SELF-CARE

“I think about maternal mortality as a sentinel event similar to tossing a pebble into a pond of still water. It begins with a maternal event that expands with ever enlarging ripples impacting the child, her partner and other siblings, her other children, her extended family, then her physicians, nurses, and other health care providers, her employer and coworkers, society at large…”

- King, J.C. (2012). Maternal mortality in the United States – why is it important and what are we doing about it? Seminars in Perinatology, 36(1), 14-18.


Vicarious trauma, or secondary trauma is a condition that may occur when an individual who did not witness a traumatic event or catastrophe absorbs or integrates disturbing aspects of someone else’s traumatic experience into her or his own functioning. It is usually the cumulative result of repeated exposure to traumatized people or, as with members and staff of Maternal Mortality Review Committees (MMRCs), the trauma of repeatedly reviewing stories of death.

It is common for a person to remain in denial about how he or she is being affected by vicarious trauma until symptoms become too strong to deny.

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Signs & Symptoms of Vicarious Trauma

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BEHAVIORAL

Impulsivity
Inability to listen to one more story
Unrealistic expectations of self, friends, family and coworkers
Not fulfilling obligations and commitments
Inability to concentrate
Overthinking or obsessing
Changing view of work
Belief of not accomplishing changes

MENTAL/EMOTIONAL

Depression
Anxiety
Turmoil in relationships and intimacy
Erosion of trust
Blaming Lack of connection with a source of meaning, purpose, or hope
Erosion or questioning of faith or beliefs

PHYSIOLOGICAL

Fatigue
Illness
Psychosomatic complaints
Inability to sleep or having nightmares

MOOD

Irritability
Intolerance
Impatience
Feeling overburdened
Feeling out of control of life and situations

MOOD

Irritability
Intolerance
Impatience
Feeling overburdened
Feeling out of control of life and situations

Vicarious trauma is exacerbated by feelings of professional isolation, large caseloads, and frequent contact with traumatized people. Vicarious trauma is heightened or exaggerated when a person has a traumatic history, seeks to avoid re-experiencing his or her own emotions, or overidentifies with or responds personally to others’ emotional states.

To prevent or reduce the negative impact and accumulation of vicarious trauma on MMRC members, MMRCs can institutionalize a systemic prevention program focused on self-care to maintain staff well-being. MMRCs can educate members and staff about vicarious trauma and selfcare strategies. MMRCs should make self-care a priority and staff and members should create personal self-care plans that offer in-the-moment and long-range, workplace, home and community interventions.

An easy place to begin in devising a plan is to remember the ABCs of self-care: A for Awareness, B for Balance, and C for Connection. From there, MMRCs can support the creation of self-care plans.