangibles rather than a blood pressure.
Sure, that's helpful, but the little look in their eye or the little-- they look confused or they're not fully nodding in agreeance here, and instead of just going forward assuming that's a yes, going, "Let me slow down and get curious." I think that so many of you listening are doing so much of that. What I'm hearing is that is already so much of being trauma-informed.
Krysta: 100%. Yes. I think that one of the things that's really fun about talking to your audience, your people in particular, is I'm not having to start at the beginning. If I was talking to somebody else right now and they asked me the same questions, I would give a different answer. For some people, they need the concrete answer. They need to start at the beginning, and they really need someone to map out concretely like, "I do what?" We'll talk at the level. I'd pause at the door, pull up a seat, make eye contact. Those are important skills. I'm not knocking any of that. You have to start there.
I know when I'm talking to your audience, that a lot of them are just nodding along, like, "Yes, I'm doing that, and then what?" They're so ready for the next part of the conversation. I think what you brought up is beautiful. I want to highlight, number one, pulling up a chair. First of all, that's so beautifully trauma-informed. Why? Because you're at their level. You're understanding the nervous system, and you're understanding the metacommunication of body language to remove hierarchy as much as possible and to communicate a sense to their nervous system. I'm not standing over you. I'm not above you. You're not below me. I'm with you. I'm hearing you. I'm perceiving you.
We talk about that seeing safe and soothed concept, which is one of the things that I've taught with your people before, about seeing safe and soothed, and the nervous system response to those things. You're showing that they're seeing. You're showing that they're safe. You're attempting soothing. I think that's what I want to highlight, though, is how that made it-- I watch your face light up, that made it better for you.
Sarah: Oh my God. Tell me about it.
Krysta: Yes. This is one of the things I always say when I start out talking with a group of particularly birth nurses, who, this is not pandering, they're my favorite people. Not only are they so warm and so genuinely maternal caregiving caring people, who are also very smart and problem-solvers, which is a fun combination anyway, but as a group of people, they're just really fun.
Sarah: That's for sure. We're the best.
Krysta: The best of the dance party. So fun. Yes. What I want to say is, when I start to talk to a group of particularly birth nurses, I often start out to get a laugh. I'll be like, "You could have picked any job. You also could have picked a different job in medicine that wouldn't have had you up all night missing important days in your family's life, on your hands and knees, using flashlights. You could have picked a job in medicine or in another field that would have been easier on your body, easier on your heart, easier on your schedules, and you didn't."
I want to tap into that because what I want to say about this group of people is there is something about you that you are motivated by something other than ease and convenience. There's something where you're pulled and motivated by meaning, by connection, and by something special about birth that pulled you into it, because it doesn't on paper make sense that you chose this, you chose this because there's something about it.
I think what I see on your face when you talk about that aha moment of sitting in front of them or pulling up a chair, I see that light up for you. I see the thing I see in other people when their spark comes back. When they get through the burnout and the spark starts to return, I see the way that their face lights up and it's like, there it is. That's the reason you're doing it, because that feeling that you get when you make that connection with an expectant family and you know that they felt seen, safe, and soothed, they felt connected in your presence, their nervous system is regulated, and you walk out of that room proud, that's the good stuff.
It's almost like, from a patient angle, do I care? I absolutely care. I want our patients to receive trauma-informed care. It's very important to me. I want new families to receive that, but I also want the nurse that's listening to get the good stuff.
Sarah: Yes, same.
Krysta: If you're giving so much hard work, care, anyway, you may as well-- [crosstalk]
Sarah: You might get something in return. Yes.
Krysta: Yes, like, go away [unintelligible 00:22:27] like, "Oh, I got it." Not that every day is euphoric, because there are hard and bad moments in this job, but we can have more meaning. We can have it feel meaningful.
Sarah: Yes. This season and in this mentorship cohort, we've been talking a lot about burnout and going into MOVE learning retreat for 2026. I am acutely aware that the current state of nursing right now is not what it was two years ago, three years ago. We are still recovering from the pandemic and systemic stuff that just has made the job so much harder. When you talk about this, I'm going back to mentorship, to be honest, and what it felt like to put together so much meaty education that is so infused with humanity.
I think that, to me, is a lot of what's missing in nursing right now that we've gotten so stuck on the protocols and the checklists and, "You didn't chart this." I also recently went to Synova, which was a bunch of perinatal leaders, and I think we're just missing each other. So much of the various issues, which we're not about to begin to describe and try to figure out right now, but just looking at the state of healthcare and the state of nursing, specifically labor and delivery, right now, as you're talking, I'm like, I wonder if this perspective, and it really is a way of being, to me, that I'm either trauma-informed or I'm not. Call it that. Call it sensitive to humanity, call it empathetic, call it-
Krysta: Embodied?
