Traumatic experiences, such as exposure to violence, sexual trauma and medical complications, can impact a person’s health and how they engage in their care, said Dr. Mallory Scogin, an obstetrician-gynecologist with University Medical Center.
Scogin, also an assistant professor with UA’s College of Community Health Sciences, said a trauma-informed care approach can help.
During a recent academic lecture to CCHS faculty, residents and medical students, Scogin explained that trauma-informed care is an approach that encourages health-care providers to recognize the possibility of trauma in every patient interaction and adjust their behavior accordingly.
“While trauma is often unspoken, it regularly shows up in exam rooms,” she said.
Trauma-informed care emphasizes building trust, ensuring emotional and physical safety and actively involving patients in decision-making about their care.
Trauma can be associated with a range of health issues, including chronic pain, mental health conditions and reproductive complications. In obstetrics and gynecology care, health issues seen in patients who have experienced trauma can include chronic pelvic pain, sexually transmitted infections, unplanned pregnancies and postpartum complications.
To address the impact of trauma, Scogin recommends that health-care providers adopt the four key principles of trauma-informed care: realize the widespread effect of trauma and understand potential paths for recovery; recognize the signs and symptoms of trauma in patients; respond by fully integrating knowledge about trauma into procedures and practices; and seek to avoid re-traumatization.
Scogin also encouraged providers to explain procedures clearly, ask for consent before physical contact and be mindful of how tone, touch and exam-room dynamics may affect a patient’s sense of safety.
In reproductive and pelvic health care, Scogin said that personal questions and sensitive procedures, if not handled thoughtfully, can be triggering for patients. She advised providers to create an environment where patients understand what to expect and feel empowered to express discomfort or decline participating at any time.
“When patients feel heard and respected, they are more likely to return for follow-up visits and participate actively in their health management,” she said. “Every member of the care team contributes to building a trauma-informed environment. That includes maintaining a calm, welcoming space where both patients and staff feel physically and emotionally safe.”