Overcoming Compassion Fatigue

MoMMAs Voices stands with you on the challenging path of pregnancy and childbirth, recognizing the unique situations you've faced. In our community, you are not alone. You are a vital partner in the ongoing mission to improve maternal health outcomes. We hope the resources below will help you navigate the emotions of patient advocacy and Compassion Fatigue.

What is Compassion Fatigue?

Compassion Fatigue is a term used to describe a set of symptoms experienced by helpers, caregivers or other individuals working as advocates. The caregiver becomes overwhelmed by the feelings and experiences of their clients and begins to experience similar feelings of pain, fear, sadness, and suffering. The condition may include intrusive or obsessive thoughts, nightmares, loss of energy, avoidance of certain situations or stimuli, and generalized or specific anxieties. 

The onset of Compassion Fatigue can be triggered by a single challenging or traumatic experience or be the result of repeated experiences helping others through trauma. This extreme state of anxiety and preoccupation with the suffering of those being helped becomes traumatizing for the helper. For this reason, it is sometimes called "vicarious traumatization" or "secondary traumatization" (Figley, 1995).

Compassion fatigue is not exclusive to doctors, nurses, or social workers. Research shows it affects anyone in a helping role, including peer advocates who draw on their own lived experience to support others. In fact, peer support workers face a particular risk because their personal history overlaps directly with the experiences of the people they serve. This creates a kind of double exposure: the original trauma, and the repeated retelling of it. 

Studies of helping professionals broadly find that between 21% and 45% experience compassion fatigue depending on the setting and role. Among peer support workers specifically, research has identified that listening to multiple people recount traumatic experiences is one of the strongest contributors to compassion fatigue onset. (Steenekamp &Barker, 2024, Community Mental Health Journal).

This does not mean advocacy work harms you. It means the work asks a lot of you, more than most people around you will ever fully understand. That deserves acknowledgment, not just a pep talk.

What’s the difference between Compassion Fatigue and Burnout?

Burnout is one of the primary symptoms of Compassion Fatigue. It is associated with feelings of hopelessness and difficulties in dealing with work or in doing your job effectively. These negative feelings usually have a gradual onset. They can reflect the feeling that your efforts make no difference, or they can be associated with a very high workload or a non-supportive work environment. Burnout can also happen in any industry and could be used to describe a multitude of workplace annoyances in any industry (low pay for the work being done, fear of job loss, new management, coworker disturbances, and more). 

Compassion Fatigue, sometimes called “the cost of caring,” can come on gradually or via a traumatic event. Compassion Fatigue tends to be more emotionally driven than burnout.  

Recognizing the difference between burnout and compassion fatigue is important because each requires its own unique strategies and tools for management. 

The table below can help you identify what you may be experiencing. 

These two things can look similar from the outside, but they feel different on the inside and they need different kinds of support. If you have been resting and still feel emotionally depleted, compassion fatigue may be what you are actually dealing with. If you try to rest your way through compassion fatigue without processing the emotional content, symptoms are likely to return. 

What does Compassion Fatigue look like as a Patient Advocate?  

Serving as a patient advocate often means sharing your own traumatic pregnancy experience or holding space for the stories of others. This can involve voicing thoughts and emotions you may not have shared even with your closest friends and family, while also offering hope to others, even in moments when you may feel defeated yourself. 

Here’s what Compassion Fatigue could look like:  

Emily’s Story:  Emily had always loved her job as a nurse in a busy OB office, until her own experience with postpartum preeclampsia changed everything. What began as a routine recovery after childbirth quickly turned into a life-threatening emergency she never saw coming. Now, months later, she’s back at work caring for expectant and postpartum mothers, but the confidence she once carried has diminished. She misses her daughter while she’s at work and carries worry with her throughout the day.  

Emily finds herself double-checking every blood pressure reading, and when a number reads to high, she has trouble reassuring her patients. At night, she experiences sleeplessness, often times reviewing the day in her head and focusing on the negative. She wants to reassure her patients, to be steady and calm, but anxiety lingers every day. She feels torn between taking PTO now for a day off, because she pays for daycare even when she doesn’t use it. In reality, she needs a full day to focus on herself and the things that bring her joy!   

Neveah’s Story: Neveah is a new MoMMAs Voices Patient Family Partner, who just completed her training. After spending much of the past month sharing her maternal health experience in meetings, trainings, and community conversations, she receives a call from a local church asking her to speak with a group of pregnant women. 

Initially, Neveah is excited for the opportunity to use her new skills and begin preparing  her presentation. But as she works through her story again, she realizes how  emotionally demanding it feels to revisit difficult details—barriers she experienced  during care, the isolation she felt postpartum, and the fear she carried after returning  home from the hospital. 

Neveah begins questioning not only how much she wants to share publicly, but whether  she currently has the emotional capacity to continue telling her story in such personal  detail. She worries about disappointing the organizers and the women attending,  especially knowing her experience could help others feel seen and informed. 

Ultimately, Neveah decides to reschedule the engagement and take time to reset. Even  so, she struggles with guilt and replays the decision in her mind, wondering whether  setting  boundaries means she let others down. To work through this, she shares her  experience with the MoMMAs Voices team for support and reviews the symptoms of  compassion fatigue and tips for setting boundaries with her trauma-informed therapist. 

Adrienne's Story: Adrienne has been a MoMMAs Voices Certified Patient Family Partner for two years. She joined after her own near-fatal experience with severe preeclampsia and found deep purpose in helping other families navigate the healthcare system. She speaks at conferences, participates in research advisory panels, and mentors newer PFPs. 

