Causes, Health Effects, and How to Begin to Heal

Whereas my being pregnant journey wasn’t what I’d hoped for, I set my sights on the start, hoping it could be a redemptive expertise. Don’t get me fallacious, I knew start could possibly be unpredictable—I’d taken childbirth schooling courses and researched start outcomes advert nauseam (I’m a well being journalist, in spite of everything)—however nonetheless, I used to be optimistic.

I’d assembled a tremendous medical group—a caring, affirming midwife observe and a compassionate doula—so I felt assured that my start preferences can be honored and revered. My ideally suited situation was an unmedicated vaginal start. Certain, I knew it could be the toughest factor I’d ever do, taking me to the sting of what I believed bodily potential. However I needed to dig deep and push forward (actually) to have an expertise I might solely describe as a religious, transformative ceremony of passage to motherhood, the place I would emerge on the opposite aspect as an empowered new mother with a wonderful, wholesome child in my arms.

Sadly, at 34 weeks, I developed preeclampsia—a doubtlessly life-threatening situation that causes hypertension and may injury organs within the physique. By 36 weeks, my situation had change into so extreme it landed me within the hospital. Whereas there, my blood strain skyrocketed, and my liver and kidney features dropped dangerously low. Issues have been shortly changing into very unsafe for me and my child, and I used to be scared.

After discussing dangers, my care group determined a C-section was the most secure route. It was a serious blow to the thought of my dream start. However my child’s well being and my very own relied on it.

Earlier than surgical procedure, I used to be given medicine to stop me from having a stroke or a seizure (which may occur when preeclampsia develops into eclampsia). The medication made me extraordinarily sick and crazy. Within the OR, as they pulled my child out of me and into this world, I used to be gagging and spitting up saliva.

The reminiscence of seeing my son for the primary time is hazy, and I don’t bear in mind a lot else from these first few days. I did not get that magical “golden hour” of bonding with my child post-birth, or any candy pics of us snuggling. I might barely even care for myself. Nurses took over my look after the next 48 hours, right down to giving me sponge baths in mattress.

I spent per week within the hospital stuffed with ups and downs of attempting to manage my blood pressure, and was lastly discharged on a freezing Friday night time in January. I bundled up my child, untimely by 4 weeks, and drove away from the hospital, abandoning my hopes for a optimistic start expertise and the particular person I used to be only a few days earlier.

After I left the hospital, feeling fragile, shaken, and numb, I didn’t but have the precise phrases to explain my birthing expertise. Now I do know it is referred to as start trauma.

“Giving start has been depicted as probably the most lovely issues a lady can do. For some this can be true, however for others, it is traumatic.” —Paige Bellenbaum, LCSW, therapist

What’s start trauma?

Beginning trauma occurs while you undergo a distressing occasion throughout being pregnant, childbirth, or postpartum that overwhelms your thoughts or physique’s means to manage, says Farrah Sheehan, MSN, RN, IBCLC, CCBE(BFW), a nurse educator, researcher, and professional on start trauma prevention and restoration.

“Traditionally, giving start has been depicted as probably the most lovely and superb issues a lady can do; for some, this can be true, however for others, giving start is traumatic,” says Paige Bellenbaum, LCSW, a maternal psychological well being advocate, therapist, and founding director of The Motherhood Center in New York Metropolis.

Like all trauma, start trauma is subjective. What could also be traumatic to you might not be for another person. Because of this, there’s a variety of experiences that may trigger start trauma—together with bodily, emotional, and interpersonal.

Forms of start trauma

Bodily trauma

Bodily trauma entails a critical bodily damage, or the risk/concern of damage or dying, to the birthing particular person (or the newborn), in line with the Maternal Mental Health Leadership Alliance (MMHLA).

Some examples embrace the next, per the MMHLA:

• Emergency C-section or instrumental vaginal supply
• Feeling overwhelming ache or the denial of ache aid
• Third- or fourth-degree perineal lacerations or tears
• Undesirable or unannounced episiotomy (a surgical minimize made on the opening of the vagina)
• Issues with anesthesia
• Guide removing of placenta
• Urinary catheterization
• Unplanned hysterectomy
• Hemorrhage
• Preeclampsia
• Stillbirth/ toddler dying
• Untimely start
• Fetal misery or hurt to child
• Separation from toddler within the NICU

Emotional trauma

Even with out bodily damage, start can nonetheless really feel emotionally (or psychologically) traumatic. It occurs when one thing throughout childbirth makes you’re feeling unsupported, unsafe, or helpless.

