B.O.T Birth Oriented Thinking
B.O.T (Birth Oriented Thinking) is a professional field that focuses on the emotional aspects of the pre- and post- partum period and labor itself and offers unique training programs for birth professionals.
B.O.T has evolved from the needs of pregnant and birthing women (and their families) who lacked adequate response to the emotional challenges typical of this period.
Medical examinations, processing a traumatic birth, pregnancy loss, miscarriage, etc. require knowledgeable support and attention. B.O.T aims to provide practical tools for caregivers to enable them to optimally address those specific situations.
The B.O.T center offers knowledge and training to professionals in various fields, such as healthcare providers, psychotherapists, delivery unit personnel, birth workers, lactation consultants and doulas.
Keren Fridman-Gadassi is the founder of B.O.T (Birth Oriented Thinking), an organization that promotes mindful communication around birth through education and training. Keren has been working with hundreds of professionals such as family physicians, midwives, psychotherapists, nurses, doulas and social workers. In her clinic she has over 20 years of experience meeting women and couples affected by pregnancy loss and birth trauma, as well as with professionals affected by the same events. The practical approach developed by Keren aims to address the needs of all involved.
Training Program
The B.O.T program is aimed to offer hands-on practical tools for pregnancy & birth caregivers to address emotional aspects in short-term encounters within medical setting (medical examinations, fertility treatments, stillbirth etc.) or while providing breastfeeding counseling or processing a traumatic birth. At the same time, the B.O.T training provide the caregiver applicable ways to relate to her own inner state within the same setting
The B.O.T Program Leading Topics
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Emotional first-aid tools
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Addressing emotional difficulties during or following emergency medical procedures
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How to approach sensitive issues such as a past trauma or pregnancy loss.
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The caregiver somatic awareness as a vital communicating tool
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Partnership model for collegial support
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Unique themes such as: sexual trauma/abuse, vulvovaginitis, birth trauma, IUFD and the emotional challenges that can manifest at birth and at the postpartum period
Core questions we would like to explore
# How do we create a meaningful interaction in a limited setting such as a medical examination?
# How do we encourage an intimate conversation where there is no privacy (like in a labor ward)?
# Is it possible to invite an open dialogue about emotional aspects when you are a doctor and not a psychotherapist and working within the time constrains of a hospital checkup?
The B.O.T program for midwives
The B.O.T program for midwives is aimed to offer hands-on practical tools for caregivers to address emotional aspects in short-term encounters within medical setting (fertility treatments, stillbirth etc.) as well as to provide the caregiver applicable ways to relate to her own inner state within the same setting.
Our Premise: We believe that promoting the midwife’s capability to address her own emotional needs is an essential step to establish healthcare communication skills.
The B.O.T Program Leading Topics
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Emotional first-aid tools
-
ddressing emotional aspects during/following emergency medical events
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Sensitive issues such as trauma history and pregnancy loss.
-
The caregiver somatic awareness as a vital communicating tool
-
Partnership model for collegial support
-
Unique themes such as: sexual trauma/abuse, Vulvovaginitis, , birth trauma, IUFD
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The 4E's Model
(FIGURE by Rony Askapa Shani)
The 4E's
Rationale and Theoretical Framework
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Delivery room staff faces trauma and loss on daily basis.
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Most of the staff are required to act without a specific training how to address emotional needs of the woman and her partner/ family.
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Research findings regarding childbirth experiences highlight the importance of the relationship and the communication among the women and their healthcare provider during childbirth.
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The midwife’s cognitive and emotional state is crucial for communication during childbirth.
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Working alongside the setting limits of the delivering room.
Midwives' Emerging Need
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Practical tools enabling responses for the patient's (and her family) emotional needs.
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Strategies to regulate stress following their care work.
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A support system after adverse incidents and complex situations.
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A meaningful relationship, continuum of connection and a sense of meaning
The Ripple Effect of Childbirth
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Obstetric procedures have a high potential to trigger trauma or re-traumatize women by their association with exposure or penetration due to their invasive nature.
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Insufficient communication during childbirth is one of the factors associated with birth trauma.
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Cheryl Tanto Beck (2015) demonstrated in her "Middle Range Theory" the ever-widening ripple effect of a traumatic birth on the woman, her surroundings and on the healthcare providers.
Teaching and Learning Methods
Learning communication skills through exploring the caregiver's own professional conflicts
Using "midwifery senses" for teaching "Felt-Sense Communication"
Tools, Practices and Models, are developed to be applicable in different settings
B.O.T practices can be implemented within the caregiver-patient interaction, as well as for self-care.
Midwives' Experiences Using The B.O.T Approach
The B.O.T program for midwives is aimed to offer hands-on practical tools for caregivers to address emotional aspects in short-term encounters within medical setting (fertility treatments, stillbirth etc.) as well as to provide the caregiver applicable ways to relate to her own inner state within the same setting.
CONTENT WARNING: The following contains some graphic descriptions of childbirth and traumatic experiences.