Vulnerability in medical dialogue

As a critical life event, birth is an example of a phase of pronounced vulnerability. It is a transitional crisis in the original sense of "crisis as a turning point, decision or separation". Daniel Stern and Nadja Bruschweiler-Stern call the resulting space of possibility a "workshop of parent-child interaction" in which new ways of dealing with oneself and others can be tried out.

However, vulnerability begins earlier - during the desire to have children and during pregnancy. If something unexpected occurs during these phases, such as a pathological finding, a birth with many complications or even the loss of a child, the parents' resilience is put to the test. This is when careful communication, genuine empathy and understanding the narrative of the mother and the couple are key. This includes taking needs and ideas seriously, weighing up options together and coordinating collaboration within the interprofessional team. This is how biopsychosocial medicine becomes tangible, especially when it comes to ethically complex issues.

At the same time, professionals find themselves in the role of destroying ideas of a carefree pregnancy or a desired birth - and in doing so, they themselves have a hurtful effect. This inevitably confronts them with their own vulnerability. This not only affects the family system, but also the support system: a late abortion, a difficult birth or the death of a child trigger reactions in the team, sometimes with lasting stress.

The awareness that carers are also vulnerable has increased, but should be more firmly anchored. At a higher level, the question arises as to what extent the concept of the "resilient organisation" must be linked to the acceptance of the vulnerability of all those who work or are treated within it.