Many occasions may cause emotional start trauma, however they usually all have one factor in widespread: It wasn’t in any respect what you’d anticipated.

In all its unpredictability, “start is an innately ‘traumatic’ expertise,” says Sheehan. Irrespective of how a lot you analysis, be taught, and prep for start, there’s all the time one thing sudden that occurs. And if the unexpected occasion causes you nice misery, it will possibly make you’re feeling powerless. It may possibly additionally make you query your belief on the planet, sense of order, or perception in your self, she provides.

Care-related interpersonal trauma

Typically emotional trauma occurs while you’ve been mistreated by your physician or the health-care system at massive. That is referred to as care-related interpersonal trauma. A staggering 1 in 5 birthing folks report getting some kind of mistreatment throughout being pregnant or childbirth, per the MMHLA.

Examples of care-related interpersonal trauma embrace the next, per the MMHLA:

• Feeling disrespected by health-care suppliers
• Feeling deserted or alone
• Feeling pushed, rushed, coerced, or not seen or heard
• Feeling that embodied data is disregarded
• Being yelled at, ignored, scolded, or threatened
• Poor communication (lack of correct translation, spotty and insufficient conveyance of vital data, partial knowledgeable consent, un/misinformed by health-care personnel, and so forth.)
• Lack of company; lack of management and participation in choice making
• Medical suppliers speaking in regards to the start as if the birthing mum or dad weren’t current

How widespread is start trauma?

Sadly, all too widespread. Although analysis continues to be restricted, there’s a rising physique of proof suggesting that many birthing folks have start trauma. Working example: As many as 1 in 3 folks have developed some trauma signs from their start expertise, in line with a September 2023 evaluation in Women and Birth.

Different research estimate this quantity even increased. For example, a June 2018 examine within the Journal of Perinatal Education famous that just about half (as much as 45 %) of latest moms have reported feeling traumatized by their childbirth expertise.

Who’s most in danger? Although it will possibly occur to anybody, sure teams are disproportionately affected by start trauma. “For individuals who have a historical past of trauma or are marginalized or stigmatized in well being care (i.e., girls with substance use dysfunction, LGBTQ+ folks, Black girls, folks of coloration, and other people with a historical past of abuse), the danger for start trauma is larger,” says Sheehan.

Signs and well being results of start trauma

Beginning trauma will be like an earthquake: It shakes the very basis of your sense of self, and it will possibly come up later in all areas of life like aftershocks. In different phrases, its results are far-reaching.

Signs will also be totally different for everybody, says Sheehan, with some folks not feeling results till weeks, months, and even longer after start.

Listed below are only a few methods start trauma can have an effect on your psychological well being, bodily well being, and relationships within the quick and long run.

Psychological well being results

Going by trauma can actually alter the best way your mind features, in line with the Jed Foundation. That’s as a result of trauma overwhelms your nervous system’s means to manage. As a way to survive, your mind protects itself and switches right into a 24/7 fight-or-flight mode, that means it is all the time on excessive alert.

It is no shock then that start trauma may end up in a spread of psychological well being points, together with anxiety, depression, and in some instances, post-traumatic stress dysfunction (PTSD).  Actually, “PTSD impacts round 17 % of postpartum dad and mom,” says Bellenbaum.

Signs of postpartum PTSD would possibly embrace the next, per Postpartum Support International:

• Intrusive re-experiencing of a previous traumatic occasion (which on this case could have been the childbirth itself)
• Flashbacks or nightmares
• Avoidance of stimuli related to the occasion, together with ideas, emotions, folks, locations, and particulars of the occasion
• Persistent elevated arousal (irritability, issue sleeping, hypervigilance, or exaggerated startle response)
• Nervousness and panic assaults
• Feeling a way of unreality and detachment

Whereas many birthing folks don’t meet the scientific standards for PTSD, they will nonetheless have PTSD signs, says Bellenbaum. I fall into this group. Although I don’t have a PTSD analysis, I’ve struggled with well being anxiousness and hypervigilance since my start expertise. It has been over a 12 months, and to this present day, the beeping sound of hospital machines (just like the blood strain monitor) sends my coronary heart racing.

