Due to intersectional structural inequities, individuals seeking abortion have experienced
disproportionately high rates of trauma. We sought to elicit patient perspectives
on how prior trauma(s) influenced their abortion experiences.
We recruited individuals from Chicago-area abortion clinics to participate in semi-structured
interviews exploring how prior trauma(s) influenced their abortion experience and
how interactions with providers/staff ameliorate or worsen the impact of past trauma(s).
Participants were aged 18 or older, had experienced an abortion and self-identified
a history of trauma (sexual assault, domestic violence, or adverse childhood experience).
We used modified grounded theory to identify salient themes.
We conducted 30 interviews, identifying trauma-activating factors and trauma-responsive
strategies before, during, and after obtaining the abortion. Participants reported
that, pre-abortion, restricted access and a lack of procedure options activated trauma-related
feelings of autonomy loss and that they desired unbiased information, particularly
from peers. Participants described how physical pain/discomfort and provider/staff
use of inappropriate language during procedures worsened their experience; while use
of neutral language, warnings prior to touch, proper draping, and constant checking-in
and offering options helped mitigate effects of prior trauma(s). Post-procedurally,
participants desired mental health support specifically addressing stigma, though
this resource was rarely available.
Applying key tenets of trauma-responsive care to all patients seeking abortion mitigates
impacts of prior traumas on the abortion experience. Providers can resist re-traumatization
on a clinical level via the use of language, bi-directional communication, and by
offering options, including pain management and behavioral support. On a systemic
level, providers can advocate for increased abortion access and address stigma.