Trauma-Informed Abortion Care

Prevalence of Trauma Among Patients

A history of sexual violence or intimate partner violence are common among women, girls, transgender, nonbinary and gender nonconforming people. Here are just a few statistics that outline the prevalence: 

  • An estimated one in four women have experienced rape or attempted rape during their lifetime (1) 
  • 34% of American Indian and Alaska Native women are raped in their lifetime (1)
  • 81% of women reported experiencing some form of sexual harassment and/or assault in their lifetime (1) 
  • One in eight transfeminine people experience intimate partner violence in their lifetime (2)
  • 24% of American Indian transgender students, 18% of multiracial transgender students, and 15% of Black transgender students experience sexual assault (1)

Reproductive Healthcare can be a source of primary trauma as well as re-traumatization

Survivors’ Experiences with Pelvic Exams

Pelvic exams can be a source of stress for survivors of sexual violence. Survivors often did not report their experiences to their healthcare providers.

Principles of a Trauma-Informed Approach

Many patients do not disclose their history of past trauma to their healthcare provider. Therefore, it is critical to employ trauma-informed practice with all patients.

Check out this table from the TEACH Early Abortion Training Curriculum on trauma-informed practices!

Check out this video from the University of Ottawa about trauma-informed interviewing and pelvic exams

Pain Control as a Trauma-Informed Approach

One way to center patients’ comfort is to utilize appropriate pain control. Everyone’s response to pain is different and therefore patients may require an individualized pain control plan.

Visit the TEACH ebook to read more specifics about pain management options.

Responding to a Trauma Response

If symptoms of a trauma response occur, try to use grounding techniques with the patient (4).

  • If possible – stop the procedure
  • Speak in a calm voice and reassure the patient that everything is okay
  • Avoid sudden movements
  • Continue to explain what you are doing
  • Ask or remind the patient where they are 
  • Offer them a drink of water, extra gown, or washcloth for their face 
  • If possible, offer to move to a different room to provide a change of environment

Trauma-Informed Abortion Care Framework Summary

The University of Buffalo School of Social Work put together this framework that summaries many of these points above!

References

  1. me too. Movement. 2022. Statistics. [online] Available at: <https://metoomvmt.org/learn-more/statistics/> &nbsp;
  2. OBGYN opinion: Cahill, E. & Doyle, A. (2021). Trauma-informed abortion care. Current Opinion in Obstetrics and Gynecology, 33 (6), 453-457. doi: 10.1097/GCO.0000000000000749.
  3. Goodman S, Flaxman G, and the TEACH Trainers Collaborative Working Group.* TEACH Early Abortion Training Workbook, Fifth Edition. UCSF Bixby Center for Global Reproductive Health: San Francisco, CA (2016).
  4. Sharkansky, E. (2007, January 31). Va.gov: Veterans Affairs. Sexual Trauma: Information for Women’s Medical Providers. Retrieved from https://www.ptsd.va.gov/professional/treat/type/sexual_trauma_women.asp&nbsp;
  5. Substance Abuse and Mental Health Services Administration. SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach. HHS Publication No. (SMA) 14-4884. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2014.
  6. Goodman S, Flaxman G, and the TEACH Trainers Collaborative Working Group.* TEACH Early Abortion Training Workbook, Fifth Edition. UCSF Bixby Center for Global Reproductive Health: San Francisco, CA (2016).