Sarah: Yes.
Krysta: Present.
Sarah: Present, where I'm hyper aware of myself and doing that work outside of work and investing in myself in its own up level, and even investing in my own skills so that when I show up, I'm not so focused on the detail, and I can't even get a word out. The more competent you are, the more space you have for this kind of care that, sure, is amazing for the patient, but also, like you said, is so good for us. I think somewhere in there, we've lost a lot of that magic. Do you have anything you could say to that, just with your wisdom, your psychology side of things? What do you have for this audience related to all that?
Krysta: Yes, absolutely. Thinking about the changes that have happened just since we started working together, at the time that you and I started working together, I was being asked to talk a lot about patient trauma, and that's where I started, was teaching about giving trauma-informed care to patients. In the time since I started working with you, almost all of my requests, to your point, are coming, "Please come talk to our nurses about their trauma." Almost all the time, I'm either teaching directly about secondary vicarious nurse trauma, or I'm teaching a combination of patient and professional trauma, but very rarely is it only patient.
I'm glad for that because I think that it was the elephant in the room that wasn't being acknowledged before, and has now gotten to be such a concern that it can't be ignored anymore. It has to be acknowledged. Unfortunately, what it took to get us there is a lot of problems. It's only being acknowledged, I think, now systemically, because systems are really struggling to keep up, though, with turnover, with burnout, with staffing ratios. Now they're like, "Oh my gosh, this workforce is really burned out. We need to do something about it." It's the light bulb at the higher levels. I'm thankful that there's awareness. I'm thankful I'm being asked to talk about it. I hate that it took this much hurt to get us here.
One of the things I say when I talk about the topic is, if I go to the medical literature and I pull all the literature on nurse burnout, because there's a lot, they like to talk about it, and I take a list of what are the symptoms of burnout, and I put it on a piece of paper, and then I go over to the psych literature, my corner of the world, and I pull out symptoms of chronic untreated PTSD, and I make a print out of that, if I put them side by side, the list of symptoms is a near identical match.
I deeply believe that when we are talking about burnout, especially with medical professionals, what we are mostly talking about, without calling it, this is untreated PTSD. What we're calling burnout is a very predictable outcome for a lifetime of ignoring PTSD and not appropriately attending to it. I just want to say that I'm glad we're talking about it in this way, because what I have seen is that when it's talked about as burnout, oftentimes it's talked about in a way as the nurses need to do one more thing. It's on them to fix.
I'm just going to tell you, I don't know how to fix burnout, but I know how to fix trauma. I find this incredibly hopeful. Hopeful because trauma is very treatable, trauma is very preventable. We can actually be proactive in the way that we go about this and not just be like, "Oh, what a surprise, somebody got burnt out." Instead, we could say, "Oh, hey, you had an experience that was traumatic." That's, unfortunately, the risk of doing this job, but we have this plan for you.
Back to what you were talking about, one of the things that is measured in nurses that's so important is this compassion satisfaction. It's literally just the measurement of how much do you enjoy giving care? How satisfying is it to be in a position of compassion? We know that burnout/trauma is a direct inverse relationship, meaning the more trauma you have, the less compassion satisfaction you have. No doubt. Obviously, that seems pretty intuitive. We also know the reverse is true.
I think it's what you're talking to, Sarah, which is nurses come at this as already resilient people. They are a gritty resilient group of people. They don't need, nor do they want, a ton of babying. They won't accept it. It's not the solution. We also know is that they weather these difficult days so much better if they feel that the care they give is meaningful. If the care I give is meaningful, if the patients show me and demonstrate that what I did mattered for them, and I go home feeling that, then when I have a bad day and I have a bad outcome, it does hurt. It doesn't change that it hurts, but I carry it differently if the next shift I have something meaningful happen again. It helps restore something in me.
What we have now is we still have-- in some places I'm hearing, acuity is changing, and comorbidities are changing, and so bad outcomes are even changing in some places, but whether they are or not at your facility, those are, unfortunately, always a part of the job, and everyone gets into it knowing that. I think that where it used to be this teeter-totter of, I have these really bad things happen, but I have so much good here, so much meaning, and so much satisfying.
