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Reproductive health care for female trauma survivors with or without posttraumatic stress disorder

Author
Nina M Carroll, MD
Section Editors
Robert L Barbieri, MD
Joann G Elmore, MD, MPH
Deputy Editor
Kristen Eckler, MD, FACOG

INTRODUCTION

Women presenting for reproductive health care may have experienced trauma in the forms of sexual or physical abuse (childhood or adult), violence, accidents, disaster, war, death, and medical events, such as traumatic birth. These events may be directly experienced or witnessed. For women exposed to traumatic events, resultant posttraumatic stress disorder (PTSD) appears to develop more commonly compared with trauma-exposed men. Thus, providers of reproductive health services must understand the impact of trauma and PTSD on women and the unique needs of trauma survivors who access reproductive care.

This topic will review reproductive care issues specific to women with trauma-exposure (with or without PTSD), challenges in providing obstetric and gynecologic care for this population, and techniques to reduce re-traumatization. As the available study data are limited, the information in this topic comes largely from the clinical experience of health care providers, including obstetrician-gynecologists, psychiatrists, psychologists, and social workers who have broad experience in this field. Topics on posttraumatic stress disorder and its management are presented separately.

(See "Posttraumatic stress disorder in adults: Epidemiology, pathophysiology, clinical manifestations, course, assessment, and diagnosis".)

(See "Pharmacotherapy for posttraumatic stress disorder in adults".)

DEFINITION OF TRAUMA AND PTSD

The American Psychiatric Association defines trauma as "exposure to actual or threatened death, serious injury, or sexual violence in one or more ways" [1]. The traumatic event can be experienced directly, witnessed, experienced by a family member or close friend, or result from repetitive exposure to aversive details related to a traumatic event. The psychological response to a stressful event is quite variable and may reflect inherent emotional as well as genetic factors. (See "Posttraumatic stress disorder in adults: Epidemiology, pathophysiology, clinical manifestations, course, assessment, and diagnosis".)

                             

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Literature review current through: Jun 2017. | This topic last updated: Jan 08, 2017.
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