Sources and Methods
The publications behind the Trauma-Informed Care tool, what each one supplies, and how the content was built.
PUBLICATIONS USED IN THIS TOOL
- American College of Obstetricians and Gynecologists' Committee on Health Care for Underserved Women. Caring for patients who have experienced trauma: ACOG Committee Opinion, Number 825. Obstet Gynecol. 2021;137(4):e94-e99. doi:10.1097/AOG.0000000000004326. PMID: 33759830.
GUIDELINEPrimary source ACOG's recommendations for ob-gyns; examples of trauma; prevalence data; health effects; ObGyn conditions associated with trauma; signs of trauma (Box 1); re-traumatization; practices for examinations and procedures; obstetric violence; screening; staff and organizational steps; resilience. - 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.
FRAMEWORK The definition of trauma, the Four Rs and the six key principles of a trauma-informed approach. ACOG Committee Opinion 825 builds on this framework. - Kimberg L, Wheeler M. Trauma and trauma-informed care. In: Gerber MR, editor. Trauma-informed healthcare approaches: a guide for primary care. Cham: Springer; 2019. p. 25-56.
EXPERT OPINION The Four Cs (calm, contain, care, cope), as modified in ACOG Committee Opinion 825, Table 1.
Data cited through ACOG Committee Opinion 825
The prevalence figures on the tool are taken as reported in ACOG Committee Opinion 825, which cites the original studies (its references 14, 15 and 17): the Adverse Childhood Experiences study (Felitti et al.), the Philadelphia Urban ACE Survey, and a 2009-2011 survey of women veterans (Barth et al.). These are observational survey data.
Levels of evidence
Guideline
ACOG Committee Opinion 825: professional society recommendation.
Framework
SAMHSA 2014: federal agency concept and guidance document.
Expert opinion
Kimberg and Wheeler 2019: book chapter.
How the content was built
- Every factual statement on the tool traces to one of the three publications above, marked with a numbered link.
- ACOG Committee Opinion 825 gives practices for examinations and procedures but no separate protocols for prenatal, labor or postpartum care. The checklists for those settings apply ACOG's general practices and are labeled "Applied from ACOG guidance."
- The sample scripts are example wording written for this tool. They follow the elements ACOG describes and are not quotations from ACOG.
- The patient care plan options are preferences a patient may choose to share. They are not clinical recommendations.
- The tool is available in seven languages. The translations were prepared with AI assistance from the English version, which is the reference text.
Verification
- Reference 1: citation, DOI and PMID verified against PubMed. Status: verified. Whether ACOG has since reaffirmed or replaced this Committee Opinion should be checked on acog.org.
- Reference 2: SAMHSA publication number verified against multiple citing sources.
- Reference 3: verified as cited in ACOG Committee Opinion 825, Table 1.
Help lines listed on the patient track
- National Domestic Violence Hotline: 1-800-799-7233, or text START to 88788. thehotline.org
- RAINN National Sexual Assault Hotline: 1-800-656-4673. rainn.org