Mental Health and My Birth Trauma

I recently completed a new section of the website! If you haven’t already, I encourage you to check out the new “Mental Health” section and learn about mental health, birth trauma, and nerve damage from childbirth. Healing from any birth trauma, including nerve damage, is not only a physical journey but also a mental and emotional one. No mom I have spoken to about their injury has come out unscathed mentally. It is essential we talk about this part of our healing too. 

So, in honor of the website’s new addition, in this blog post I am going to focus on the mental health aspect of my nerve injury from childbirth.

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MICA Month 2022: Standing up for Those Who Can’t

May, the month we celebrate mothers, launches our fifth annual MICA Month. Standing Up for Those Who Can’t is our theme to advocate and to educate globally concerning maternal nerve injury from childbirth awareness. MICA, run by a team of dedicated volunteers, has achieved a great deal since our launch in 2018. We are very proud of the many resources we have developed that are now available to any mom globally suffering from a nerve injury. Our advocacy focuses this year on maternal mental health and specific positions during childbirth as the primary cause of nerve injury. Please celebrate with us our many achievements from the past five years. For I will restore you to health and heal your wounds declares the Lord. Jeremiah 30:17

Social Media: MICA has continued to develop its presence on social media. The MICA Month Facebook page has over 700 followers and the Facebook support group Moms with Femoral, Peroneal, Sciatic Nerve Damage from Labor and Delivery has tripled in size to over 2,000 members with approximately 30 new members per month since 2018. We are also active on Instagram @micamonth with 120 followers. Our social media presence during MICA Month is vibrant with 100’s of advocates sharing posts with their communities including their favorite Mom’s Facebook groups.

Website: The website receives 11,000 views annually and is an invaluable resource we share with every new member to the Facebook support group. In 2020, the Zazzle store opened with a variety of advocacy t-shirts, momma bling, and baby attire. This May a new section on maternal mental health will be added to assist injured mothers with their emotional recovery from nerve injury.

Medical Team: Our talented medical team has made major strides in raising awareness for nerve injury and developing protocols for the prevention of future injuries. In 2020 the Journal of Obstetric, Gynecological and Neonatal Nursing (JOGNN) published two articles written by our team: Lower Extremity Nerve Injury in Childbirth: AWHONN Practice Brief Number 11 and Integrative Review of Lower Extremity Nerve Injury During Vaginal Birth. The Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) has endorsed the new protocols for prevention of nerve injury and the medical team continues to share these at national medical conferences in the United States.

Partnerships: Allard USA, a manufacturer of orthotic and prosthetic devices, will collaborate with us again in 2022 to share the MICA message. Please follow Allard on Facebook and Instagram @Allard USA and look for their MICA posts and stories featuring our moms. Unhindered Steps and National Foot Drop Awareness Day are ongoing alliances, and we are grateful to A Midwife Nation for their coverage of LENI (lower extremity nerve injury.)

A huge thank you to the MICA Team who gives so selflessly of their time to help  many moms navigate through nerve injury recovery. Our volunteer team members include: Molly Carey (Facebook group support, writer), Omar Farooq (Co-Founder of Unhindered Steps, writer), Emily Kleine (Graphic Design), Jodi Manny (Facebook group support, writer), Reagan Smutny (Website creator, Facebook group support, Social Media: NDFC on Instagram and LinkedIn), Samia Sami (Co-Founder of Unhindered Steps, Facebook group support and writer), and Paula Wroble ( Founder of the Facebook support group). Medical Team volunteers: Cheryl Parker, DNP, Martha Sleutel, PhD, RN, CNS, C-EFM and Jennifer Webb, RN, BSN, CCRN.

Please join us in celebrating our fifth year of advocacy for MICA Month by following us on our Facebook page, MICA- Maternal Nerve Injury from Childbirth Awareness Month, and on Instagram @micamonth. We will be posting weekly advocacy tips for you to share the MICA Message with your community as we continue to be  Standing Up for Those Who Can’t.

About the Author: Martha Valentine Tutrani is a proud grandmother of two, including a precious Nib (nerve injury baby) and a Pleni (protected lower extremity nerve injury) baby. Her daughter Molly suffered nerve injury from labor and delivery in 2016. The tremendous challenges the family faced while pursuing diagnosis and treatment for Molly inspired her family to start the first MICA Month in 2018. Martha holds an M.Ed. in Dance Education and believes that her background as a classical ballet and Pilates instructor, as well as leadership roles in arts administration, equipped her perfectly for her new role as MICA advocate. She can be reached at

Martha with her daughter Molly sporting their MICA ribbons.

