Having midwife care for the births of my two babies and for years after, I recently turned to midwives again. My trust in gynecology had been destroyed by non-consensual cutting and the institutional betrayal that protects the abusive doctor and makes me out to be the problem if I object. I knew I would feel much safer with midwives than gynecologists.
Over about 18 months, I had a few visits with a wonderful midwife named Karen, who seemed to understand the horror of what the gynecologist did to me, and was able to attune, listen compassionately, offer empathy, and verify that, yes, this was outrageous abuse. But everything suddenly changed at my last appointment.
Without notice, the practice switched me to a midwife I had never met. This created an immediate shock and disruption to my nervous system. For a trauma survivor, safety includes knowing what to expect, and this lack of preparation was deeply destabilizing.
The midwife’s behavior compounded the negative experience. Despite my clear verbal communications and a prepared handout, the midwife did not attune to my needs. Instead, there was a big disconnect between what I needed and what she thought I needed to know. She was all about what I should know from her perspective, according to her agenda. She was not curious about what I wanted to know. She blabbed on, rapidly changing directions, but always far off the mark.
Of course, this amplified my distress and left me in a worse state than when I arrived. The significant negative impact included increased anxiety, intrusive thoughts, and flashbacks. I had to spend considerable time and energy repairing the damage from this one visit, including dedicating half of a subsequent therapy session to process what occurred.
The midwife’s subsequent refusal to recognize the impact, own her behavior, and make an authentic apology, and with the clinical director’s brush-off–both of which seemed to imply I was the problem for having such high expectations–convinced me that I’m done with “women’s health.” If I can’t trust midwives with my care, who can I trust?
It wasn’t just her talking too much, but the lack of resonance. With her being ungrounded, there was no relational anchor that would have helped me settle into my own body. That absence of attunement can feel like abandonment in the moment, an added burden. The experience also caused me to examine the Interpersonal Neurobiology (IPNB) of the dynamic between the midwife and me.
When someone who is supposed to be present is instead preoccupied with their own inner chatter, it creates a kind of dissonance in the space between. Their inability to settle into their own body means they can’t attune to another’s, and instead of receiving support, they are tasked with managing the mismatch. That can be overwhelming, especially in a context where the body and nervous system need calm, presence, and safety.
When a person feels the need to rapidly deliver information without pausing to check in with the other person, especially a healthcare practitioner, several things could be happening in their system from an IPNB perspective:
State of urgency or threat: Their nervous system is likely in a heightened state of arousal. They may feel internal or external pressure to “fix” something quickly, solve a problem, or assert competence. This creates a sense of urgency that overrides curiosity and attunement.
Focus on their own agenda: Their attention narrows toward what they want to communicate or accomplish, rather than the relational context. When the system is in survival or high arousal, the capacity to notice another person’s needs or responses diminishes.
Reduced regulation capacity: High arousal reduces access to flexible thinking, empathy, and social attunement. Their nervous system prioritizes action over connection. In this state, pausing to ask questions or gauge understanding can feel risky or inefficient to them, even unconsciously.
Social hierarchy and role expectations: In healthcare, practitioners are often in a position of authority. That role can unconsciously trigger a “teach or lead” mode, where their system assumes that giving information is their primary responsibility, rather than co-regulating or listening.
Lack of attunement training: Many practitioners are never taught to notice the other person’s nervous system cues or prioritize relational presence. Without practice, curiosity and verification of the other person’s needs don’t naturally emerge, especially under stress or time pressure.
The result: The person offering information may come across as dismissive or overbearing, not because they intend harm, but because their nervous system is operating from urgency, authority, or incomplete regulation rather than relational attunement.
Without a repair, I will have to work extra hard to resolve the issue. I need to address the impact and find recovery through the options that remain: filing complaints, experiencing compassionate witnessing about the visit from my healthcare team, and public expression of my lived experience. This effort is necessary solely due to the lack of relational repair that could have quickly bridged the rupture.
This experience solidified my understanding that true healing and trust in healthcare require genuine attunement and relational repair. Moving forward, I am committed to advocating for myself and others, ensuring that the critical need for presence and empathy is recognized and prioritized in healthcare interactions.