As we have, with all the problems you've alluded to within the system, stripped away some of that meaning, stripped away some of that human connection, stripped away some of the good, that teeter-totter starts to be really one-sided. We need the meaning, we need the relationship to get through the hard days. We need it. As humans and as caregiving types of people, we got into jobs like this because we thrive when we make a real connection. I actually do think that what you're tapping into is what you're calling the magic or what we're calling trauma-informed or we're calling compassion satisfaction, or whatever label you want to put on it, that undercurrent of connection and meaning in what you're doing is everything.
Sarah: Then, can you give us some tips for connecting if we're feeling disconnected?
Krysta: Connecting to ourselves or to our patients?
Sarah: Both. When I think about when we were putting together the objectives for this upcoming MOVE, you talked about trickle-down grounding. If you could weave that in of how that plays into our connection, so connecting with ourselves and then ultimately how that leads to connecting with our patient?
Krysta: Yes, absolutely. I won't say everything because we obviously got to keep some of it for the people that show. We got to keep some of the good stuff. One of the things that I talk about a lot and I think is really relevant here is, okay, we all know this because if you work in birth, you've seen this. We are born as dyadic co-regulators. All that means is that we are born with the ability to read the room. We're born with the ability to read the regulation state of the people close to us. We don't ever lose that.
We see this all the time. Why do I say people in birth know this? Because you see mom's upset, baby's upset. Mom's calm, baby's calm. We are born coming into the room with our little senses saying, "Is this a safe space? Is this a calm space? Is this a loving space? Can I be at peace here or do I need to be on guard here?" We are doing that all the time. One of the first factors in figuring out this whole thing when you're talking about trickle-down grounding is this understanding that the nervous system state I bring into the room is contagious.
People who are birthing are particularly sensitive. Why? Nature is really smart. Nature knows that if they're in a space that feels unsafe, they shouldn't have a baby there, they shouldn't become vulnerable there. All the things that we know, pain goes up, progress slows when we start to feel like we are not in a safe space. So much of the work that we do is to try to create that space where their nervous system can go into a regulated state because that brings the baby.
Knowing that this person giving birth is already going to be so sensitive to what I'm bringing in the room, our work to connect starts with connecting with ourselves before we walk in the room. What does that look like? It depends on your life because some of us have the ability to do that at home, and some of us, home is not a place we can do that. For some of us, that's in the car. For others, we're not taking a car.
What all of us can do that I really like that I've seen you highlight is the pause at the door. We can pause at the door, no matter what we took to work today and no matter what interaction we just had with our co-worker outside the door, we can pause at the door and say, "I'm walking into a new room. What I'm bringing into this space will be contagious to the person I give care to. Let me check what I'm bringing in."
That's when we do things like the breath work that we've talked about, checking in on the tension in our body, checking on the state of our mind. There's rituals and tricks and tips, some of which can be universally applied and some of which are unique to you and your own belief system and what works for you and how you let stresses go. As therapists, I have all these therapist employees, we talk about this all the time because you're going from hour, hour, talking with people about really heavy stuff. Then you need to show up for the next hour ready to receive what they give. We talk all the time about that in between, which sometimes is literally seconds.
What do we do in the in between? How do we imagine the last room sliding off of us? How do we imagine that comet sliding off of us? How do we imagine our stresses at home staying at home? How do we breathe in calm? How do we exhale the nonsense that we're not going to bring into this room so I walk in with a nervous system that I actually want to be contagious?
Instead of what somebody is in the habit of doing, especially caretakers, often we're such good room readers, we walk into the room and say, "What are you bringing? Let me go in and read the room." I'm suggesting, yes, we read the room, but before we read the room, we set it. We say, "What am I bringing into this room? That's connection point number one.
Connection number two, how do we make connections? Well, that's all the good juicy stuff. I like what you said. I think it has to start with, we need to observe first. First I set myself, then I walk into the room and read the room. I got myself, as an anchor, and then I've got my awareness. I'm perceiving what vulnerabilities am I seeing in this room? What resources am I seeing in this room? What's going well? What's not going well? What's the state of things? Because if things are flowing, then I'm going to join. I'm not going to do a lot of changing. If things aren't flowing, I'm going to go back to that anchor I'm bringing into the room and bring it into the situation that's not going very well.
This is where all the micro skills come in. The eye contact, the getting down at their level, the using their name, the reviewing and referencing a birth plan, the asking their preferences. One of the things that I love to talk about when I'm doing a longer-form class is ambiguity invites projection. If we don't know what somebody's bringing in the room, and I've had bad or good experiences in my past, I'm going to project that into this a moment. I'm either going to assume goodwill, or I'm going to assume you're out to get me on the basis of my previous experiences if you don't make it clear to me.
