Self-Care: Taking Care of Ourselves to Optimize the Care We Provide.

Abstract

Midwives must also make themselves [author underlined for emphasis] a priority with a focus on the self-care, self-love, and realistic expectations that we teach our patients about daily. Let us serve as role models. There really are only 24 hours in a day. As a strong group of women and men who are used to putting themselves on the back burner while caring for others, if we are to grow stronger and more effective at caring for women across the country, we must also care for ourselves. This comment led me to want to explore self-care in more detail: what is it, why is it important, and how do we do it? The concept that people need to take care of themselves is not a new one. In fact, the World Health Organization (WHO) first defined self-care in 1983 as “the activities individuals, families, and communities undertake with the intention of enhancing health, preventing disease, limiting illness, and restoring health.”2 The scope of self-care seems to be more broadly defined today as taking time for activities that focus on ourselves and our well-being, including our physical, mental, emotional, and spiritual health. Self-care helps us maintain and restore balance in our lives. Life is chaotic, and we can think of self-care as the umbrella we take into the inevitable storms.3 As the concept of self-care evolves, one aspect of the WHO definition remains key: intentionality. Rather than allowing self-care to be something that happens, or doesn't happen, by accident, it must be a deliberate priority.4 While everyone needs self-care, it is particularly important for midwives and other clinicians whose profession is providing care for other people. This work is not only intellectually demanding, but also takes its toll emotionally as we care for individuals who face a variety of positive and negative challenges, divulge intimate details of their lives, and seek our advice. There is a great infographic from the University of Buffalo School of Social Work,5 which depicts self-care using a flower representing the care provider. Compassion fatigue, burnout, and secondary traumatic stress are like the drought, lack of sunshine, and plant-eating creatures that threaten a flower's survival. Self-care is the water and nutrients the flower needs to have strong roots and thrive. Another frequent analogy is self-care being like the instructions to adults flying on a plane with children to put the adult's oxygen mask on first then the child's. We can't take care of our patients, family, and friends if we don't take care of ourselves. We must think of self-care as essential and life-giving rather than optional, selfish, or overindulgent. Self-care doesn't necessitate significant time or money, though certainly vacations and spa days can be wonderful forms of self-care. Rather we can focus on “small actions that restore a sense of balance in our hectic lives.”6 Eating well, dancing, taking a short walk, getting enough sleep, laughing, reading a good book, drinking a cup of your favorite tea or coffee, taking a long bath or shower, spending time outdoors, taking a few deep breaths, unplugging from devices, listening to music, making a list of 5 things you're thankful for, and talking with someone about your feelings are all forms of self-care.7-10 Self-care isn't something we can do once and check off our to-do list. It's an ongoing process that requires frequent repetition of a number of small good habits.7 It is easy for self-care to be ignored in our busy lives, and it may take scheduling self-care, just like other important tasks and appointments, to ensure it happens. There is no shortage of available ideas for self-care; a Google search of self-care returns 240 million hits. A couple of great starting points for clinicians who want to begin or improve their self-care are the University of Buffalo's Self-Care Starter Kit12 and a post about developing a self-care practice on the Feminist Midwife blog.13 As 2016 begins, I am including self-care in my goals for the year to come. I hope you will join me.