Trauma-Informed Care for Obstetric and Gynecologic Settings

Trauma and the perinatal period: A review of the theory and practice of trauma‐sensitive interactions for nurses and midwives

“…Awareness of, and sensitivity to, trauma is being increasingly recognised as crucial for all areas of healthcare delivery, including perinatal care. Calls for ‘trauma‐informed care’ have occurred in obstetric and gynaecology (Nagle‐Yang et al, 2022 ; Sobel et al 2018 ), obstetric anaesthetics (Vogel & Coffin, 2021 ) perinatal psychiatry (Sachdeva et al, 2022 ) and midwifery (LoGiudice et al, 2023 ; Sperlich et al, 2017 ). Trauma‐informed care (or trauma‐sensitive care as it is referred to herein) describes a way of considering and delivering care, which is sensitive to needs of patients, clinicians and staff who may have experienced trauma.…”

Integrated Care for Pregnant and Parenting People With Substance Use

“…TIC increases physical and emotional safety for both patients and clinicians and has the potential to not only improve an individual's engagement in care but also to inform a more effective treatment plan. 30 The 6 principles of TIC provided by the National Center for Trauma-Informed Care provide a helpful scaffold for how to incorporate TIC into a specific practice or program and include: safety, trustworthiness and transparency, peer support, collaboration and mutuality, empowerment and choice, and cultural and sex identity. 31 For example, for a patient who is using cannabis during pregnancy, the clinician may incorporate the principles of collaboration/mutuality and empowerment/choice by asking what benefits the patient may perceive from cannabis, providing evidence-based information to the patient about potential harm from perinatal cannabis use, and offering alternative options for addressing the underlying concern (ie, anxiety and nausea).…”

“…Notably, individuals may experience childbirth as traumatic or experience fear of death during childbirth even outside of scenarios that are obstetrically complex or high risk. 30 TIC principles of trustworthiness, transparency, and collaboration can mitigate the risk of postpartum PTSD. In a recent survey of women who reported a traumatic childbirth experience, most identified that their caregiver could have done something differently to prevent the traumatic experience, including listening more to their concerns, better communicating about what was happening, and explaining why decisions were made.…”

“…Trauma-informed care (TIC) is not one specific action but a framework for care that aims to: (1) realize the widespread impact of trauma and understand potential paths for recovery, (2) recognize signs and symptoms of trauma, (3) integrate knowledge about trauma into policies, procedures, and practices, and (4) prevent retraumatization. TIC shifts the question from “What is wrong with you?” to “What happened to you?” TIC increases physical and emotional safety for both patients and clinicians and has the potential to not only improve an individual’s engagement in care but also to inform a more effective treatment plan 30 …”

“…Survivors of trauma are at increased risk for postpartum posttraumatic stress disorder (PTSD), which describes PTSD that develops or recurs as a result of a traumatic birth experience. Notably, individuals may experience childbirth as traumatic or experience fear of death during childbirth even outside of scenarios that are obstetrically complex or high risk 30 . TIC principles of trustworthiness, transparency, and collaboration can mitigate the risk of postpartum PTSD.…”