Restorative Justice and Birth Work: Healing Trauma in the Perinatal Period

Childbirth is a transformative experience, yet for many, it is also marked by trauma. This trauma can have long-lasting impacts on both the birthing person and their infant, especially when compounded by systemic issues in healthcare. When we approach the intersection of restorative justice and birth work, we open a path to healing that honors the trauma experienced while simultaneously fostering accountability and systemic change. This approach can help address not only individual wounds but also the broader societal conditions that perpetuate harm, particularly for marginalized birthing parents.

The Impact of Trauma on Pregnancy and Birth
Trauma, especially during pregnancy, can deeply affect both the birthing person and their child. When a pregnant person faces distress or trauma, whether physical, emotional, or psychological, it can lead to both short- and long-term effects on the infant. Short-term effects may include increased fetal heart rate or slower reaction times. Long-term consequences can be even more significant, such as psychopathology, unhealthy attachment styles, obesity, and mental health challenges throughout life.
The biological basis for this lies in the HPA (Hypothalamic-Pituitary-Adrenal) axis, which regulates stress hormones like cortisol. Cortisol crosses the placenta, affecting the fetus, and long-term exposure can contribute to irritability, depression, poor sleep, and other issues. Importantly, trauma during the perinatal period isn’t just psychological—it is also physical.

The Need for Trauma-Informed Care in Birth Work
Support for those who have experienced trauma during the perinatal period requires a multi-faceted approach. Trauma-informed care, doula support, and childbirth education have all proven to be beneficial for reducing retraumatization and alleviating PTSD symptoms in birthing individuals. These practices create a compassionate, informed environment where birthing individuals are supported in their journey toward healing.
However, the experiences of people of color—particularly Black, Indigenous, and other marginalized communities—can be significantly different. Black birthing people, for example, face a stark maternal health crisis, with the risk of dying during childbirth being three to four times higher than for white birthing people. This disparity is rooted in a history of medical mistreatment and racial discrimination, which only exacerbates the trauma experienced during pregnancy and childbirth. Alongside this, socioeconomic barriers—such as lack of access to transportation, childcare, and financial resources—further limit access to crucial interventions.

The Need for Restorative Justice in Birth Work
Restorative justice offers an innovative and healing-centered approach to addressing the trauma that often accompanies childbirth. At its core, restorative justice involves creating spaces where individuals impacted by harm can come together to acknowledge their experiences, heal, and rebuild relationships. In the context of birth work, restorative justice can help those who have suffered from medical mistreatment, abuse, or neglect during childbirth to reclaim their power and heal within a supportive community.
When applied to childbirth, restorative justice practices can take many forms. For example, community circles allow survivors to share their birth stories in a safe and supportive environment. In Spokane, Washington, restorative justice circles are already being used to improve training for local healthcare workers, highlighting the transformative potential of this approach. Additionally, accountability measures for healthcare providers—such as probation periods with informed consent training—can promote growth and healing, both for the survivors and the practitioners themselves.
Restorative justice emphasizes the importance of community involvement and accountability. By acknowledging the root causes of violence and mistreatment, such as systemic racism, healthcare professionals can work towards dismantling the biases and harmful practices that contribute to trauma in birthing spaces. This approach fosters a culture of mutual respect, empathy, and trust, which is crucial for breaking the cycles of mistreatment that disproportionately affect marginalized birthing parents.

Centering the Experiences of BIPOC Birthing People
The intersections of racism, healthcare, and gender-based violence are especially pronounced for Black, Indigenous, and People of Color (BIPOC) birthing individuals. For example, Black mothers face both increased risk of birth trauma and an increased likelihood of experiencing medical oppression during childbirth. These experiences are often compounded by implicit bias and a lack of culturally competent care. As a result, Black birthing individuals may not only experience physical harm during childbirth, but also long-lasting emotional and psychological scars.
In the context of restorative justice, it is essential to center the experiences of these marginalized communities. Through processes like the Birth Trauma Restorative Justice Circle, we aim to support those who have been harmed by the healthcare system, particularly Black, Indigenous, and other marginalized birthing parents. This initiative provides a platform where survivors can express their trauma, rebuild their sense of agency, and take part in community-based healing. At the same time, it challenges healthcare professionals to confront their biases, engage in meaningful self-reflection, and create more equitable systems of care.

Trauma-Informed Prenatal Interventions
Interventions for birthing individuals who have experienced trauma must be multi-layered and tailored to the unique needs of each person. One crucial resource is Penny Simkin’s When Survivors Give Birth, which provides practical guidance for integrating trauma-informed care into the perinatal period. This care should extend across the prenatal, labor, delivery, and postpartum stages of birth, with special attention paid to the needs of those who are at greater risk of trauma, such as BIPOC and LGBTQ+ individuals.
Effective interventions, when used together, can reduce the likelihood of retraumatization and improve outcomes for both birthing individuals and their infants. Providers—whether doctors, midwives, doulas, or nurses—should be trained in a variety of modalities to offer holistic, individualized care that addresses the mental, emotional, and physical impacts of trauma.

The Role of Restorative Justice Circles in Birth Trauma
The Birth Trauma Restorative Justice Circle is designed to provide a healing space for survivors of birth trauma, particularly those from marginalized communities. Through restorative justice practices, we create a collective process that acknowledges harm, fosters empathy, and promotes growth and accountability within the healthcare system.
One example of this process is community circles where individuals impacted by birth trauma can share their experiences in a safe and supportive space. These circles also serve as a platform for providers to reflect on their practices and take accountability for their roles in perpetuating harm. In addition, these circles can influence training programs and policies within the healthcare system to ensure more culturally competent and empathetic care.
Through the lens of restorative justice, we aim not just to heal individuals but to create systemic change that prevents further trauma in the future. This includes addressing institutional racism, implicit bias, and the mistreatment of marginalized birthing individuals in healthcare spaces.

Building a Culture of Accountability and Healing
The journey toward healing for birth trauma survivors is complex, but restorative justice offers a path forward. By recognizing the emotional, physical, and psychological toll that trauma takes on birthing people, we can build a more compassionate, accountable, and trauma-informed healthcare system. This system must not only address the needs of survivors but also promote systemic change that dismantles the structures of oppression that perpetuate harm.
Through restorative justice practices, we can create a supportive and healing environment for all birthing individuals, particularly those from historically marginalized communities. In doing so, we take a step toward a future where trauma is no longer a permanent part of the childbirth experience, but rather a catalyst for growth, healing, and collective transformation.