One of the first things we do to make connection, as silly as this sounds, because you can't even believe it, but the first thing we do is affirm goodwill. What does that sound like? Whatever sounds natural to you. What it sounds like when I do it is, "I'm Krysta. I'm here to be with you. I'm so excited to be supporting you. I'm here to be your advocate. I'm here to listen to you. Please tell me about how this is going for you. Is there anything that I can get you right now?"
How it can also sound is, "Hey, my buddy over here is going to take over. She's excellent at counter-pressure. She's the person I would want taking care of my sister. She's the person I would want at my birth. You're going to love her. She's an expert in this thing that you care about. She's notorious for this positive thing that you've asked for." Creating very direct references to goodwill, "I'm here to care for you. I'm here to listen to you. I'm here to make sure that what you're asking is heard. I'm here to make sure you understand everything. You let me know if any question ever comes up for you. We got this. I'm in your corner."
That is, honestly, huge because it removes the ambiguity and the projection, and it lets them know your intentions. If you're coming in with a centered nervous system, and that's your first thing you do, is somehow affirm goodwill, already, we've totally shifted the way that we're connecting together. We've set up the situation to where their nervous system is going to entrain with ours in a positive way. This is how you get those nurses and providers that have this reputation, where it's like, "I don't know what it is that she does. Let's send Sarah down there. She'll probably fix it."
Sarah: Yes, totally.
Krysta: They're like, "How do you do that?"
Sarah: Again, we're so concrete as medical people. We want the skill. It's like people come to physiologic birth and they want the position. They want the formula. They want the, "When you rotate the knee this way, it does this, and it will make the baby," blah, blah, blah. You may be disappointed if you come to that class because pretty much everything I teach is outside of that. There's a chunk, of course, on positions and all of that. To me, the most important thing that we can do is how we show up, because, to use your terminology, that everything trickles down from there.
What I also love about this is that I think frequently when we are feeling hurt by our environment or that our environment is less than what we would dream, it's easy to blame all outside circumstances for the care that you provide. This, to me, puts agency in my hands to say, "You know what? I don't love that they just threw a new Pitocin checklist at me, or they're forcing me to go up and give a reason to not go up on Pitocin." I have a moral issue with that, or I have a professional issue with that. That can be so wearing and is the noise.
If you've listened to-- it was a previous episode on here, I'll link it down below, where I talk about content versus context. I read a section of a book where basically you imagine you're in a football stadium. The football stadium is totally empty. It's silent. There's no crowds. That is the context. Yet there's this little baby radio up in the corner somewhere that's on loud, but it's still a little baby radio. That is all you hear in that environment.
The same is true of a forest with a loud birdie. That is the content. Frequently, the Pitocin checklist becomes the content, and you miss the context of the environment that is so much bigger, so much more expansive, so much more hopeful that you give up your agency. You choose to focus in on that little baby radio when there's an entire empty stadium of peace and beauty. I don't know about a stadium being beautiful, but you get the idea.
I love that this puts the agency back in our hands to say, "Regardless what's happening outside of here, I'm going to choose to take that deep breath, to slow it down." We all know what it's like. You have a kid around and they're freaking out. You have a choice to either completely lose it and run and respond, and kid, rein it in, or you take a deep breath and you go, [exhales] "What I'm telling you right now is that I need you to go to bed."
That you feel in your body when you're feeling that heightened state, that's a dysregulated state in your nervous system. Yet very quickly, I feel like I do this literally all day, every day, where I'm like, and you choose to bring it down. That alone gives you agency over your environment that then everything outpours. It's like, "I'm going to walk to that radio. I'm going to turn down the volume. I might not be able to turn it totally off, but I'm going to turn it down so it's not so glaring, blasting," whatever the word is. Then I can show up to the bedside. Still, what happens in that little bubble of a room that I have the privilege to be in, then I can shift everything literally by how I show up.
Krysta: 100%. Yes. I feel like what you're tapping into is, in an environment where, for all the reasons, there's so much that is happening outside that room that is affecting you and your day and the care your patient's getting and the way you're interacting with colleagues, just there's so much, it's not even worth dwelling there because I'm talking to the people who already know.