Bodily well being results

In the event you developed a critical bodily damage or medical situation whereas giving start, therapeutic could be a lengthy and sophisticated highway.

Take third- or fourth-degree perineal tears, for instance. These tears trigger extreme injury to the tissues and muscular tissues of your vagina and anus. Not solely are they painful within the days after supply, however the ache can persist lengthy after start (particularly throughout intercourse) and scarring may cause bowel issues like incontinence, in line with the University of Chicago Medicine. These ongoing signs can majorly have an effect on your high quality of life and even your psychological well being.

Well being situations, like my preeclampsia, may proceed to have an effect on your life post-birth. It took a number of months to get my blood strain below management—with medicine and below a specialist’s care.

Equally, stress from start trauma can have an have an effect on in your well being in the long run. For instance, Sheehan says that sure psychological well being points like stress can be linked to inflammation within the physique. It’s true: Extended stress can set off inflammatory responses within the physique, and, over time, can contribute to persistent ailments like coronary heart illness, most cancers, and arthritis, in line with the ebook Oxidative Stress.

Your physique is extra vulnerable to this irritation throughout the postpartum interval while you’re not getting much sleep—which is the physique’s pure solution to restore and mitigate irritation, provides Sheehan.

Results on relationships

Not solely does start trauma have an effect on you, however it might additionally have an effect on your relationships with the folks you’re keen on. For instance, your traumatic expertise could make it troublesome to bond with or breastfeed your child, or be intimate together with your companion, per the MMHLA. Your companion could even really feel traumatized by what they noticed and skilled throughout your labor and supply.

Give your self permission to name your expertise what it was. In case your start felt traumatic to you, then it was. Interval.

The way to course of and heal from start trauma

While you’ve been by start trauma, the world can really feel like a lonely, darkish, and even scary place. As painful as it may be, there may be mild on the finish of the tunnel. With time, endurance, and help, you possibly can start to get better. Listed below are some issues that can assist you alongside the trail to therapeutic.

Give your self permission to name your start “traumatic”

First, give your self permission to name your expertise what it was. “Within the work I do with new moms daily, I nearly invariably have to offer them permission to make use of the phrase “traumatic” to explain their painful and troublesome start,” says Bellenbaum.

Folks concern that calling their start traumatic makes them a horrible mum or dad, she provides. They might marvel, What sort of mum or dad would use that phrase to explain what is supposed to be such a tremendous expertise?

Others could query whether or not they even have the best to name their start traumatic. For example, should you have been lucky sufficient to have a wholesome child, and/otherwise you’ve bodily recovered from the supply, you would possibly really feel the necessity to justify your expertise or emotions. You would possibly query, am I simply overreacting?

It doesn’t matter what you went by, your emotions are legitimate. “Trauma is within the eye of the beholder,” provides Bellenbaum. “What feels traumatic to you would possibly to not another person, however on the finish of the day, all that issues is how you felt it.”

In case your start felt traumatic to you, then it was. Interval. You shouldn’t must bury your true emotions or placed on a contented face for the world. Therapeutic can solely start once we acknowledge our trauma.

Don’t blame your self

When one thing goes fallacious throughout start, many individuals really feel ashamed. They assume, if solely I did one thing totally different, if solely I had ready extra for start, if solely I had spoken as much as the physician.

Some birthing dad and mom even really feel as in the event that they failed themselves and their child. “When the expectation of 1’s start expertise relies on what it ‘ought to’ be like—and it’s not like that in any respect—a brand new mom can really feel shrouded in disappointment, disgrace, and guilt,” says Bellenbaum.

With this deep sense of disgrace usually comes self-criticism. You would possibly beat your self up asking, Why can’t I simply be stronger? Why can’t I simply deal with gratitude? It’s possible you’ll concern different folks will choose you, too.

Please cease beating your self up: Beginning trauma wasn’t your fault, and also you’re to not blame. Disgrace and guilt will solely hold you trapped in a darkish, lonely place and stop you from therapeutic.

Be part of a start trauma help group

Beginning trauma is isolating. For me, the alienation was nearly as heartbreaking because the trauma itself.

After the preliminary shock of my start, I used to be determined to attach, be heard, and really feel understood. However once I shared my expertise, I used to be incessantly met with some model of, “A minimum of you and your child are each wholesome. Now you possibly can transfer ahead.”

