Maternal Health Awareness: Trauma Informed Model of Care
The ACOG Maine Section would like our members to integrate a “Trauma-Informed Model of Care” in your practices in order to aid in the improvement of maternal health outcomes. Please share the following information with your colleagues and staff, so that together we can work towards equitable, patient-centered care.
Trauma-informed Model of Care in Obstetrics
Trauma-informed care is grounded in an understanding of and responsiveness to the impact of trauma. This model encompasses policies and practices that emphasize physical, psychological, and emotional safety for people who have experienced trauma. Trauma-informed Care creates opportunities for survivors to rebuild a sense of control and empowerment, as well as improve health outcomes.
Why a Trauma-informed Model of Care is Important
Multiple studies have shown that the prevalence of trauma in the U.S is very high. Marginalized populations are exposed to trauma and re-victimization at higher rates.
Trauma contributes to long-term adverse physical and mental health outcomes and can have a profound effect on survivors’ attitudes and interactions with the healthcare system.
Clinicians and staff need to be trained to recognize and understand the consequences of trauma, including patients’ behaviors and choices, which are often adaptations to traumatic experiences. This training will allow for more effective interactions with survivors and improve their health outcomes.
Strategies to implement a Trauma-informed Model of Care
- OB/GYNs are uniquely positioned to be leaders in building clinical environments that are emotionally and physically safe for patients and staff.
- Universal screening for trauma is recommended by numerous agencies and organizations, including ACOG. A trusting provider-patient relationship is paramount and may take time to develop. Therefore, providers must be open and observant during every interaction.
- Avoid stigmatizing. Focus on respect and resilience rather than pathology. Seek input from survivors on how best to make them comfortable.
- Create space for dialogue: “Traumatic events are very common and can have direct effects on physical and mental health. For these reasons, I ask all of my patients about any prior difficult experiences they’ve had and if they feel comfortable sharing them with me.”
- Seek permission prior to initiating physical contact.
- Provide descriptions before and during examinations and procedures.
- Allow clothing to be shifted rather than removed.
- Establish an agreement that you will stop the exam at any time upon request.
- Limit the number of exams and repeated interview questions when a learner is present.
- Realize the widespread effect of trauma and understand paths towards recovery
- Recognize the signs and symptoms of trauma
- Respond by fully integrating knowledge about trauma into policies and practices
- Resist policies and practices that re-traumatize
- Calm yourself to help model and promote calmness for the patient
- Contain the level of detail that will allow for patients’ emotional and physical safety
- Care and Compassion for patients and yourself
- Coping skills; facilitate these in order that patients can build strength and resilience
Adapted from ACOG Committee Opinion No. 825, 4/2021