How Trauma May Affect Healthcare Visits

by: Jessica McNeil-Santiel, DNP, APRN, CNM, RNC-OB, C-EFM

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Anxious about routine cervical exams and Pap smears? A 2019 study by Cornforth found a significant number of women ages 18-71 reported feeling at least some anxiety during gynecological exams.

For some, though, a pelvic exam can be so paralyzing they avoid care. If you’ve had traumatic experiences, you may benefit from receiving trauma-informed care.

What is Trauma-Informed Care?

Trauma-informed care assumes most people have experienced some form of trauma. It uses actions and techniques to avoid re-traumatizing a person. Healthcare providers who practice trauma-informed care have received training to help them recognize the signs that a person may have experienced a form of trauma. They’re able to modify care to minimize re-traumatizing you.

Be Your Own Advocate

The main thing you can do to have a positive health care experience is to be your own advocate. Find a healthcare professional that you trust, and who listens to your needs and concerns. Ask if they’re familiar with trauma-informed care, and share your experiences or concerns, as desired.

During trauma-informed care you should always feel respected and in control. You may never look forward to your annual well-woman exam, but it doesn’t have to be an experience that gives you anxiety or leaves you feeling re-traumatized.

Principles of Trauma Informed Care

  • Individuals feel physically and psychologically safe
  • Healthcare decisions build and maintain trust, and ensure that the person is the primary decision-maker
  • Individuals receive access to peer support and can connect with others with similar experiences
  • Your healthcare provider collaborates with other members of your care team
  • Individuals are empowered to recognize their own strengths, and ability to heal and overcome past traumas
  • Biases in relation to race, sex, gender, religion, etc. that a person may have experienced are affirmed and acknowledged

Receiving Trauma-Informed Care

Use these tips to seek trauma-informed care. Healthcare providers who practice trauma-informed care will:

  • Give you as much time as you need to emotionally prepare before beginning any physical care or examination

  • Tell you exactly what they are going to do before doing it, and wait for your permission to proceed

  • Encourage you to sit up during a pelvic exam as opposed to laying on your back

  • If it helps you maintain control or feel comfortable, they may have you put your hand over theirs during your exam

  • During childbirth they will encourage you to give birth in whatever positions feel most comfortable and effective for you

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By Jessica McNeil, DNP, APRN, CNM, RNC-OB, C-EFM

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AUTHOR

Jessica McNeil-Santiel, DNP, APRN, CNM, RNC-OB, C-EFM

Jessica McNeil, DNP, APRN, CNM, RNC-OB, C-EFM, is a certified nurse midwife and adjunct professor. Her career focus is on maternal-child health and she’s served in positions ranging from perinatal educator to women’s services manager. In 2015, Jessica was selected as an AWHONN Emerging Leader and was the AWHONN Convention Host Committee Chair in 2016 and 2020. Currently, she serves as an AWHONN section advisory leader, an ACOG maternal levels of care surveyor, and on the Institute for Perinatal Quality Improvement Advisory Board. Previously, Jessica served as a contributing author to the 7th edition of Foundations of Maternal-Newborn and Women’s Health Nursing. In 2019, she was recognized as a D magazine top 100 nurse.