“Typically, the folks we share our tales with can hold the trauma wheel spinning,” says Sheehan. That is actually true in my case. Whereas speaking to others, I discovered to maintain the much less fascinating particulars of my story to myself, and in doing so, suffered in silence.

Even amongst different new dad and mom I felt just like the odd one out. I attempted to make connections in a number of new mothers’ teams, however I simply couldn’t relate to anybody. Each mother I met had (or at the least appeared to have had) a reasonably “regular” or routine supply. This solely intensified the loneliness I felt. Typically I’d assume, Am I the one one who looks like this?

Six months post-birth, my therapist really helpful I take a look at a digital start trauma help group. It was a small group— simply me and two different new mothers—nevertheless it was an enormous piece of my therapeutic puzzle. For the primary time, I felt like I might actually relate. Whereas all of us had totally different tales, we shared one factor in widespread: We have been grieving a birthing expertise we did not get to have. We mourned what was taken from us and expressed our true emotions of devastation and rage with out judgment.

Since then, I’ve additionally discovered quite a lot of validation in on-line communities. On Instagram, accounts like @theteaonbirthtrauma and @thebirthtrauma_mama (each run by start trauma specialists who’re survivors themselves) have helped give a voice to what I used to be feeling and made me really feel much less alone.

In the event you’re in search of a help group, you can begin by testing PATTCh (Prevention and Treatment of Traumatic Childbirth), a company devoted to creating consciousness and data in regards to the results of trauma on childbearing folks. The web site has a useful listing of digital and Fb teams, in addition to different helpful assets.

There’s rising proof that implies the results of trauma not solely reside within the thoughts, however within the physique, too, leaving our nervous programs in states of battle, flight, or freeze.

Inform your story

It’s possible you’ll wish to overlook your start trauma ever even occurred—I hear you. However avoidance gained’t serve you. A key to therapeutic is dealing with all your emotions, and telling your story will be an important a part of that.

“The extra girls discuss their traumatic start expertise, the much less energy and maintain it has over them,” says Bellenbaum. (To be absolutely clear, that’s a part of the rationale why I’m writing this text.)

Sharing your start story may assist you reframe your expertise to offer it new that means, rebuild your confidence, and regain your id and sense of self, in line with the March of Dimes. Among the finest methods to do that is by writing all of it down. In the event you’re undecided the place to start, you possibly can obtain templates on-line, like this birth story guide from March of Dimes, for recommendations on find out how to write your story.

After all, who we share our tales with additionally makes a distinction. The consequences of trauma could also be lessened with the “delicate touchdown of human compassion…an individual to deeply take heed to your start story and assist you develop on and discover that means within the expertise,” says Sheehan. In conventional cultures, this particular person could also be a medication girl, or one other girl thought to be somebody who “returned” from the ordeal of start, she provides. Nevertheless it will also be somebody in your life who holds house for you.

In order for you a extra structured choice, you possibly can strive one thing referred to as “Birth Story Medicine,” says Sheehan. In these periods, a educated start story listener guides you thru the sharing course of and helps you make that means of your trauma, in hopes that it’s going to assist you heal different areas of your life, says Sheehan.

“The concept is, the hardship of start trauma didn’t break you, however fairly introduced you with an sudden alternative to heal different elements of your self,” she provides. This falls in keeping with a philosophy referred to as post-traumatic progress, in line with the Journal of Perinatal Education.

Simply have in mind: Submit-traumatic progress is not meant to negate your ache. Your trauma gained’t magically go away. Relatively, your traumatic expertise can reside alongside a brand new appreciation of life, newfound energy, and religious change.

Search skilled assist

The emotional burden of start trauma can change into insufferable, even with household and buddies to lean on. Regardless of having a strong help community, and an arsenal of coping expertise I would collected over time, I used to be drowning. I wanted skilled assist.

Remedy will be an integral a part of the restoration course of. However discovering a talented and skilled counselor is vital. Attempt to discover somebody who is not going to solely validate your emotions and expertise, however who understands that start (whether or not traumatic or not) is an ordeal, says Sheehan.

I used to be lucky sufficient to discover a therapist who makes a speciality of postpartum points and start trauma (a privilege I’m keenly conscious of). My therapist has been my lifeline on this journey, nevertheless it did take a while and digging to discover a clinician with this experience.