Holiday Healthy Tips

A mama, a warrior, and an advocate shares a bit about her journey with nerve damage over the holiday season. We are so appreciative to Jodi. Thank you for being willing to share your story with us, thank you for helping others, and thank you for digging into the tough topics.

Wishing everyone an amazing end to December. But, if it doesn’t feel so amazing right now, that is okay too. You are not alone.

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MICA Month 2021: Standing Up for Those Who Can’t

May, the month we celebrate mothers, launches our fourth annual MICA Month. Standing Up for Those Who Can’t is our theme to advocate and to educate globally regarding maternal nerve injury from childbirth birth awareness.

Continue reading “MICA Month 2021: Standing Up for Those Who Can’t”

Mental Health After Femoral Nerve Damage

An incredibly strong mama shares with us today her mental journey with femoral nerve damage. Her powerful story truly shows that this injury reaches far beyond our lower extremities. It affects every aspect of life after having a baby. Thank you so much for being brave enough to share this story with us and helping so many others by doing so.

Once the physical healing is done, it seems that everyone else move’s on without a second thought. Sometimes it feels like friends and family do not care anymore, and that is understandable simply because they do not know the full struggle of this recovery.  Only those who have faced this challenge will ever understand the true impact this injury has on a mother, and coming to terms with what happened, to be okay with your experience, that can feel impossible.  

Continue reading “Mental Health After Femoral Nerve Damage”

Awareness and Education on “A Midwife Nation”

Jamie is a certified nurse midwife. Her goal is to help women through their pregnancy, birth, postpartum. She loves what she does and feels so blessed to walk alongside any woman’s joy or hardship, and truly believes that together we are stronger.

In February, Jamie posted a great blog post about lower extremity nerve injury that I’d love to share here. I so appreciate her helping spread the awareness and educating about nerve damage in the lower extremities from childbirth. To check out the original post (and her awesome website) go to To contact Jamie, email her at

Continue reading “Awareness and Education on “A Midwife Nation””

Awareness and Education on “A Midwife Nation”

Jamie is a certified nurse midwife. Her goal is to help women through their pregnancy, birth, postpartum. She loves what she does and feels so blessed to walk alongside any woman’s joy or hardship, and truly believes that together we are stronger.

In February, Jamie posted a great blog post about lower extremity nerve injury that I’d love to share here. I so appreciate her helping spread the awareness and educating about nerve damage in the lower extremities from childbirth. To check out the original post (and her awesome website) go to To contact Jamie, email her at

Women Ask Wednesday: What is lower extremity nerve injury? (And can it happen during birth?)

By Jamie Jamie Guertin

Hello! Today we’re chatting lower extremity nerve injury (LENI). I read an article in JOGNN (Journal of Obstetric, Gynecologic, & Neonatal Nursing) that was the impetus for today’s topic. After reading the article, I immediately reached out to my dear friend Chelsea – someone I knew personally that experienced LENI and asked if she would share her journey. She shared her story with us this past week (if you missed it, read it here and here!) and although she had a strong recovery, many women do not.

I asked her to share her story because I don’t think we talk enough about LENI as a risk factor of childbirth. I don’t remember having much education (if any) during my midwifery program on LENI. Nerve injury is on the birth consent in the facility I practice in, but it is often glossed over during counseling. Unfortunately, many women don’t actually read the consent and simply sign on the line where they are told. I’ve also seen women during postpartum visits that still struggle with some numbness in a foot or a leg and I wonder: How many women feel that their symptoms are “just normal” and they never say anything?

With that said, I think that there is an opportunity to educate women, nurses, providers (OB/GYNs, anesthesiologists/CRNAs), doulas, or any birth worker about LENI. More importantly, I think that we need to focus on prevention whenever possible as the standard and not the exception.

The content and references for today’s post are from the article published by Sleutel, True, Webb, et al. (2020) in the November issue of JOGNN and can be found here.

The authors did an outstanding job with the article. One of the reasons that LENI isn’t at the forefront of obstetric practice is because LENI is rarely mentioned in obstetric literature. Instead, LENI articles are most often published in anesthesia journals. I’m hoping the article by Sleutel, True, Webb, et al. (2020) paves the way for more articles on LENI in nursing and obstetric journals alike.

Let’s get into it! First, did you know nerve injuries from vaginal delivery are cited in literature back to the 1800s? The same nerve injury was also noted from farm workers in the 1900s – something called “strawberry pickers’ palsy” from all of the squatting involved in the occupation (Sleutel, True, Webb, et al., 2020). I had no idea! But I think it’s important to mention it’s not a new phenomenon and even more so to emphasize why talking about it is important.

