Dr. Tracey Vogel sits for a portrait at West Penn Hospital on Feb. 7, 2023. (Photo by Quinn Glabicki/PublicSource)
Trauma echoes through childbirth, and childbirth can amplify trauma. Pittsburgh’s Dr. Tracey Vogel refuses to ignore that.
by Meg St-Esprit, PublicSource
Content warning: This piece contains a description of a traumatic medical birth experience.
She never set out to turn the world of maternal health care on its head, but local anesthesiologist Dr. Tracey Vogel may do just that.
Working in obstetrics at Allegheny Health Network, she began her career focusing on how to make pregnant people more comfortable during delivery. A well-placed epidural or spinal block can make all the difference during a difficult birth, and she prided herself on being one of the only anesthesiologists that worked solely with pregnant people.
Vogel, through connecting with patients across Western Pennsylvania, began to notice a critical gap in maternal care for her patients. She was able to ease the physical pain they experienced on the delivery table — but what about the emotional pain they brought into the room with them? Many pregnant people enter the delivery room with a history of trauma related to previous birth experiences or sexual assault, though traditional obstetrics has often failed to acknowledge that.
“Why don’t we think that birth is traumatic?” Vogel asked.
“We are taught a social concept that birth should be beautiful; we should be happy,” she continued in an interview. “It’s always joyous. And we know that it’s not always joyful in the land of obstetrics.”
The rosy image pregnant people see on social media neglects to highlight the trauma and emotional pain that often go hand-in-hand with pregnancy. When Vogel noticed this gap, she began to expand her view of what pain management could truly look like — a novel concept in obstetrics. As her vision broadened, Vogel began to bring trauma-informed counseling into the childbirth process, and then to teach that approach to a growing number of obstetrics professionals.
Maternal mental health care in the United States is abysmal. According to the Centers for Disease Control and Prevention, one in eight pregnant people experiences postpartum depression. Further research, such as a study completed in Texas in 2021 by Mathematica, found that half of the perinatal women diagnosed with postpartum depression do not receive appropriate mental health care, and that number was higher for Black and Hispanic women. A 2011 Harvard Medical School study found that Black women in New Jersey were less likely to receive care once postpartum depression was diagnosed. The United States has a higher maternal mortality rate than any other developed country in the world. Follow-up care is also lacking.
For pregnant people with a history of sexual assault or a previous traumatic birth, this critical gap in the healthcare system often leaves them approaching birth without any consideration given to their trauma history.
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