When it comes to women's health, particularly in the field of obstetrics and gynecology, a compassionate and understanding approach can make all the difference. This is where trauma-responsive care comes into play, a method that recognizes and addresses the impact of past traumas on a patient's health and well-being.

To shed light on this important aspect of care, we spoke with Lauren Harrington, MD, an expert in the field. Dr. Harrington serves as the medical director at CU Medicine Obstetrics and Gynecology - Central Park and holds a position as an assistant professor at the University of Colorado School of Medicine in the Department of Obstetrics and Gynecology.

In our discussion, Dr. Harrington helps us understand what trauma-responsive care means in an OB-GYN setting, why it's crucial and how it's being implemented to improve patient experiences and outcomes. Dr. Harrington also shares her insights and practical advice to help patients understand and benefit from this approach to care. 

“Trauma-responsive care is particularly important in obstetrics and gynecology,” shares Dr. Harrington. “In OB-GYN, one’s most private, intimate and vulnerable moments intersect with scenarios that could potentially evoke or create significant emotional and physical trauma.”

Understanding trauma-responsive care

Trauma can take many forms and may significantly affect a patient's experience in OB-GYN care. Common traumas that patients might have experienced include:

• Sexual assault or abuse
• Domestic violence
• Traumatic childbirth experiences
• Medical procedures performed without proper consent
• Discrimination or mistreatment in healthcare settings

These experiences can lead to various impacts on patients, such as:

• Anxiety or fear during exams or procedures
• Difficulty trusting healthcare providers
• Avoidance of necessary medical care
• Physical symptoms like pain or discomfort during exams
• Emotional distress during pregnancy or childbirth

Dr. Harrington shares that she was introduced to trauma-responsive care during her residency at Stanford University. “Once I saw the power that healthcare providers have to create either a safe or unsafe space, I became steadfast in my commitment to creating safe environments for patients and for training the next generation of healthcare providers to do the same.”

Key principles and implementation

The core principles of trauma-responsive care in OB-GYN settings revolve around creating a safe environment, building trust and empowering patients.

These principles include:

Safety: Ensuring patients feel physically and emotionally safe during all interactions.

Trust: Developing a trustworthy relationship through transparency and consistency.

Patient empowerment: Giving patients control over their care decisions and respecting their choices.

“The goal with trauma-responsive care is to avoid situations and dynamics that are either re-traumatizing or create new traumas,” Dr. Harrington says. “Instead, there is a safe space that can promote healing, recovery, resilience, empowerment and prosperity.”

Another approach Dr. Harrington takes is normalizing and universalizing the discussion about trauma.

Dr. Harrington shares that she asks all of her patients if they have had past difficulties or traumas they would like to share with her. She goes on to say, “It’s also important to note that patients should not have to disclose a history of trauma to receive trauma-responsive, respectful and consenting care.” 

What patients can expect and do

In a trauma-responsive OB-GYN practice, patients can expect a more thoughtful and accommodating experience. Providers will offer clear explanations of all procedures, ensuring you understand each step before it occurs. Throughout your visit, you'll notice frequent check-ins about your comfort level, allowing you to voice any concerns or discomfort. Remember, you always have the option to pause or stop a procedure at any time.

Respect for personal boundaries is paramount in this approach. Your provider will be attentive to your verbal and non-verbal cues, adjusting their approach as needed. If you have specific needs or preferences, don't hesitate to express them. Trauma-responsive care aims to accommodate these requests whenever possible, creating a more comfortable and empowering experience for you.

Patients can expect:

• Clear explanations of all procedures
• Frequent check-ins about comfort levels
• Option to pause or stop at any time
• Respect for personal boundaries
• Accommodations for specific needs or preferences

Self-advocacy

Dr. Harrington encourages patients to:

• Communicate concerns or past experiences that may affect care
• Ask questions freely
• Request explanations in simpler terms if needed
• Bring a support person to appointments if desired
• Express discomfort or the need for a break during procedures

Dr. Harrington emphasizes that trauma-responsive care should extend beyond the confines of the doctor's office. "In our practice, this approach carries through to labor and delivery and even into the operating room," she explains. 

Dr. Harrington stresses the importance of patient autonomy throughout all aspects of care. "The core principle is respecting the patient's control over their own body," she says.

"This means giving patients as much choice as possible in procedures and how they position themselves during examinations or treatments."

To learn more about trauma-responsive care and the patient-centered approach at CU Medicine Obstetrics and Gynecology - Central Park, click here.