(BPT) - At 26 weeks pregnant in 2022, Azhia Kirk was rushed into an emergency delivery where everything happened in an instant — without explanation or time for her to process — leaving her scared and alone. Under general anesthesia, she missed the birth of her daughter, Sloane, entirely. When she woke up, her baby was already in the neonatal intensive care unit, where she remained for 113 days.
The experience left Azhia with profound psychological and physiological trauma, including distressing memories and fears. The idea of another pregnancy felt overwhelming. She and her husband, Brent, wanted a second child, but as Sloane approached her first birthday, Azhia realized she needed support to process her delivery experience. She found help through trauma-informed care provided by obstetric anesthesiologist Tracey Vogel, M.D., director of the Perinatal Trauma-informed Care Clinic at Allegheny Health Network, Pittsburgh. Dr. Vogel screened Azhia for anxiety and post-traumatic stress disorder (PTSD), with which she was ultimately diagnosed; helped identify triggers from her experience; and connected her to peer support and a program that supported healing through music therapy called the Lullaby Project. She worked closely with Azhia's obstetrics team, who understood her past trauma and saw her more frequently in the early stages of her second pregnancy.
"I don't think I would have gotten pregnant again without Dr. Vogel's support," said Azhia, a lawyer and mother to Sloane, who is now 3, and Hayes, 1. "She gave me the tools to face another delivery with confidence instead of fear, and my son's birth was completely different."
"Anesthesiologists are physicians who are trained to manage high-risk, high-stress situations, which puts us in a unique position to help patients not just physically, but emotionally, when they're at their most vulnerable," said Dr. Vogel. "Trauma-informed care starts with listening to each patient to identify what they've been through, what triggers their fear, and then building a plan with them and their care teams so they can move through their medical care feeling supported and in control."
Trauma-informed care recognizes that past experiences can negatively impact a patient's response to medical care. These may include childhood abuse, intimate partner violence, military service or prior medical trauma — such as poorly managed pain or feeling a loss of control. Trauma can also stem from difficult or emergency births, complications like excessive bleeding, anesthesia challenges or the loss of a baby. Because these experiences can heighten anxiety and trigger stress responses, trauma-informed care focuses on understanding each patient's emotional and physical needs and emphasizes clear communication, patient choice and step-by-step guidance, creating a sense of safety and control throughout the medical experience.
Understanding Trauma and Building Care Around the Patient
As an anesthesiologist providing anesthesia and pain management during and after labor, Dr. Vogel noticed how often past traumas affected women's birth experiences. Many carried emotional scars that influenced their response to pain, stress and medical care. Wanting to better support them, she trained in sexual assault counseling and created a specialized clinic to support patients with a history of trauma.
Dr. Vogel has worked with more than 1,000 patients and trained hundreds of clinicians in trauma-informed care. She also supports patients with a history of trauma who have other types of medical procedures, such as surgery, helping them identify triggers, understand what to expect and feel more in control throughout their care.
A Much Better Birth Experience
For Azhia, trauma-informed care made all the difference. When Hayes was born in April 2025, Azhia felt calm, informed and in control, a stark contrast to her first experience. Getting ready for his birth, she was able to ask questions, share her preferences and feel supported throughout her scheduled delivery.
"During my first delivery, I felt scared and completely alone because no one was explaining what was happening," said Azhia. "This time, Dr. Vogel walked me through every step, including what I would feel, what was happening and what would come next. I learned that I could ask questions and advocate for myself without interfering with my care. That gave me the confidence to be part of the process."
To learn more about how anesthesiologists keep patients safe during childbirth and before, during and after surgery, visit the American Society of Anesthesiologists at: https://www.asahq.org/madeforthismoment/.
Photo courtesy of Harley Steed Photography.