She does not point to a single difficult moment. Instead, she describes a slow shift. She stopped returning personal calls as quickly. She found herself scrolling through news about maternal mortality late at night when she should have been sleeping. She declined a family trip because she had a panel commitment she could have rescheduled. 

One morning, she realized she had not felt hopeful about her work in several months. She still showed up. She still performed. But something had changed underneath. 

Adrienne eventually named it as compassion fatigue with the help of a therapist. She had not burned out, and she had not experienced a single traumatic event during her advocacy. She had simply absorbed more than she had released, over a long period of time, without a structured way to process it. 

Her story is common. Compassion fatigue does not always announce itself. Sometimes it accumulates. 

Symptoms of Compassion Fatigue 

If you’re experiencing the following symptoms, you may be experiencing Compassion Fatigue.  

• Feeling estranged from others, including loved ones 

• Difficulty falling or staying asleep (insomnia) 

• Outbursts of anger or irritability with little provocation 

• Startling easily 

• Flashbacks connected to my own traumatic pregnancy experience 

• Feelings of isolation (there is no one to talk with about highly stressful experiences) 

• Focusing only on my patient advocate work to the detriment of other areas of my life (family, profession, faith, health) 

• Experiencing intrusive or obsessive thoughts about my or another individual's pregnancy experience 

• Feeling that I am trapped by my work as a patient advocate 

• Feeling hopeless or disillusioned about maternal health or my work as a patient advocate 

• Feeling weak, tired, and rundown as a result of my work 

• Finding it difficult to separate my advocacy from my personal life 

• Feeling that my work is worthless or pointless 

• Feeling resentful of the individuals, organizations or cause for which I am working 

List developed from: https://www.compassionfatigue.org/pages/symptoms.html 

Developing Resilience  

The good news is that if you are feeling symptoms of Compassion Fatigue, there are a number of things that may help.  

• Restore a healthy balance in your life, including good sleep, good nutrition and exercise. 

• Speak with a trauma-informed therapist or other medical professional about symptoms that are interfering with your daily functioning.  

• Reach out for support to friends, family members, or fellow patient advocates.  

• Implement regular mini-escapes in your life, like recreation, creative therapies or other things to look forward to doing.  

• Read below to find out what our team is doing to help connect you to others who might be experiencing Compassion Fatigue.  

Setting Boundaries Is Part of the Work 

Nobody joins this work planning to burn out. But the advocates who stay in it longest are the ones who learned, often the hard way, that protecting their capacity is part of the work. Advocacy without boundaries is not sustainable. Saying no to an engagement, rescheduling a speaking request, or choosing not to share a specific detail of your story are not failures. They are professional decisions that protect your capacity to continue showing up. 

Here are boundaries you can set right now, without explanation or apology: 

• Decline a speaking request if you have already shared your story more than once in the past two weeks. 

• Tell an organizer you need a full agenda and context before committing to an engagement. 

• Set a personal cap on the number of emotional conversations you take in a single week. 

• Step away from maternal health news and social media for a defined period after a difficult engagement. 

• Identify one person on the MoMMAs Voices team you can contact within 24 hours of a hard experience. 

If you feel guilt after setting a boundary, that is normal. Guilt is not evidence that you made the wrong decision. 

Before You Say Yes: A Quick Self-Check 

Before committing to an engagement, run through these questions honestly. 

• Have I shared my full story in the past two weeks? 

• Am I sleeping consistently? 

• Have I eaten and moved my body today? 

• Do I have at least one person I can debrief with after this engagement? 

• Am I saying yes because I want to, or because I am afraid to say no? 

• Is my capacity today above a 5 on a scale of 1 to 10? 

If you answered no to three or more of these, consider rescheduling. One conversation does not have to happen today to matter. Showing up at half capacity serves no one well, including you. 

How to Tell Someone You Trust 

Reaching out is easier when you have words ready. Here are a few ways to start the conversation. 

With a friend or family member: "I have been feeling the weight of my advocacy work more than usual lately. I am not in crisis, but I need to talk to someone who is not involved in the work." 

With a fellow PFP: "I think I am experiencing some compassion fatigue. Can we talk? I want to hear if you have felt this way too." 

With a therapist: "I do advocacy work that involves sharing my own trauma story and listening to others' experiences. I would like to work with someone who understands secondary traumatic stress." 

With the MoMMAs Voices team: "I need to step back from [specific commitment] for a period. I am managing my emotional capacity and want to communicate that directly rather than go quiet." 

You do not owe anyone a detailed explanation. You do owe yourself honesty. 

Join our Patient Family Partner Community 

The best patient advocates are passionate, patient and persistent. They understand that patient advocacy is a marathon, not a sprint. They know that bridges have to be built, not burnt down. They have courage to share their story and advocate for others who cannot, but also the strength to know when they need to care for their own well-being.  

MoMMAs Voices Certified Patient Family Partners meet monthly in a structured community session. These sessions are not just check-ins. PFPs discuss specific experiences from recent engagements, share what has helped them manage the emotional demands of advocacy, and hear from others who understand this work firsthand. Connecting with others who share your experiences is one of the most effective protective factors against compassion fatigue. 

You do not have to figure this out alone. If you are a certified PFP, keep an eye on your inbox for your next session invite. If you are not yet certified and want to learn more about becoming a partner, we would love to talk with you.