In the event you’re in search of a psychological well being skilled to information you within the aftermath of traumatic start, listed here are some assets to get began:

• Postpartum Support International (PSI): A company devoted to increasing consciousness in regards to the emotional modifications that childbearing folks really feel throughout being pregnant and postpartum. You may search their provider directory to discover a certified perinatal psychological well being skilled in your space. In the event you want just a little extra one-on-one help, you possibly can converse to a specialized coordinator that can assist you navigate the method of discovering the best start trauma-related assets for you.
• PATTCh (Prevention and Treatment of Traumatic Childbirth): Right here you’ll discover a number of directories the place you possibly can seek for a supplier who makes a speciality of start trauma (in addition to different useful assets like help teams, podcasts, and books associated to start trauma).
• The Motherhood Center (primarily based in NYC and digital): A complete remedy heart for brand spanking new and anticipating birthing dad and mom that provides remedy and medicine administration. Their psychological well being professionals specialise in perinatal temper and anxiousness issues (PMADs), together with postpartum PTSD. In addition they have reproductive psychiatrists on employees, who can prescribe medicine that’s protected and efficient to soak up postpartum. The middle additionally runs help teams for folks coping with psychological well being points in being pregnant or postpartum.

Strive somatic remedy

There’s rising proof that implies the results of trauma not solely reside within the thoughts, however within the physique, too, leaving our nervous programs in states of battle, flight, or freeze. Trauma can manifest in numerous bodily methods—together with muscle pressure, physique ache, and disturbed sleep.

Enter: somatic therapy. It is is a comparatively new kind of remedy that goals to deal with how our our bodies maintain and specific traumatic experiences. In contrast to conventional discuss therapies (which deal with our ideas) somatic remedy facilities across the physique because the car for therapeutic. The purpose is to deliver consciousness to bodily sensations, and in the end, to assist folks really feel protected of their our bodies whereas they discover painful ideas, feelings, and reminiscences, in line with Harvard Health Publishing.

Somatic remedy can contain a spread of mind-body methods together with acupressure, hypnosis, breathwork, and dance. Different methods a somatic therapist could use to assist launch trauma embrace the next, per Harvard Well being Publishing:

• Physique consciousness: Helps folks acknowledge pressure spots within the physique in addition to conjure calming ideas
• Pendulation: Guides folks from a relaxed state to feelings just like their traumatic experiences after which again to a relaxed state
• Titration: Guides folks by a traumatic reminiscence whereas noting any accompanying bodily sensations and addressing them in actual time
• Resourcing: Helps folks recall issues of their lives that promote emotions of calm and security, akin to particular folks and locations

Whereas there’s nonetheless restricted analysis on somatic remedy and trauma restoration, the rising proof exhibits nice promise. A small June 2017 randomized managed examine discovered somatic remedy was an efficient remedy for PTSD, per the Journal of Traumatic Stress. And anecdotally, many individuals declare it may be life altering.

In the event you’re taken with discovering a somatic therapist, you possibly can seek for a educated practitioner by the U.S. Association for Body Psychotherapy or Somatic Experiencing International.

Give your self grace (it takes time)

We reside in a “snap-back” society on the subject of therapeutic after start, however the course of should not be rushed. It may possibly take as much as a 12 months to heal emotionally and bodily from start—not the usual six weeks instructed by most docs, says Sheehan.

“This isn’t a six-week course of, and our tradition and medical neighborhood does an entire lot of disservice to birthing folks by suggesting so,” she provides.

Beginning—whether or not traumatic or not—is a “symbolic dying of who we have been earlier than,” says Sheehan. We’d like time to grieve our former selves and heal our our bodies and minds. Sheehan likens the method to a metamorphosis, which is messy. Caterpillars fully break right down to change into a butterfly. In different phrases, therapeutic is messy, laborious work, and it takes time.

One 12 months postpartum, I’m nonetheless in metamorphosis. I additionally see my therapeutic course of like my C-section scar. The superficial layers of pores and skin have healed, however beneath the floor, deeper layers of tissue are nonetheless regenerating. In time, they may heal, too. However we’re all on our personal distinctive timeline. I’m attempting my greatest to be sort and affected person with myself throughout the course of. I hope you may be, too.

Are you able to stop start trauma?

