Washington, D.C. — New guidance released by the American College of Obstetricians and Gynecologists (ACOG) emphasizes the importance of obstetrician–gynecologists recognizing the prevalence and impact of trauma on both patients and the health care team and implementing a trauma-informed approach to care across all levels of their practice.
The Committee Opinion, “Caring for Patients Who Have Experienced Trauma,” states that understanding how trauma affects health, relationships, utilization of the health care system, health care experience, and ability to adopt health-related recommendations is critical to improving outcomes and the patient experience.
While there is no single definition of trauma, according the Committee Opinion, intimate partner violence, childhood sexual abuse, violence perpetrated based on race or sexual orientation, and traumatic birth experiences, including the minimization of patient symptoms and differential treatment based on race, are some examples of traumas experienced by patients throughout their life span.
“Statistics show that there is a large percentage of people who have experienced some form of trauma in their lifetime,” said Colleen McNicholas, DO, MSCI, lead author of the Committee Opinion. “It’s important for clinicians to realize that they have the power to create an environment in which patients feel safe both physically and emotionally through the interactions they have with them every day. Simple things that can help shift or diminish the power dynamic like seeking permission before initiating contact, providing descriptions before and during examinations and procedures and allowing clothing to be shifted rather than removed can cause less anxiety, prevent re-traumatization, and help foster trust.”
Trauma is a risk factor for unhealthy behaviors and is associated with long-term physical and mental health outcomes, including premature mortality. Universal screening for both current trauma and a history of trauma is important to improving health outcomes and should be part of providing medical care.
Building a trauma-informed workforce is important and considering the needs of staff and clinicians who have experienced trauma in their own lives is also important.
“Overall, there needs to be a focus on creating a supportive environment for all, where there is genuine concern and compassion for survivors,” said Serina Floyd, MD, MPH, vice chair of the ACOG Committee on Health Care for Underserved Women, which issued the document. “This allows staff to provide the best care to patients and allows patients to rebuild a sense of control and empowerment.”
Committee Opinion 825: “Caring for Patients Who Have Experienced Trauma” will be published in the April edition of Obstetrics & Gynecology.