The basics of nerve injury are simple: nerves are injured by stretching or compression. Symptoms of nerve damage vary among women but can manifest as numbness, paresthesia (tingling, pricking, chilling, burning), pain or loss of muscle function to the area affected (Sleutel, True, Webb, et al., 2020). In birth, a nerve injury can be devastating to the postpartum period – think of all the carrying, walking, diaper changing, etc. a new mama does for her babe.

The incidence of LENI is from five studies and ranges from 0.3%-2.3% depending on the study. Nerve injury can occur in vaginal births with and without anesthesia, operative births (birth assisted by use of vacuum or forceps) and cesarean sections with/without labor (Sleutel, True, Webb, et al., 2020). That’s every birth mode.

Most LENI cases are thought to be caused by positioning. Anesthesia, such as epidurals, are thought to mask early signs of nerve injury more than cause the injury (Sleutel, True, Webb, et al., 2020). This makes sense! If you wouldn’t lay with a peanut ball between your legs on your side for three hours on your couch at home, why would that be a good position in labor? Without anesthesia, your body would give you signs that you are uncomfortable in that position and that discomfort would prompt you to change positions.

Nerves are like any other tissue in the body – they need blood supply with oxygen. The femoral nerve and peroneal nerves are most commonly injured in LENI cases due to the nature of how the hips and knees are positioned in pushing (Sleutel, True, Webb, et al., 2020).

So, how do we work to prevent LENI in practice? Sleutel, True, Webb, et al. (2020) recommend these practices:

  • Educate birth workers in every discipline on the following equation:


  • Laboring women should be encouraged to be mobile and change positions frequently
  • Hand position behind a woman’s knees should be placed to prevent deep tissue compression (especially near the lateral knee or posterior thigh)
  • Women should be educated on positions to avoid in labor to prevent LENI
  • Active pushing should be shortened to allow for passive descent
  • If LENI is diagnosed, a multidisciplinary team, including psychological support, should be employed “until full recovery is achieved” (p.520)
  • Lastly, if women voice concern or symptoms about the possibility of LENI, that the care team takes time to listen and address those concerns.

Going forward, Sleutel, True, Webb, et al. (2020) mention some really great points that I think are worth mentioning for any one working with birth (these are great long-term goals):

  • Electronic health systems should work to make documentation in labor, especially with positions, easy for care givers. The authors recommend offering pictures of birthing positions versus having to select or type out a position would as a great option.
  • Future publications should work to make consistent terminology to describe LENI
  • “Research is urgently needed on the effectiveness of preventative measures and optimal strategies to prevent recurrence with subsequent vaginal births” (p.521) – I love this recommendation, especially the use of the word urgent.
  • Qualitative research is recommended to evaluate women’s experiences of LENI

Wow. I just love everything about this article. It’s a great article to read if you have access to it – especially the review of the LENI articles previously published. If you work in birth settings, please take these recommendations to heart. Education about labor and birth starts in the clinic and LENI should be included in counseling and consent about birth as well as in the education women receive should they choose to receive anesthesia.

If you can’t access the article, you can read AWHONN’s practice brief for LENI for free. Either would be a wonderful journal club article to review with a team or unit!

Hope your Wednesday is lovely!




Sleutel, M., True, B., Webb, J., Valdez, E., & Van Thi Tran, M. (2020). Integrative review of lower extremity nerve injury during vaginal birth. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 49(6), 507-524.

Nerve Damage Education and Advocacy Update

Today I would like to share huge news for the prevention of maternal nerve injuries! A big thank you to Jennifer Gibson Webb, RN, BSN, CCRN, and Martha Sleutel, PhD, RN, CNS, C-EFM for their tireless work and advocacy to the medical community on behalf of all women who have suffered nerve damage from childbirth in their lower extremities

In May, Jennifer and Martha presented virtually to the American College of Nurse Midwives conference about lower extremity nerve damage from childbirth. Then in November, they virtually presented protocols for the prevention of LENI ( Lower Extremity Nerve Injury) at the AWHONN ( Association of Women’s Health, Obstetrics and Neonatal Nursing) National Conference, which is a national conference for nurses. Jennifer was then was invited by AWHONN to record a podcast detailing her story, along with an anesthesiologist that helped rewrite some change in literature on the subject. This podcast was sent out to all members of AWHONN across the nation. They talk about nerve injuries from positioning and how to prevent them, what to look out for, and more. Check out the podcast here:

Additionally, the LENI protocols are being endorsed by AWHONN and were recently published in the Journal of Obstetric, Gynecologic and Neonatal Nursing. Please read more about the practice brief here:

So grateful for all of this news! And thank you again to Jennifer and Martha!

