Planning for a Good Birth: Respectful & Trauma-Informed Obstetrical Care

Jennifer Pedley, and Rachel Vogel

At CHA we care for a culturally diverse patient population, many of whom suffer from mental health disorders, discrimination and trauma, putting them at risk for adverse experiences in our hospitals. This is particularly true for our pregnant patients, who face uncertainty, pain, and often fear during their birthing process. We lack a standardized system to elicit patients’ preferences, concerns and fears as they prepare for childbirth and a way to consistently communicate this information to the inpatient team. Additionally, we are not all trained in Trauma-Informed Care on our unit and that puts us at risk of inadvertently re-traumatizing a patient, or providing disrespectful care.

We plan to co-produce a patient-centered, culturally-sensitive birth plan, available in multiple languages, to empower our most vulnerable patients to advocate for what is important to them during their birth. We will ask patients to share past experiences with childbirth or hospitalization. We will assess their ability to cope with stress, pain and sleep deprivation and their attitudes toward Cesarean sections and breastfeeding. We will help them identify tools and people that will provide support during their birthing process.

During labor, patients, providers and nurses will review this birth plan together. Then, after birth we will survey patients at their postpartum visit about whether they felt listened to and understood, and whether they were treated with respect. Our goal is to minimize obstetric emotional trauma, and foster a better culture of emotional safety on our unit.