In all of that, what I feel like I'm hearing you say is this is about controlling the controllables. There's so much that we don't have control over, including the outcome of that birth. As a doula, I don't have control over whether or not my client has that dream vaginal birth. Neither do they. I have influence, but I don't have control. There's so much that's outside of our control. There are so few things that we actually can choose, and we often give those away because we don't think about them. I feel like what I'm hearing you say is this is empowering because these are the things I can actually choose.
Sarah: Exactly. Krysta, I know we actually talk once a month. We have our little coffees once a month, so I get to see you again. I'm like, oh, I want so much more, which makes me very excited about our upcoming MOVE learning retreat. If you are loving this conversation, know that this is not the end of it. If you are looking for more from Krysta, we'll link her information down below in the show notes. We also have four classes on the Bundle Birth site, preventing trauma level one, preventing trauma level two, a grounding techniques class, and then healing trauma and the birth professional, which really is her gift to you, specifically related to your trauma.
If you are having a hard time, you are recognizing you're having maybe some PTSD, symptoms of burnout, you are struggling with the job and the challenges of the weight that we hold, we'll link that class down below. That's also available to you. Then, of course, we want to invite you to our MOVE learning retreat. We'd love to see you there. We are going to get deeper into this.
I will also drop the objectives of what we're learning. For those of you that don't know, we are going to Mexico in May of 2026. It is, right now, our last one. I know I said that last time. We're approaching that from a different perspective. I am not putting anything on the calendar. We got to get our lives together first. I'm not saying never, but right now there's no plan for a future one. If you want to come, we would love to have you there.
The point/the theme of where we're going, really, it's called Live Colorfully. That came from a place of knowing that right now, a lot of our job may feel pretty black and white, whether that be rigid, whether that be strict and restrictive, or just boring, where we've lost the color in our work.
What we want to do over this week is infuse life, infuse color, give you opportunity to not only learn, yes, and we're going to talk about the creative art of nursing and centering the patient experience for better outcomes, that's the clinical term, but really, we're going to use that as a vehicle and Krysta's learning, and we're bringing on Teresa, who's a doula from Mexico who did a rebozo healing ceremony. She's going to teach us about the use of the rebozo. We'll get to practice. We'll get to heal. We'll get to process.
Really, like we said, the sneaky goal is that, yes, we want to train you and help you to be more equipped to give the beautiful, creative art of a practice that you get to offer your patients for a better experience while also helping you find your community, find that connection for yourself, learn to downregulate your nervous system with some not only very practical tools, but just in an environment that just forces you to do that.
Krysta: I feel like it's a very life-giving environment. [crosstalk] Not only is the training life-giving, and obviously all the magic you bring to it, and the enthusiasm you bring to it, and the humanity you bring to it, it's also a colorful, beautiful environment. It's like, you're so spoiled, by the end, you had just the best time. I think you make some besties. I saw so many people becoming besties in the pool after training. Some margaritas, some sunshine. There's wild iguanas walking around, and beautiful foliage, and the gorgeous beach is right there.
Living colorfully just sits so well there that I feel like I went home, even from the trainings, I went home, even on the trainer side, inspired. I walked away feeling like I got a little boost from being around everybody else who's so excited to be in this space. It was a little shot in the arm before you go back out.
Sarah: Totally. It was for me, too, even just running it. I didn't go in the pool, other than for a meeting that I scheduled with participants, where I was like, let's talk about it in the pool because otherwise I'm not going to the pool, or when I jumped in the pool in my dress the very final night after everything was over, that was also very fun. I also went snorkeling with a group of you because you were scared of that, and I love a snorkel.
Now that I say that, I'm like-- but still, it was scheduled time. It wasn't like, it's not a vacation for me. Yet what I love about this is it's the opportunity for every single one of you to infuse yourself into creating this culture that we say will only exist once, that we get to create our little microcosm of community, of support. We're very clear about our boundaries and what's acceptable or not. There's no mean girl vibes. We're not here to judge each other. We're here to exercise what it means to be able to just show up and be cared for, show up and be accepted exactly as you are, and then choose to accept others as they are as well.
Obviously, we're very excited about it. I'll link everything down below. You're more than, not only welcome, we would love to have you there. Come say hi. Come learn alongside of us. Thanks for spending your time with us during this episode of Happy Hour with Bundle Birth Nurses. If you like what you heard, it helps us both if you subscribe, rate, leave a raving review, and share this episode with a friend. If you want more from us, head to bundlebirthnurses.com or follow us on Instagram. Now it's your turn to take what you learned today, apply it to your life, and-
Krysta: Go make a meaningful connection with someone else.
Sarah: We'll see you next time.