Modifying procedures
Many procedures in obstetrics can be activating for trauma survivors, but small changes can make people feel safer and in control.
Every patient’s care plan is different, regardless of the disclosed history of trauma. It is important to make sure that we are asking about initial concerns the patient has with their care plan and how this may be related to a history of trauma. It is not always necessary to outright ask about traumatic experiences to better understand patient’s needs and provide trauma-informed care. See below for a sample conversation:
Clinician: “Thank you for coming in today, I was hoping that we could talk about any specific concerns you had about your prenatal care – this could be things like high blood pressure or needing to change how we do specific procedures.”
Patient: “What do you mean change procedures?”
Clinician: “For example, vaginal exams are one way we measure the progress of labor, but many women find them uncomfortable. We could measure progress by checking the frequency, length, and strength of your contractions OR doing abdominal palpations.”
Patient: “I didn’t know that we could do that, I actually have some concerns about the vaginal exam, they were awful with my first kid it was really horrible and made me nervous about this kid.”
Clinician: “Let’s find a method that works for you, is it okay if I write this down in your chart so other team members have this information?”
See this article on improving vaginal examinations for midwives!
Trauma-informed Pelvic Exams
[coming soon]
When patients are “difficult”
[coming soon]
Induction of Labor
[coming soon]
Role of Doulas
[coming soon]