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The Importance of Trauma-Informed Care during Pregnancy and Childbirth


Trauma experienced during pregnancy and postpartum is common and can have a significant negative impact on one's mental and physical health. Additionally, it can make bonding and attachment to the baby much more difficult. If you have experienced a trauma during pregnancy, birth, postpartum, or even before becoming pregnant and feel a resurgence of trauma-associated symptoms that are difficult to cope with it, it is important to find the right care and support to aid in your recovery. In today's article, we will discuss what trauma is and looks like the perinatal period, explore trauma-informed care, and discuss ways to seek and advocate for this type of care.


WHAT IS TRAUMA IN THE PERINATAL PERIOD?

Trauma during the perinatal period refers to traumatic events that occur during pregnancy, childbirth, and the postpartum period. These events can include:

  • unexpected medical interventions

  • emergency cesarean sections

  • prolonged labor

  • stillbirth

  • miscarriage & neonatal loss

Trauma during this time can also include emotional and psychological trauma, such as experiencing domestic violence, sexual assault, or emotional abuse during pregnancy or postpartum. In fact, pregnancy is a very high risk time for someone to experience intimate partner violence.


Exposure to trauma can lead to post-traumatic stress disorder (PTSD), depression, and other mental health and substance use issues.


WHAT IS TRAUMA-INFORMED CARE?

Trauma-informed care is a way of providing care that recognizes the potential for trauma and addresses the needs of individuals who have experienced trauma. It is a strengths-based, person-centered approach that emphasizes safety, trustworthiness, choice, collaboration, and empowerment. The goal of trauma-informed care is to create a safe and supportive environment for individuals who have experienced trauma, while also addressing the potential for re-traumatization.


Providers, staff, and clinical environments that are attuned to trauma-informed care are able to provide a holistic approach takes into account the physical, emotional, and psychological well-being of the individual. Some key elements to trauma-informed care include:

  1. Safety: creating a safe and secure environment for individuals who have experienced trauma, both physically and emotionally.

  2. Trustworthiness: building trust with individuals by being respectful, non-judgmental, and empowering.

  3. Choice: giving individuals control over their own care, and allowing them to make decisions about their treatment.

  4. Collaboration: working with other healthcare providers to provide continuity of care and support.

  5. Empowerment: helping individuals develop the skills and resources they need to take control of their own lives and well-being.

  6. Cultural sensitivity: recognizing that trauma can have a different impact on different communities and individuals, and providing care that is sensitive to cultural and individual needs.

  7. Self-care: recognizing the importance of self-care for both the patient and the provider.

  8. Flexibility: being flexible and responsive to the needs of the patient, and being willing to adapt the care plan as needed


SEEKING TRAUMA-INFORMED CARE

Seeking and advocating for trauma-informed care during the perinatal period involves being informed about your rights and options, and being an active participant in your own care. One step in cultivating a care approach that is to find providers who have background, certification, or other specific training in trauma and trauma-informed care. Rightness of fit is one of the most important, if not the most important, factors for a path toward recovery. Here are some sample questions to use when trying to find the right provider for your needs:


QUESTIONS TO ASK YOUR PROVIDER

  1. Can you tell me about your experience and training in treating trauma?

  2. How do you approach care with patients who have a history of trauma?

  3. Are you familiar with the concept of trauma-informed care and how do you incorporate it into your practice?

  4. How do you ensure that my care is tailored to my individual needs and concerns related to past trauma?

  5. How do you handle situations where a patient may be triggered by a procedure or treatment?

  6. Can you provide me with resources such as support groups or therapy for individuals who have experienced trauma?

  7. How do you handle situations where a patient may feel re-traumatized during their care?

  8. How do you collaborate with other healthcare providers to provide a continuity of trauma-informed care?

  9. How do you address cultural sensitivity in your practice and how do you take into account the unique needs of different communities?

  10. Are there any alternative options or services that you offer that may be more trauma-informed or tailored to the needs of individuals with a history of trauma?

OTHER HELPFUL STRATEGIES

One of the key elements of trauma-informed care is communication; it's important to speak up about your experiences and let your healthcare provider know if certain procedures or treatments may trigger memories of past trauma. Additionally, having a support system in place, such as a trusted friend or family member who can provide emotional support and help advocate for you can aid in your journey toward healing. If you feel that your healthcare provider is not providing appropriate care or if you feel re-traumatized in any way, it's important to speak up and ask to speak with a supervisor or manager. If you are not satisfied with the care you are receiving, consider looking into alternative options such as midwifery care, home birth, or out-of-hospital birth centers.


Remember, you have the right to safe, respectful and culturally sensitive care. It's important to advocate for yourself and your needs, and don't be afraid to speak up if you feel that your care is not meeting your needs.


TRAUMA-SPECIFIC THERAPIES

It's important to note that being trauma-informed is different from being trauma-specific; while trauma-specific care focuses on providing specialized treatment for individuals who have experienced trauma, trauma-informed care is a way of providing care that recognizes the potential for trauma and addresses the needs of individuals who have experienced trauma in all aspects of their care.


Some trauma-specific therapies include Cognitive Processing Therapy, Prolonged Exposure Therapy, and Eye-Movement Desensitization & Reprocessing. If you are interested in learning more about what CPT is like, take a look at this podcast called, "Ten Sessions," which was recorded at the University of Washington Outpatient Psychiatry Clinic.


OTHER RESOURCES FOR TRAUMA

There are several resources available for women who have experienced trauma during pregnancy or postpartum. Some options include:

  1. Support groups: Joining a support group for women who have experienced similar trauma can provide a sense of community and validation.

  2. Hotlines: National hotlines such as the National Domestic Violence Hotline (800-799-7233) or the National Sexual Assault Hotline (800-656-4673) can provide immediate support and resources.

  3. Perinatal mood and anxiety disorder support: Many hospitals, health clinics, and community organizations have support groups specifically for women experiencing perinatal mood and anxiety disorders, which can be related to trauma.

  4. Medical care: It's important for women who have experienced trauma during pregnancy or postpartum to receive regular medical care, to ensure the well-being of both the mother and baby. Use of gentle exercise and routine nutrition can also be a helpful way to reset a nervous system that has been impacted/rewired by trauma.

  5. Specialized treatment centers: There are specialized treatment centers that provide care and support for individuals who have experienced trauma, such as residential treatment centers or intensive outpatient programs.

  6. Online resources: There are many online resources available, including websites and forums, that provide information and support for individuals who have experienced trauma.

It's important to remember that healing from trauma is a process and it may take time, but with the right resources and support, recovery is possible. Seeking out a healthcare provider who understands and prioritizes trauma-informed care is an important step in the healing process. Additionally, having a support system in place, whether it be friends, family, or support groups, can provide emotional support and validation. It's also important to educate yourself on trauma-informed care and to advocate for yourself and your needs. Remember, healing is possible and there is hope for a brighter future.


Reach out for help, take the first step and don't give up on your journey towards healing.


If you are someone who may be struggling with post-traumatic stress and you are wanting help in your path to recovery, consider seeking a care here at Wyoming Psychiatry & Consultation. Dr. Rork has specialization in trauma, trauma-infomed care, and Cognitive Processing Therapy.

If you are a healthcare provider who cares for pregnant and postpartum women and you want to learn more at PTSD in the perinatal period, register here to join our lecture and case-based discussion on Wednesday Feb 1st from 12-1:15pm MT.


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