Trauma-informed care is defined by the Substance Abuse and Mental Health Service Administration (SAMHSA, 2018) as “a strengths-based service delivery approach that is grounded in an understanding of and responsiveness to the impact of trauma, that emphasizes physical, psychological, and emotional safety for both providers and survivors, and that creates opportunities for survivors to rebuild a sense of control and empowerment.”
Experiencing trauma can affect and change one’s behavior over the life course; these changes have an impact on interpersonal and intergenerational relationships. Trauma’s mode of transmission is most often through adverse power dynamics. Remember, being traumatized or re-traumatized during healthcare is considered a healthcare disparity because it mostly affects women, especially those of color. For many, this power differential may include Native women at the mercy of non-Indigenous healthcare providers during labor and birth. Inequitable power differentials are root causes of trauma (Committee on Community-Based Solutions, 2017). Historical and current societal structures and policies that create and perpetuate these inequitable power differentials drive health and healthcare disparities.
Survivors of trauma may be “triggered”, consciously or unconsciously, by situations they encounter in the healthcare setting especially during episodes of obstetric violence. Traumatic memories provoked by healthcare encounters, may make medical care intolerable to a patient and contribute to worsened health outcomes (Raja et al., 2014). Exposure to one traumatic event increases the vulnerability of individuals and communities to future trauma. Because trauma is pervasive (It’s everywhere) and associated with many chronic illnesses and high-risk behaviors, it is essential that all healthcare providers assume that all patients have histories of trauma and thus, should automatically be treated with trauma sensitivity. Disclosure of trauma should never be required to receive complete and competent care.
If you feel that you are not receiving trauma-informed care, you have the right to request someone who has been trained in trauma-sensitivity. Being trauma-informed means that they should not make you feel rushed, ignored, minimized, shame, stigmatized, discriminated against or stereotyped. Obstetrical violence during labor is another form of trauma which is unwarranted and unacceptable and should be reported and addressed appropriately. If a woman is approached for anything that makes her feel uncomfortable, she has the right to open the lines of communication, speak up and say NO or STOP. She also has the right to file a formal complaint about her experience and have the institution respond to her in a timely fashion.
The following information will guide you through your Trauma-informed journey and help to ensure that you are treated appropriately and competently in the care of your pregnancy.
Trauma-informed Care Implementation Resource Center for Women and Providers
ACEs Aware Trauma-informed Care
Healthcare Tool Box