Sadly, start trauma cannot all the time be prevented. On a macro stage, there are bigger systemic obstacles at play, together with institutionalized racism which prevents Black girls and other people of coloration from getting high quality reproductive care. This places them at increased threat for harmful, demeaning, or humiliating conditions, per the MMHLA.

“The explanation why we’ve alarming rates of maternal mortality within the U.S. is as a result of we’ve not completed sufficient to stop medical/bodily trauma in start,” says Sheehan. Whereas issues persist system large, there’s hope. Beginning advocates and activists are pushing for change, consciousness, and fairness for birthing folks.

Nonetheless, there are issues you are able to do on a private stage to advocate for a optimistic start expertise, and decrease your threat of start trauma.

Select your care suppliers fastidiously

In keeping with the MMHLA, one of many major contributing components to start trauma is affected person notion of poor care or communication with their medical team. This implies discovering the best physician or midwife is of utmost significance. On the naked minimal, you need somebody you possibly can belief, and really feel snug asking questions or expressing considerations to.

“All folks need to have compassionate, caring, affected person, and expert health-care professionals at their aspect throughout start… somebody who will maintain their hand, inform them what is occurring when one thing is frightening, and allow them to know they aren’t alone,” says Sheehan.

However this isn’t all the time the truth. Too many birthing folks have felt unheard, dismissed, or downright disrespected (myself included). Actually, I switched suppliers in my third trimester after my then-OB/GYN wasn’t open or receptive to my birth-related questions.

Once more, this poor bedside method appears to be, partly, a systemic situation. “Our health-care system does little to nothing to coach health-care professionals—nurses, docs, or others—on these expertise, so birthing individuals are left on the mercy of who they get once they stroll within the door that day,” says Sheehan.

So how are you going to choose the best caregiver? Ask relations or buddies who’ve given start who their physician was, and whether or not they had a optimistic expertise. Whereas they might not find yourself being the best supplier for you, private referral is all the time an excellent place to begin.

You can even flip to apps like IRTH, a “Yelp-like” platform for folks of coloration that has prenatal, birthing, postpartum, (and pediatric) critiques of care from different Black and brown dad and mom.

When you make an appointment with a possible supplier, do not be afraid to ask questions which can be vital to you, in line with UT Southwestern Medical Center. For instance, you would possibly ask about their stance on pain management, how they really feel about working with doulas, or request their price of induction or C-section stats. By way of their responses, you may get a way of their strategy to care and the way they could react in sure conditions. You can even spot potential pink flags (like in the event that they’re dashing you or appear dismissive).

Contemplate a doula

Whereas docs and midwives play an important function in your start, they’re not the one individuals who can improve your start expertise. You might also wish to think about working with a doula. Doulas are educated professionals who provide bodily, emotional, and academic help earlier than, throughout, and in some instances, after childbirth. Their whole purpose is that can assist you have a protected and satisfying start.

Actually, “analysis exhibits individuals who work with doulas have higher start outcomes, together with a extra optimistic start expertise and fewer issues,” says Bellenbaum.

Regardless that my start trauma couldn’t have been prevented, I’m eternally grateful for my doula. All through my being pregnant, start, and early postpartum, she was a heat shoulder to lean on, a fierce advocate, a reassuring cheerleader, a affected person instructor, and a lot extra.

To discover a certified doula in your space, you should use DONA International’s search tool.

Put together for the unpredictability of start

On paper, I did all of the “proper” issues to have a optimistic start. I educated myself and assembled a group of compassionate medical suppliers. However nonetheless, my start went south and rocked me to my core. All this to say, there are elements of start you possibly can put together for, and others you possibly can’t.

The fact is “we’re wholly unable to regulate the end result of start by the issues we do to affect start,” says Sheehan. That does not imply we will not put together ourselves in any respect—we could have to tweak the best way we do it. This may occasionally embrace planning for sudden occasions, and growing wholesome coping expertise prematurely.

“We are able to and may assist folks put together for start and return from it as complete, beloved, and new folks,” says Sheehan. Stay inquisitive about what might unfold throughout start that could be unanticipated, shocking, and even undesirable. Spend time desirous about the way you would possibly navigate this situation.

Ultimately, you possibly can’t predict what is going to or will not occur throughout start. However recognizing what’s out of your management and the way you would possibly cope with an unexpected scenario may also help (hopefully) soften the blow if it does.