The Trauma-Informed Doula: Beyond Birth Plans and Into the Nervous System
by Adria Moses
It was the fall of 2023, and my dear friend, Mykeia, had just experienced the unimaginable—she lost her baby.
She had made it past her first trimester, only to be met with grief that no one prepares you for. We had just begun prenatal yoga sessions when, in the midst of her heartbreak, she introduced me to her friend, Curpri, who was six months pregnant and battling breast cancer.
Mykeia and I went way back, so when she asked if I could support Curpri through her cancer journey, I agreed without hesitation.
The three of us bonded almost instantly. Mykeia would pick me up and drive me to Curpri’s home for our one-on-one sessions. Her selflessness during such a heavy time stood out to me; she embodied a communal form of care even in grief, a kind of togetherness rooted in love and connection rather than isolation.
As I began working with Curpri, I couldn’t ignore her pregnancy. She was small in stature but radiated a vibrant, bubbly energy. Even through chemo, she carried faith like armor, determined to move through it all with her head held high.
One evening, sitting together in the grass, I invited her to share about her pregnancy. She paused. The words were hard to find. I could sense how cancer had quietly disconnected her from the experience of carrying life. At that moment, I knew it was time to prepare her for something deeper. With her permission, I stepped into the role of her doula. In those sessions, we envisioned her birth. We reconnected her with her body, her breath, and her baby, gently rebuilding a bridge between survival and creation.
Over the next two months, Mykeia and I became part of her village.
We would drive over together; while I supported Curpri through breathwork and gentle movement, Mykeia supported her by caring for her older son, tidying the house, and holding space in ways only a friend could. Afterward, we would sit down to eat with her family, sharing food, laughter, and small pockets of reprieve in the midst of so much heaviness.
Curpri was induced a month early and gave birth to a beautiful baby boy.
She breathed her way through a VBAC with grace and grit. And just over a year later, Mykeia welcomed her own baby boy into the world, this time, with me as her prenatal doula.
That experience changed me.
It showed me that trauma-informed doula care goes far beyond birth plans, it’s about creating safety through regulation, presence, and nervous system attunement.
While doulas are trained to support physically and emotionally, few are taught how to read and respond to the body’s nervous system cues. Yet that awareness, the ability to know what safety, fear, or surrender looks like in the body, is what transforms support into healing.
What Does It Mean to Be Trauma-Informed?
That season with Mykeia and Curpri reminded me of what I know so well: trauma lives in the body, and so does safety. It showed me that being trauma-informed isn’t only about what we know, it’s about how we show up when things become turbulent.
To be trauma-informed is to understand that every person carries a nervous system that remembers.
It’s the awareness that birth, loss, illness, and survival all shape how the body responds to touch, sound, and even silence.
In the birth space, those memories can surface unexpectedly through a sudden freeze, a distant gaze, or a body that tightens and constricts against its own pain. It shows up in the fears our clients carry and in the ways their stories live inside their muscles and breath.
Being trauma-informed means we meet those moments with presence, not pressure.
We listen with our whole body.
We slow down.
We ask before we act.
And we hold space for both strength and fragility, knowing that healing doesn’t happen when we try to fix–it happens when the body feels safe enough to trust.
For doulas, this awareness changes everything. It turns our role from caretaker to witness, from doing to being. It teaches us to notice regulation, the rhythm of breath, the tone of voice, the energy in the room, as our most powerful tools for support.
To be trauma-informed also means we recognize the systems that directly impact the birthing person. It asks us to be flexible, to honor the lived body in front of us, and to go beyond birth plans so we can align with the nervous system.
Understanding the Nervous System
When I think back on Curpri’s story, I think about how loss, cancer, and birth reshape the mind, body, and soul. But our nervous system is like an underground design, an unseen architecture that supports us in everything we do.
Your nervous system is interacting with these words as we speak.
As doulas, we ought to have some knowledge of how the nervous system functions. At the School of Radical Healing, we teach about the nervous system in three parts:
Sympathetic: fight or flight
Dorsal parasympathetic: frozen/shut down
Ventral parasympathetic: engaged/socially connected
When we make eye contact with our clients, offer steady breath, or reassure them with tone and presence, we have the influence to shift them from fight, flight, or freeze into connection and engagement.
It’s important to know that we all climb this autonomic ladder, moving in and out of these states, every single day.
I encourage all doulas to study Polyvagal Theory and to dive deeper into nervous system understanding beyond “feeling calm.”
A healthy nervous system is one that fluctuates and can return to baseline. Regulation is not the absence of activation, it’s the ability to come home to yourself again.
The Doula as a Regulated Presence
Where we are within ourselves matters.
What I’ve learned over the years supporting women whose birthing experiences are intersectional, cancer, recovery, first-time motherhood, trauma histories, is that the greatest gift I can give is to be steady. Not to fix, not to force calm, but to be a pillar that is not easily moved.
We achieve a regulated presence by practicing somatics ourselves, by doing the internal inventory that is necessary to serve others. I know what I have in stock, so when someone needs something, I’m resourced. When we don’t know what we have, we go to give and sometimes offer the wrong thing, particularly when we are dysregulated. Or we realize we’ve run out of what was well in stock not that long ago. Sometimes we give too much, or we simply cannot access what our clients need.
The nervous system reminds us that we influence one another. When we allow ourselves to experience our own nervous system honestly and without avoidance, we can relate to our clients in a far more powerful way.
Grounding Tools for Doulas and Clients
Rhythmic Breathing:
A technique that involves establishing a consistent and regular pattern for breathing, often by coordinating inhales and exhales to a specific count. A steady breath invites the body out of survival.
Compassionate Inquiry:
Asking questions instead of making assumptions. Asking questions soaked in empathy, recognizing how stress and trauma can be present in someone bringing life into this world. We ask questions to promote trust in the birthing person–not trust of us, but trust of themselves.
Why Trauma-Informed Care Matters for Community Health
When we lack awareness, our capacity to cause harm may increase. When I’m asked, “What is trauma-informed?” I say: it is collaboration, it is trust, it is safety, it is agency. It is community-building because it recognizes how lived experiences impact our ability to connect.
When we are informed, we move through our community with awareness instead of habit or the supremacist culture of urgency, perfectionism, and disregard. And in a world that serves us trauma both hot and cold, that awareness is a lifeline.
A New Way of Holding Space
I dream of a trauma-informed world, one where the harm that Black and brown birthing people experience when bringing life into the world is met not with dismissal, but with care, with nervous system knowledge, with a trauma-informed approach that honors their whole being.
When we feel into one another, when we move beyond performance and into connection, we inherently resist systems of oppression that compromise all of our bodies. We create safety. We create protection that isn’t sympathetic or surface-level. We create care that liberates someone from feeling frozen, stuck, or alone in their body.
I don’t believe in waiting for systems to fall before offering radical care. I’ve watched mothers fight cancer and give birth at the same time. I have seen miracles of loss and life. There is nothing more precious than holding one another through the trauma the world gives us.
I see a future where being trauma-informed is the norm, where it’s the requirement. And as birth workers, we are the future of the care we deserve.
Written by Adria Moses
Founder of the School of Radical Healing
Somatic Practitioner
Birth Doula
E-RYT 200 and Prenatal Yoga Teacher