A Miscarriage after Nerve Damage

October is Pregnancy and Infant Loss Awareness Month. It was started in 1988 to recognize the grief of bereaved parents and to show support to the families who have gone through such a tragic loss. As many as 1 in 4 known pregnancies end in miscarriage, but it can still be an incredibly lonely and isolating experience. So this October I decided to open up, share my experience with miscarriage, and hopefully help someone not feel as alone. I do want to warn that this story may be triggering for some. 

Deciding to have a second child ended up being a bigger decision than I had originally planned. I had always hoped for 3 kids and never questioned having at least 2. But after the labor and delivery of my first, I wasn’t so sure: 

Continue reading “A Miscarriage after Nerve Damage”

Foot Drop Awareness Day: 2 Years of Recovery

Today’s blog post is by Jodi M, who suffered from severe peroneal and tibial nerve damage in 2016 after the birth of her first child, resulting in foot drop. A huge thank you to her for all her advocacy work.

I cannot believe that this is my third year participating in National Foot Drop Awareness day!! As hard as 2020 has been, I am beyond blessed that my journey has lead me to be celebrating another year of foot drop recovery! I had never heard of foot drop until I sustained a nerve injury giving birth to my first child that resulted in severe damage to the peroneal and tibial nerves in both of my legs. I hope that my story can help others who are dealing with foot drop as well as bring about awareness of maternal nerve injuries.

My journey through foot drop began on July 29, 2016. I had been in labor 26 1/2 hours, I was exhausted from pushing for almost 3 hours, but my daughter was finally here and she was healthy (as well as almost 2 lbs larger than predicted)!! There was so much joy as I watched my daughter being held by my husband and then our parents. I have continued to hold onto this memory because the joy I was experiencing in that moment would soon turn into panic and confusion.

It had not even been a day since my daughter had been born that it became apparent something wasn’t right with my legs. The nurses couldn’t understand why my feet were still numb and couldn’t move even though it had been more than enough time for the epidural to wear off. I was sent to have an MRI of my spine. The results came back normal so a neurologist was ordered to come and examine me the next day.

“I’ve never seen anything like this before,” were the words that came from my neurologist’s mouth after she examined me. I remember hearing that and feeling any bit of hope I had drain from my body. If this neurologist who was clearly very educated had never seen an injury from childbirth like mine, what did my future look like? Would I ever walk again? After 4 MRIs, a spinal tap, steroids through an IV, and an EMG not one medical professional I met with while at the hospital could tell me. “I don’t think this is permanent,” was the most hopeful phrase I received from a doctor during my week long stay.

After I was discharged from the hospital I was sent home with no diagnosis, a walker, instructions not to use the shower (I did shower using a seat) or try to get in the bathtub, and to make sure that someone is with me at all times. It was so difficult to function doing every day tasks and completely impossible to take care of my newborn on my own. My mom had to live with my husband and I for almost a year to help me take care of my baby. My legs lost so much muscle in such a short amount of time that it took all I had to be able to get from one room to the other. It was also mentally exhausting because I had to concentrate on lifting my whole leg up and then placing (or slapping) my foot on the floor otherwise my toes would just drag behind. I began in home physical therapy at 2 weeks postpartum and graduated to outpatient physical therapy around 6 months postpartum. I was in physical therapy until 15 months postpartum.

My recovery came in stages from barely moving my big toe, to dealing with excruciating neuropathy, to wiggling all my toes and flexing my ankles. I would say that with the severity of my injury it took me about two years to be in a place where I felt my healing was complete. The sensation in my left foot has never completely returned to normal, but that doesn’t hinder me from being able to walk or function in my day to day life. I am very thankful to have recovered from such a severe injury and I am very blessed to say that I had my second child this July without a repeat injury!!

When I was 6 months postpartum I found a Facebook group called Moms with Femoral/Peroneal/Sciatic Nerve Damage From Labor/Delivery. I was immediately connected with other moms who had suffered nerve damage and I no longer felt alone. Since then I have become an admin of this group and have worked with the other admins to help grow the number of members from around 700 to 1700!! Through this group other resources have been created by the admins for maternal nerve injuries. Our website ( was created as an educational resource that didn’t really exist for newly injured moms. We also have two advocacy groups. Maternal Nerve Injury From Childbirth Awareness (MICA) was created by two of our admins who are mother and daughter and Unhindered Steps who was created by one of our admin’s sons. We all work very hard together to advocate and bring about awareness to these types of injuries that leave moms feeling completely alone.
I am very proud to work so closely with such a strong group of women!! I would not have been able to get through my recovery journey without them!

Happy National Foot Drop Awareness Day!!!