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
  • Emotional first-aid tools

  • Addressing emotional aspects during/following emergency medical events

  • 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 

  • The 4E's Model

The 4E's Model.
(FIGURE by Ronny Askapa Shani)

Rationale and Theoretical Framework
  • Delivery room staff faces trauma and loss on daily basis.

  • Most of the staff are required to act without a specific training how to address emotional needs of the woman and her partner/ family.

  • Research findings regarding childbirth experiences highlight the importance of the relationship and the communication among the women and their healthcare provider during childbirth.

  • The midwife’s cognitive and emotional state is crucial for communication during childbirth.

  • Working alongside the setting limits of the delivering room.

Midwives' Emerging Needs
  • Practical tools enabling responses for the patient's (and her family) emotional needs.

  • Strategies to regulate stress following their care work.
    A support system after adverse incidents and complex situations.

  • A meaningful relationship, continuum of connection and a sense of meaning.

The Ripple Effect of Childbirth*
  • 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.

  • Insufficient communication during childbirth is one of the factors associated with birth trauma.

  • 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.

ripple effect.jpg
  • Beck, Cheryl Tatano. "Middle range theory of traumatic childbirth: The ever-widening ripple effect." Global qualitative nursing research 2 (2015): 2333393615575313.‏

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.